Osteoarthritis update: New ways to promote healthy joints and alleviate crippling pain

Osteoarthritis is a widespread joint disease that destroys cartilage and can lead to deformed bone growth, sometimes with crippling consequences. In elderly people, osteoarthritis of the knee is the leading cause of disability and if you are over 50, there is an 80 per cent chance that you have some degree of osteoarthritis in your joints.
Because this is such a common condition, and because the dangers of conventional drug treatment are becoming increasingly apparent, more people are now seeking alternative therapies for osteoarthritis than for any other condition.

We've featured reports on several safe and effective natural remedies for osteoarthritis in recent years. But research is moving forward at such a pace that this month we are delighted to bring you the latest findings on four further supplements that can help ease swelling and reduce pain. In addition, we felt it was important to alert you to new evidence highlighting the risks of painkillers, which many sufferers rely on to manage their persistent pain.

Conventional drugs for osteoarthritis relieve pain but at what price?

The standard medical approach is to prescribe painkilling drugs for osteoarthritis. These mostly belong to a group called non-steroidal anti-inflammatory drugs (NSAIDs). Long term use of the older NSAIDs, such as ibuprofen, diclofenac and naproxen, often causes serious digestive problems, with up to 30 per cent of patients developing peptic ulcers (Aliment Pharmacol Ther 2004; 20 (Suppl 2) 48-58).

In addition, women who regularly take aspirin or ibuprofen could also be increasing their risk of breast cancer (J Nat Cancer Inst 2005; 97(11): 805-812). A recent research review has also found that taking high doses of ibuprofen and diclofenac could increase the risk of having a heart attack or stroke (BMJ. 2006; 332: 1302-1308).

The newer NSAIDs, known as COX-2 inhibitors, were intended to avoid digestive system side effects but experience has shown that they come with other, even more sinister risks. COX-2 drugs block an enzyme called cyclooxygenase-2, which promotes the production of prostaglandins that cause pain and inflammation.  But COX-2 drugs also block a prostaglandin essential for dilating the arteries and preventing the blood platelets from clumping, dramatically increasing the risks of heart disease and stroke. 

Two of these drugs (Vioxx and Bextra) have already been taken off the market on safety grounds and now the only remaining one, Celebrex, has also been shown to increase the risk of heart attack (NEJM 2006; 355: 873-874).

Green tea extract works like COX-2 drugs, but without the side effects

One of the most exciting new natural treatments for osteoarthritis is green tea extract. Compounds found in green tea, including the polyphenol epigallocatechin gallate (EGCG), can help reduce pain and inflammation, stop the destruction of cartilage and prevent abnormal bone growth.

EGCG is a natural COX-2 inhibitor, effectively blocking the action of this enzyme, as well as inhibiting other inflammatory processes (Free Radic Biol Med 2002; 33(8): 1097-1105). In arthritic joints, an inflammatory chemical called interleukin-1beta (IL-1β) promotes the breakdown of cartilage. Laboratory studies have found that EGCG can block the action of this damaging substance (J Pharmacol Exp Ther 2004; 308(2): 767-773).

A distressing feature of osteoarthritis is additional bone growth that distorts the shape of the joints. In animal experiments, EGCG was found to suppress the growth of abnormal bone while encouraging the development of healthy cartilage (Connect Tissue Res 2002; 43(2-3): 520-523). Although human clinical trials have yet to be carried out, green tea extract could be of considerable benefit to osteoarthritis sufferers. Take 1,500 mg of powdered green tea leaf daily, standardised to 50 per cent polyphenols.

The rose hip remedy that can improve symptoms in as little as three weeks

A powder made from dried rose hips may seem like an unlikely treatment for arthritis, but in a randomized, double-blind, placebo-controlled clinical trial carried out in Denmark, a staggering 82 per cent of patients reported a reduction in pain after just three weeks of treatment with this herb (Scand J Rheumatol 2005; 34(4): 302-308). These results back up earlier findings of improved quality of life and less reliance on NSAID drugs (Curr Ther Res Clin Exp 2003; 64(1): 21-31).

Rose hips, which are fruits of the wild rose (Rosa canina), contain a specific galactolipid, given the trade name GOPO, which reduces the activity of polymorphonucleated leucocytes a type of white blood cell that is implicated in the inflammation and tissue damage that occur in osteoarthritis. Rose hip powder is now available as a herbal supplement in the UK, as a product called LitoZin. The suggested dose of LitoZin is two to six capsules daily, depending on the severity of your symptoms

How volcanic minerals can successfully help fight inflammation

A natural supplement called Sierrasil, made up of volcanic minerals from a remote location in the Sierra Mountains in the US, is also showing great promise in combating osteoarthritis. In a randomised, double-blind clinical trial, involving 107 patients with osteoarthritis of the knee, those taking Sierrasil for four weeks had an average 40 per cent improvement in their symptoms (J Inflamm 2005; 2: 11).

Laboratory experiments have shown that Sierrasil works by blocking the inflammatory effects of IL-1β like the active ingredient in green tea so preventing the destruction of cartilage in the joints (J Amer Nutr Assoc 2004; 7: 32-39).  Sierrasil is available as capsules or powder - take one capsule three times a day, or one scoop of powder daily, mixed with food or drink.

Omega-3 fatty acids can benefit sufferers of both rheumatoid and osteoarthritis

The inflammation-reducing benefits of omega-3 fatty acids, found in oily fish and flax seeds, are well known in the treatment of rheumatoid arthritis. But clinical studies have also shown the value of these essential fatty acids in treating osteoarthritis.

Increased consumption of omega-3 fatty acids and adequate intake of monounsaturated fatty acids such as those found in olive oil were found to improve osteoarthritis symptoms and to allow a reduction in the use of NSAIDs (Clin Ter 2005; 156(3): 115-23).

The most potent of the omega-3 fatty acids are eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA). Take a fish flesh oil (not fish liver oil) supplement providing 500mg to 1,500mg of omega-3 fatty acids a day. However, you should talk to your doctor first if you are currently taking blood-thinning medication.