Arthritis is a common rheumatologic disorder. It is estimated that 40 million Americans and 80 percent of persons older than 75 years are affected by arthritis, and many search for arthritis pain relief. Although symptoms of arthritis occur earlier in women, the prevalence of arthritis among men and women is equal. The diagnosis of arthritis is largely clinical because x-ray findings do not always agree with symptoms. For simplicity, I will use the term arthritis on this page to mean osteoarthritis or degenerative arthritis. My goal is to discuss natural ways to help you with arthritis pain and reduce arthritis symptoms to offer some relief. I hope this arthritis information is helpful to you.

Natural Treatment for Arthritis pain relief
The most commonly used alternative or complementary nutrients for arthritis remedy are glucosamine and chondroitin. Several other nutrients and herbs may potentially help reduce symptoms of arthritis. Some pet owners use glucosamine, chondroitin and other supplements for their dog with canine arthritis. Even a quite modest amount of exercise might be better than none at all when it comes to preventing disability from arthritis.
   Arthritis may be due to being overweight. All the excess pounds can put pressure on the joints. If you are having difficulty losing weight, consider Diet Rx for weight management with all natural herbs.

Many Nutrients have been found to be helpful in Arthritis.
It would be premature to say that these supplements or herbs are a natural arthritis cure. Even if they don't cure, they nevertheless may be helpful in many people with knee, hip, hand, or back arthritis. We need more research to make firm recommendations. Discuss these options with your doctor.
   Supplements for arthritis that may potentially be helpful include: (click on each one for more information).

Joint Power Rx -- Formulated by Ray Sahelian, M.D.

Because joint pain is so debilitating, Glucosamine and Chondroitin alone are often not enough. This powerful formula includes several additional herbal extracts and nutrients that play a role in joint health.  

Joint Power Rx Supplement Facts:
Serving Size: 4 Capsules
Servings Per Container: 30 (1 month supply)


Amount Per Serving:
Glucosamine sulfate (from shellfish). Glucosamine is helpful in arthritis particularly if combined with other nutrients.
Chondroitin sulfate. Chondroitin is a major constituent of cartilage providing structure, holding water and nutrients, and allowing other molecules to move through cartilage.
MSM - MSM appears to be a promising nutrient in arthritis and possibly certain types of allergies. A new study finds the combination of MSM and glucosamine to having synergistic effects in arthritis.
CMO complex , also known as cetyl myristoleate
Boswellia serrata extract - Boswellia serrata has been found helpful in knee arthritis
Curcumin extract, you can find Curcumin and turmeric supplements here.
Cat's claw extract
Devil's claw extract
Grape seed extract
Sea Cucumber extract

Click here to learn more about Joint Power Rx or to sign up to the FREE newsletter
Subscribe to a FREE Supplement Research Update newsletter. Twice a month you will receive an email with several studies on various supplements and natural medicine topics, including arthritis pain relief, and their practical interpretation by Ray Sahelian, M.D.

Arthritis Foundation
Unfortunately, many Arthritis organizations, such as the Arthritis Foundation, do not focus enough attention and research on natural ways to treat arthritis. Arthritis doctors (rheumatologists) also, in general, do not place enough emphasis on herbal and nutritional treatment options.

Causes of Arthritis
The exact cause of arthritis is not fully understood. Multiple factors (heredity, trauma, diet, and obesity) interact to cause this disorder. Any event that changes the environment of the chondrocyte (the cells involved in making cartilage) has the potential to cause osteoarthritis. Although usually occurring as a primary disorder, osteoarthritis can occur secondary to other processes. The cause of arthritis involves a combination of mechanical, cellular, and biochemical processes. The interaction of these processes leads to changes in the composition and mechanical properties of the articular cartilage. Cartilage is composed of water, collagen, and proteoglycans. In healthy cartilage, continual internal remodeling occurs as the chondrocytes replace macromolecules lost through degradation. This process becomes disrupted in arthritis, leading to increased degenerative changes and an abnormal repair response.

Common risk factors for Arthritis
More than 20 percent of U.S. adults have arthritis and more than a third of them have limited activity because of it.
Age older than 50

Obesity (weight-bearing joints) - For overweight people hobbled by knee arthritis, losing even one pound can diminish the stress the knees take with every step.

History of immobilization

Injury to the joint

Joint hypermobility or instability

Prolonged occupational or sports stress
Diet (see study below) -- the types of fat and foods we consume may have an influence.
Smokers with arthritis suffer quicker joint deterioration than non-smokers.

