- reduce the level of painkillers they are taking,
- have more pain free days,
- reduce levels of stiffness and increase mobility
There are a variety of different types of joint problems, and it is useful to know a little about their different causes, as the herbal approach will be different in each case.
OsteoarthritisThe most common condition affecting the joints is osteoarthritis (OA), otherwise known as wear and tear. This is a degenerative disease, in which the cartilage at the ends of the bones forming a joint gradually becomes thinner. Eventually the bony surfaces come into contact and the bones begin to thicken and become misshapen. Sometimes there is abnormal outgrowth of cartilage at the end of the bone that becomes hardened forming little spurs of bone called osteophytes. This can be most painful.
OA most commonly occurs due to previous injury to a joint, wear and tear due to increasing age, overuse of weight bearing joints (joggers beware!), and weight gain placing extra stress on joints such as knees and hips.
Most commonly, one or more of the large weight bearing joints are affected such as hips, knees and ankles. The neck, back and hands are also common sites. There may be pain, stiffness and heat and swelling around affected joints. Most people find that their joints are worse in damp cold weather, and that heat, in the form of a hot bath or water bottle, can help.
It is important that sufferers avoid weight-bearing exercise such as jogging, and instead maintain mobility by swimming, going to yoga or T�ai chi classes or cycling.
In its mild form, OA is a very suitable condition for self-help with herbal medicine, as long as you are not taking any strong orthodox medication for any other health conditions. Herbs to consider include
- Devil's Claw
- Willow bark
- Wild yam
- Black cohosh
- Silver birch
- Celery seed
Most people with OA are prescribed non-steroidal anti-inflammatory drugs to help with pain and any inflammation. However, many people find that these drugs can upset their digestive systems and it is not uncommon for antacids to be prescribed alongside them. Herbal medicine can help here, too: meadowsweet herb, especially as a tea, helps to settle the digestion and has its own anti-inflammatory effects. For those with severe OA, a visit to a qualified Medical Herbalist may produce the best results.
Osteopathy, chiropractic and acupuncture can also assist with pain relief and reduction of further damage.
Rheumatoid ArthritisRheumatoid arthritis, or RA, also causes joint problems, but the cause is very different to OA. It is a chronic, inflammatory, autoimmune disease affecting the synovial membrane inside the joint. This membrane secretes synovial fluid, which helps to keep the joint moving smoothly.
The cause is not clearly understood but auto-immunity may be initiated by a microbial infection in susceptible individuals.
RA is characterised by periods of remission and exacerbation. The most commonly affected joints are those of the hands and feet, but in severe cases, most joints may be affected. Other body systems and organs may also be affected and flare-ups can be accompanied by general malaise. This problem is usually best treated by a qualified herbalist in conjunction with orthodox healthcare.
Other autoimmune inflammatory arthritic diseases include:
- Ankylosing spondylitis in which the sacroiliac and vertebral joints become fused.
- Psoriatic arthritis occurring in some who suffer with psoriasis.
- Reiter's syndrome possibly triggered by Chlamydia infection. The arthritis is associated with conjunctivitis and urethritis.
- Arthritis associated with acute rheumatic fever.
Again, these conditions are best treated by a qualified practitioner.
GoutThis condition is caused by deposition of sodium urate crystals in the joints and tendons. It occurs in people whose blood uric acid is abnormally high. Uric acid is a waste product of cell breakdown and is produced in excess when there is large-scale cell destruction. Defective excretion occurs in some kidney problems. It is vitally important therefore that the cause of the gout is investigated. However, in most cases it is triggered by overindulgence in meat and alcohol, or a poor tolerance to these foods in susceptible individuals
Gout is characterised by episodes of exquisitely painful joint inflammation lasting days or weeks and interspersed with periods of remission. Repeated acute attacks can lead to permanent damage of the joint. The most commonly affected joints are in the big toe, the ankle, wrist and elbow.
Useful herbs include:
- Devil's Claw
- Celery seed
- Nettle herb
However, it is best to avoid herbs that contain significant levels of salicylates in gout as salicylates can reduce excretion of uric acid.
If dietary factors are to blame, then dietary changes can prove very valuable. Avoid or reduce purine-containing foods such as meat, offal, shellfish and oily fish; reduce alcohol and protein intake and avoid unrefined carbohydrates. Water intake should be high and most of the diet made up of fruit, vegetables and unrefined complex carbohydrates. Cherries, hawthorn berries, bilberries and other red-blue fruit contain high levels of anthocyanidins and proanthocyanidins that are useful in the treatment of all inflammatory conditions including gout and RA.
OsteoporosisAlthough not a form of arthritis, it is useful to rule out this problem as some of the symptoms can resemble OA, and both may be present at the same time. It mainly affects older women, but men are affected too. In this condition, the amount of bone tissue (both calcium and collagen matrix) is reduced because its deposition does not keep pace with reabsorption. It can be associated with immobility and hormonal changes associated with the menopause or removal of the ovaries. Severe osteoporosis is a serious condition and must be treated by a healthcare professional. There is no clear evidence that herbs can help to improve bone density, but a herbalist would be able to provide general dietary and lifestyle advice and use herbs to improve general health and well-being.
Dietary and Lifestyle AdviceGood circulation and nutrition are very important in any form of arthritis. As sufferers become more immobile, they tend to undertake less exercise and this can lead to a vicious cycle of increased stiffness and poor circulation. Herbs such as ginger and turmeric are useful as they are both anti-inflammatory and good circulatory stimulants. The body's nutrient needs are greater when involved in tissue healing, therefore pay particular attention to diet and consider taking a good quality vitamin and mineral supplement. Vitamin A, C, E and D are particularly useful for helping to speed the repair of connective tissue. Oily fish (best from deep sea fish from clean seas) contain omega 3 essential fatty acids, which help to reduce inflammation, as do flax seed oil and hemp seed oil.
Some people believe that a predominantly alkaline forming diet helps with many chronic health problems including various forms of arthritis. Certainly a high acid forming diet will increase the toxic load on the body. Good foods include fruit and vegetables, whereas acid forming foods include meat and dairy products.
Useful HerbsThere are many herbs that are potentially useful in the treatment of arthritis and a qualified herbalist will always devise an individual prescription of herbs to suit an individual's needs, based on a thorough case history. The following herbs however, are quite widely available and generally safe to take.
- Salix alba - White willow bark
White willow contains salicylic acid that has similar anti-inflammatory and pain relieving actions to aspirin without the side-effects on the stomach and digestive system in general. It is taken for joint pain, headaches and to reduce a fever. In addition to salicylic acid, the bark contains tannins and flavonoids.
This plant should be avoided by those allergic to aspirin, and those taking anti-coagulant therapy such as Warfarin.
- Filipendula ulmaria - Meadowsweet flowering tops
This beautiful and highly useful herb contains salicylic acid, tannin and citric acid. It is an excellent digestive remedy, reducing acidity in the stomach and helping to alleviate gastritis and peptic ulceration. This makes it tremendously useful for those with arthritic conditions who cannot take aspirin or other non-steroidal anti-inflammatory drugs due to the side effects on the stomach. Quite a large dosage is needed for treating arthritis, but it does combine well with other herbs.
Avoid if allergic to aspirin
- Harpagophytum procumbens - Devil's claw tuber
This African plant has gained its name due to the appearance of its tough, barbed fruit. It contains glycosides, phytosterols, flavonoids and harpagoquinone. It is a bitter, anti-inflammatory herb, useful for a wide-range of joint and muscular problems, including RA. It will also stimulate the digestive system.
Do not take if suffering from stomach or duodenal ulcer. Avoid during pregnancy and if taking anti-coagulant therapy.
- Zingiber officinalis - Ginger root
In addition to its circulatory stimulant properties, ginger is anti-inflammatory and this makes it useful in the treatment of joint and muscle aches and pains. It contains many volatile constituents, including zingiberene, zingiberole, phellandrene, borneol, cineole and citral. It also contains starch, mucilage and resin. It can be used internally, and externally for its rubefacient and anodyne properties.
Avoid in therapeutic doses if taking anti-coagulant therapy. Avoid very high doses in pregnancy and take care if suffering from a stomach or duodenal ulcer.
- Curcuma longa - Turmeric root
This ancient Indian spice is a relative of ginger and is a veritable medicine chest its own right. It is active against a range of bacterial and fungal infections; a superb liver remedy; helps to normalise blood cholesterol and keep blood thin; is a potent anti-oxidant and a powerful anti-inflammatory herb, which is also mildly analgesic and will strengthen connective tissue. This makes it useful for a range of joint problems. It contains a volatile oil, the pigment curcumin, a bitter principle and a resin.
Turmeric can increase sensitivity to sunlight so take care in strong sunlight. Avoid in therapeutic doses if taking anti-coagulant therapy. Seek advice if suffering from gallstones and avoid in obstructive gallbladder disease.
- Apium graveolens - Celery seed
This cleansing herb contains volatile oils including apiol, flavonoids and coumarins. The oil has a calming effect on the central nervous system and helps to lower blood pressure. The seeds increase excretion of uric acid and improve the circulation to the muscles and joints and are also a urinary antiseptic. The stems can be juiced to make a nutritious and cleansing drink useful in many chronic health problems. Avoid celery seed medicinally during pregnancy or if suffering from a kidney disorder.
Do not use seeds sold for commercial cultivation in medicinal preparations. May cause photosensitivity reactions if taken in large doses.
- Urtica dioica - Nettle flowering tops
Nettle is one of our most useful plants. It contains amines including histamine, choline, acetylcholine and serotonin; minerals including calcium, potassium, silicic acid and iron. It strengthens and supports the whole body. In addition to its major role as a skin herb, nettle improves elimination of wastes via the kidneys, in particular uric acid, making it a useful cleansing remedy and helpful in gout.
- Cimicifuga racemosa - Black cohosh root
This is a Native American remedy, used for women's "problems" alongside arthritic complaints and tinnitus (ringing/noise in the ears). It contains salicylic acid, tannins, resin and bitter glycosides. It is useful in the treatment of both OA and RA, muscular and nerve pain.
It should be avoided during pregnancy and breast-feeding, by those allergic to aspirin and people on warfarin. May increase the effect of HRT and oestrogens and progestogens in general, so seek advice if taking HRT or the contraceptive pill. Contains salicylates - avoid if allergic to aspirin. Do not exceed stated dose.
- Betula alba - Silver birch leaf
Silver birch is traditionally used as a cleansing, diuretic remedy in rheumatic conditions.
Contains salicylates. Avoid if allergic to aspirin.
- Dioscorea villosa - Wild yam
Wild yam contains plant oestrogens that can help with menopausal problems. It is an anti-inflammatory herb, useful in joint pain, and its anti-spasmodic action can help in IBS. As a bitter herb, it stimulates digestion and supports the liver.
Avoid during pregnancy and lactation. May increase the effects of HRT and other synthetic female sex hormones, therefore seek advice if taking HRT or the contraceptive pill.