What is the standard medical Arthritis treatment?
Acetaminophen and nonsteroidal anti-inflammatory medications, such as ibuprofen, remain first-line traditional medications for the treatment of arthritis, although ibuprofen can cause damage to the small intestine. Naproxen, also sold as Aleve, might increase risk of heart attack or stroke. Agents such as cyclooxygenase-2 inhibitors (COX-2) with the brand name Vioxx and Celebrex were thought to offer a safe alternative, but now we realize that they can be dangerous. Salsalate (Disalcid) or choline magnesium trisalicylate (Trilisate) are good arthritis medicine alternatives. Complementary medication for arthritis use has increased.
   Recent studies indicate that common arthritis medications such as acetaminophen may not be effective after all.
   Approximately one third of all hospitalizations and deaths related to gastrointestinal bleeding can be attributed to the use of aspirin or nonsteroidal anti-inflammatory agents (NSAIDs) painkillers like ibuprofen. Moreover, up to one third of these painkiller-related incidents may be due to low-dose aspirin.

Arthritis symptom
The following are some arthritis symptoms:
   Aching pain, stiffness, or difficulty moving the joint. The pain often gets worse with overuse and may occur in the evening. In late stages of osteoarthritis, the pain can occur at rest.
   Arthritis of Fingers : Bone enlargements in the fingertips (first joint) are common. These are called Heberden nodes. They are usually not painful.
   Hip arthritis : The hips are major weight-bearing joints. Involvement of the hips may be seen more in men. Farmers, construction workers, and firefighters have been found to have an increased incidence of hip osteoarthritis. Heavy physical workload contributes to osteoarthritis of the hip and knee. Repetitive squatting and kneeling may promote knee arthritis.
   Spine arthritis : this can cause bone spurs or osteophytes, which can pinch nerves and cause pain and potentially weakness in the arms or legs.

Arthritis Treatment Research update
Pomegranate fruit extracts can block enzymes that contribute to arthritis according to a Case Western Reserve University School of Medicine study published in the September 2005 issue of the Journal of Nutrition. The study looked at the ability of an extract of pomegranate fruit against Interleukin-1b (IL-1b), a pro-inflammatory protein molecule that plays a key role in cartilage degradation in arthritis.

More than 70 percent of patients who took painkillers such as ibuprofen for more than three months suffered damage to their small intestines. The study is yet another blow to patients trying to find ways to treat arthritis pain, after reports that the most advanced drugs, called COX-2 inhibitors, can raise the risk of heart death. Baylor College of Medicine researchers in Houston studied 21 patients taking a range of drugs called non-steroidal anti-inflammatory drugs, or NSAIDS. They compared them to 20 arthritis patients taking acetaminophen, an unrelated painkiller, or nothing. Small-bowel injury was seen in 71 percent of NSAID users compared with 10 percent of controls.

The arthritis drug Bextra, made by Pfizer Inc., has shown a high incidence of heart attacks and strokes among patients. It looks like Celebrex may also cause similar problems as Bextra and Vioxx.

The pathobiology of arthritis and the rationale for using the chondroitin sulfate for its treatment.
Curr Drug Targets Immune Endocr Metabol Disord. 2004 Jun;4(2):119-27.
Structure-modifying arthritis drugs are agents that reverse, retard, or stabilize the pathology of osteoarthritis, thereby providing symptomatic relief in the long-term treatment. The objective of this review is to evaluate the literature on chondroitin sulfate with respect to the pathobiology of arthritis to ascertain whether this agent should be classified as a symptomatic slow-acting drug, a compound that has a slow onset of action and improve arthritis symptoms after a couple of weeks. Chondroitin sulfate exhibits a wide range of biological activities and from a pharmacological point of view it produces a slow but gradual decrease of the clinical symptoms of arthritis and these benefits last for a long period after the end of treatment. Many literature data show that chondroitin sulfate could have an anti-inflammatory activity and a chondroprotective action by modifying the structure of cartilage. These properties are also related to the oral adsorption of chondroitin sulfate as high-molecular mass compounds having clusters of sulfate groups and high charge density capable of exert their chondroprotective activity in vivo.

Boston researchers report a link between low serum levels of vitamin D and decreased knee function in patients with arthritis of the knee. At the annual meeting of the American College of Rheumatology in San Antonio, researchers presented findings from 221 subjects recruited from the Boston VA Medical Center. All had knee arthritis and reported knee pain on most days in the month before they joined the study. The investigators measured blood levels of vitamin D at the start and again after 15 and 30 months. They compared change in vitamin D levels with changes in knee pain, physical function and muscle strength during the 30-month study period. Low levels were associated with higher levels of pain and disability and to a lesser extent muscle weakness. The researchers also found that about 50 percent of the population were deficient in vitamin D.

Older people with arthritis are more likely to hang on to good physical function if they exercise on a regular basis. In a two-year study of more than 5,700 older adults with arthritis, researchers at Northwestern University in Chicago found that men and women who were consistently active were less likely to develop physical limitations that interfered with their day-to-day lives.

A two-year study of chondroitin sulfate in erosive osteoarthritis of the hands: behavior of erosions, osteophytes, pain and hand dysfunction.
Drugs Exp Clin Res. 2004;30(1):11-6.
The aim of this study was to evaluate the effect of 800 mg per day of chondroitin sulfate per os plus naproxen versus naproxen over 2 years in patients with erosive arthritis of the hands. Joint count for erosions, Heberden and Bouchard nodes, Dreiser's algofunctional index and physicians' and patients' global assessment of disease activity were studied. A total of 24 consecutive patients (22 women and 2 men, mean age 53.0 +/- 6) suffering from symptomatic arthritis with radiographic characteristics of arthritis were evaluated. The patients were divided into two groups of 12 patients each. The first group took naproxen 500 mg only. The second group was treated with chondroitin sulfate 800 mg orally plus naproxen 500 mg. Joint counts, radiological hand examinations and assessment of disease activity were performed at baseline, at 12 months and at 24 months. In the second year the treated group showed significant worsening in erosion, Heberden, Bouchard and Dreiser scores was recorded. Physician and patient global assessments of disease activity showed no significant difference from baseline scores. The untreated group showed significant worsening in erosion, Heberden and Bouchard nodes, Dreiser index and physician and patient global assessment scores. This study confirms the partial efficacy of oral chondroitin sulfate in improving some aspects of arthritis.

Patients taking Merck & Co. Inc.'s Vioxx (rofecoxib) arthritis drug had a 50 percent greater chance of heart attacks and sudden cardiac death than individuals using Pfizer Inc.'s rival Celebrex (celecoxib) medicine, according to a large study financed by the U.S. Food and Drug Administration. Vioxx is being taken off the market.

Glucosamine and MSM work better together for arthritis
Two popular supplements work together to treat arthritis caused by wear and tear on the joints, a new study confirms. Combined glucosamine and methylsulfonylmethane -- better known as just MSM -- is more effective against osteoarthritis than either agent alone, according to Indian researchers. In the journal Clinical Drug Investigations, Drs. P. R. Usha and M. U. R. Naidu report that although the individual agents did improve pain and swelling in patients' affected joints, the combined therapy was more effective than the single agents in reducing these symptoms and improving the function of joints. In a clinical trial conducted at Nizam's Institute of Medical Sciences in Hyderabad, 118 patients with mild to moderate osteoarthritis were treated three times daily with either 500 milligrams of glucosamine, 500 milligrams of methylsulfonylmethane, a combination of both, or an inactive placebo. After 12 weeks of treatment, the average pain score had fallen from 1.74 to 0.65 in the glucosamine-only group. In MSM-only participants, it fell from 1.53 to 0.74. However, in the combination group, it fell from 1.7 to 0.36. The researchers also found that the combination treatment had a faster effect on pain and inflammation compared to glucosamine alone. All of the treatments were well tolerated. "It can be concluded," they observe, "that the combination of methylsulfonylmethane with glucosamine provides better and more rapid improvement in patients with osteoarthritis." arthritis foundation.
SOURCE: Clinical Drug Investigations, June 2004.

Long-term, habitual use of the painkiller acetaminophen -- known as paracetamol in many parts of the world -- may cause a decline in kidney function in some people, according to a study of middle-aged women. Overall, one in 10 of the 1,700 women studied over 11 years experienced a 30 percent decline in their kidney's filtration function. Acetaminophen, which is sold under the brand name Tylenol by a subsidiary of Johnson & Johnson and is also marketed generically, was alone among commonly used painkillers to show an association with kidney impairment.

An increase in blood pressure may be more likely when the painkiller Vioxx rather than other similar drugs are used to treat arthritis.

Just because aspirin, ibuprofen and similar pain relief medications can be purchased at a local supermarket or gas station without a prescription does not mean people should not take basic precautions when using them, according to the National Consumers League and the US Food and Drug Administration. The two groups joined together to launch their "Take With Care" campaign to educate consumers about the safe use of nonprescription pain relievers. "Although these medicines are safe when taken as directed, many consumers don't realize the potency of OTC pain relievers," Peter J. Pitts, associate commissioner of the Food and Drug Administration said during the campaign launch. Some of the potentially serious side effects associated with the misuse of over-the-counter pain relievers include an increased risk of liver problems and kidney damage. Arthritis remedy arthritis relief.

High levels of fat and (n-6) fatty acids in cancellous bone in osteoarthritis.
Lipids Health Dis. 2004 Jun 18;3(1):12.
Arthritis is strongly linked with obesity and patients with osteoporosis (OP) have a low body mass index. Anecdotal evidence, clinical and laboratory, suggests that Arthritis bone contains more fat. However, conversion of osteoblasts to adipocytes is reported in OP and this would suggest that the more porous OP cancellous bone would have a high fat content. Objectives: To test the hypothesis that Arthritis bone contains more fat than OP bone. Methods: Cores of cancellous bone were obtained from femoral heads of patients undergoing surgery for either Arthritis or OP. Lipids were extracted using chloroform-methanol, weighed and expressed as a fraction of core mass and volume. A fatty acid analysis was performed using gas chromatography. Results: Arthritis bone contained twice as much fat per unit volume of tissue as OP. Levels of n-6 fatty acids were elevated in Arthritis, especially arachidonic acid (C20:4 n-6) which was almost double that found in OP. Conclusions: These data support the hypothesis that lipids may play a significant role in the pathogenesis of Arthritis and may provide part of the key to understanding why Osteoarthritis and OP lie at opposite ends of the spectrum of bone masses.

Intermittent treatment of knee osteoarthritis with oral chondroitin sulfate: a one-year, randomized, double-blind, multicenter study versus placebo.
Osteoarthritis Cartilage. 2004 Apr;12(4):269-76.
To investigate the efficacy and tolerability of a 3-month duration, twice a-year, intermittent treatment with oral chondroitin sulfate in knee arthritis patients. DESIGN: A total of 120 patients with symptomatic knee arthritis were randomized into two groups receiving either 800mg chondroitin sulfate or placebo per day for two periods of 3 months during 1 year. Primary efficacy outcome was Lequesne's algo-functional index (AFI); secondary outcome parameters included VAS, walking time, global judgment, and paracetamol consumption. Radiological progression was assessed by automatic measurement of medial femoro-tibial joint space width on weight-bearing X-rays of both knees. Clinical and biological tolerability was assessed. RESULTS: AFI decreased significantly by 36% in the chondroitin sulfate group after 1 year as compared to 23% in the placebo group. Similar results were found for the secondary outcomes parameters. Radiological progression at month 12 showed significantly decreased joint space width in the placebo group with no change in the chondroitin sulfate group. Tolerability was good with only minor adverse events identically observed in both groups. CONCLUSION: This study provides evidences that oral chondroitin sulfate decreased pain and improved knee function. The 3-month intermittent administration of 800mg/day of oral chondroitin sulfate twice a year does support the prolonged effect known with symptom-modifying agents for arthritis. The inhibitory effect of chondroitin sulfate on the radiological progression of the medial femoro-tibial joint space narrowing could suggest further evidence of its structure-modifying properties in knee arthritis.

Chondroitin Useful in Arthritis
Back in the mid 1990s the American public became aware of effective nutritional alternatives to standard medical drugs for the treatment of osteoarthritis. Glucosamine was the first nutrient that became popular. Since then, many other nutrients and herbs have been promoted, including chondroitin. Chondroitin sulfate is a major constituent of cartilage providing structure, holding water, and allowing other molecules to move through cartilage—an important property, as there is no blood supply to cartilage. In degenerative joint disease, such as osteoarthritis, there is a loss of chondroitin sulfate as the cartilage erodes. But, few studies have looked at the long-term benefit of oral chondroitin supplements. In a study performed at University of Genova Medical School, in Italy, 12 individuals with arthritis of the hands were treated with 800 mg/day of chondroitin sulfate plus naproxen, and compared to 12 others who were given naproxen only. Naproxen is an anti-inflammatory medicine similar to Motrin and sold over the counter as Aleve. X-rays of the hands were done at the start of the study and again after 24 months. In both groups, degeneration of joints showed a general tendency to increase over time, however, the damage was much lower in those treated with chondroitin sulfate plus naproxen than in patients taking naproxen alone.
     Dr. Sahelian says: Although chondroitin by itself did not stop the continuing damage to joints, it did slow the progression of the arthritis. Glucsosamine supplements are known to enhance joint health in those with arthritis, and it seems reasonable to take both supplements for the treatment of arthritis. The most common dose of glucosamine is 1500 mg a day while that of chondroitin is 500 to 1000 mg per day.

Research in mice suggests that a newer class of painkilling drugs called COX-2 inhibitors could trigger a chain of events potentially harmful to the cardiovascular system.
        These findings might explain the outcome of a recent major trial in which patients taking a COX-2 inhibitor--the arthritis drug Vioxx (rofecoxib)--had higher rates of heart attack and other cardiovascular complications compared with patients on naproxen. Naproxen, used in painkillers such as Aleve, belongs to a group of drugs known as nonsteroidal anti-inflammatory drugs (NSAIDs), which includes many familiar painkillers such as aspirin and ibuprofen. COX-2 inhibitors--which besides Vioxx include the arthritis drugs Celebrex among others--are a newer type of NSAID shown to be easier on the stomach.

Though it's widely used as an alternative pain remedy, willow bark extract may not bring much relief to people with arthritis. German researchers found that six weeks of treatment with the botanical failed to ease painful symptoms among patients with either arthritis or rheumatoid arthritis. Arthritis is associated with aging, while rheumatoid arthritis is an autoimmune disorder in which the immune system mistakenly attacks the lining of the joints, leading to inflammation, pain and stiffness. Willow bark has been used for centuries as an analgesic. Its principle active ingredient is salicin, a precursor to aspirin. In Germany, preparations containing willow bark extract have been licensed by federal health officials for the treatment of arthritis. However, the effectiveness of the alternative pain reliever has been less than clear. Two recent studies have suggested that willow bark extract may ease lower-back pain, while a two-week trial, by the same authors of the new study, found a modest benefit for arthritis. In this latest, longer study, Dr. Lutz Heide of the University of Tubingen and his colleagues followed 127 adults with arthritis of the hip or knee. The patients were divided into three "arms." Over six weeks, one group took two doses of willow bark extract every day, while another took two daily doses of the anti-inflammatory drug diclofenac, and a third took placebo pills. In addition, the researchers followed 26 RA patients who were randomly assigned to take either willow bark extract or placebo pills for six weeks. By the end of the study, pain scores on a standard measure had fallen among osteoarthritis patients who were on willow bark extract, but only to a degree similar to that seen in the placebo group.

The effect of nutritional supplements on osteoarthritis.
Altern Med Rev. 2004 Sep;9(3):275-96.
Arthritis is the most common form of joint disease and cause of musculoskeletal disability in the elderly. Conventional management of arthritis primarily focuses on the relief of symptoms, using agents such as analgesics and non-steroidal anti-inflammatory drugs (NSAIDs). These drugs, however, are associated with significant side effects and fail to slow the progression of arthritis. Several nutritional supplements have been shown to be at least as effective as NSAIDs at relieving the symptoms of arthritis, and preliminary evidence suggests several of these supplements may have a role in influencing the course of arthritis . The purpose of this article is to review the available literature on the effectiveness and safety of nutritional supplements for the treatment of arthritis . arthritis of the spine neck.

Arthritis natural treatment with dietary supplements questions
Q. Is a magnetic therapy knee support as good as chondroitin or glucosamine for osteoarthritis?
     A. I seriously doubt this. There is much more reliable research on these nutrients for osteoarthritis than there is for magnetic therapy.

Q. Does Lyprinol work in arthritis?
     A. It may, there is some research available at the Lyprinol web page.

Q. I take 1800 mg. c3 complex tumeric but it doesnt seem to help with my arthritis pain and stiffness. I have cervical and facet joint arthritis lower back can i take say 3600mg or is to much.
     A. We really can't advise you personally what to take since that would be acting as your doctor and we can't be responsible for that. We just provide general information on this page that you can review with your doctor.

Q. Some years ago I hear a well known nutritionist on the radio stating that Flax seed causes "flare-ups" in people with arthritis. She suggested borage oil as opposed to Flaxseed. I would love to take flaxseed, knowing of the many benefits, but have been afraid. What would be your take on this issue? Thank you so much for your most informative articles and wonderful products.
   A. I do not understand the rational for the claim that flaxseed is harmful for arthritis patients. I have not seen such research or feedback from any patient.