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 this joint disease. Many search for natural ways to obtain arthritis pain relief as an alternative to medications such as Motrin or Aleve. Although symptoms occur earlier in women, the prevalence among men and women is equal. The diagnosis is largely clinical because x-ray findings do not always agree with joint symptoms. For simplicity, I will use the term arthritis to mean osteoarthritis or degenerative arthritis. My goal is to discuss natural ways to help you with pain reduction and reduce the severity of joint symptoms. I hope this information is helpful to you and you are able to reduce the discomfort in your joints.

Having knee pain while using the stairs may be an early sign of arthritis.

Weight loss helps
If you are overweight, try to shed some pounds. It will ease your symptoms. Skipping certain meals at night can help.

Natural treatment for arthritis pain relief, home remedy
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. Some pet owners use glucosamine, chondroitin and other supplements for their dog with canine arthritis.
   Arthritis can be made worse by being overweight. All the excess pounds can put pressure on the joints. Obesity is a major risk factor for knee arthritis, and shedding extra pounds on a low calorie diet is of benefit in reducing pain and discomfort.
   Strength training can help older people function better and reduce pain. Even a modest amount of exercise might be better than none at all when it comes to preventing disability.
   Walking half an hour a day improves knee arthritis and reduces the risk of disability.

Many nutrients have been found to be helpful as natural therapy
It would be premature to say that these supplements or herbs are a natural cure. Even if they don't cure, they nevertheless may be helpful in many people with knee, hip, hand, or back discomfort. We need more research to make firm recommendations.

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This powerful formula includes several herbal extracts and nutrients that play a role in joint health.
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 has been researched more lately.
Grape seed extract
Sea Cucumber extract

Chondroitin
The pathobiology of arthritis and the rationale for using the chondroitin sulfate for its treatment.
Curr Drug Targets Immune Endocr Metabol Disorder. 2004.
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.

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 sulfate, 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. 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. Glucosamine 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.

Intermittent treatment of knee osteoarthritis with oral chondroitin sulfate: a one-year, randomized, double-blind, multicenter study versus placebo.
Osteoarthritis Cartilage. 2004.
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. Oral chondroitin sulfate decreased pain and improved knee function. The inhibitory effect on the radiological progression of the medial femoro-tibial joint space narrowing could suggest further evidence of its structure-modifying properties in knee arthritis.

Glucosamine sulfate or sulphate
Glucosamine and MSM work better together to treat arthritis caused by wear and tear on the joints. Combined glucosamine and methylsulfonylmethane is more effective against osteoarthritis than either agent alone. 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 1.7 to 0.65 in the glucosamine-only group. In MSM-only participants, it fell from 1.5 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. Clinical Drug Investigations, June 2004.

Diet and food
A diet high in oily fish like salmon, halibut, and mackerel may help improve inflammatory conditions such as arthritis. A key anti-inflammatory fat in humans -- resolvins -- is derived from a fatty acid found in fish oil.
Losing a large amount of weight slows the loss of knee cartilage in obese people. Obesity is a major risk factor for knee osteoarthritis, a degenerative joint disease that often leads to joint replacement surgery.

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.

J Med Assoc Thai. 2015. Efficacy and Safety of Fish Oil in Treatment of Knee Osteoarthritis. Fish oil 1,000-2,000 mg daily supplementation had significant efficacy to improve knee performance and also are safe in mild to moderate stages of knee osteoarthritic patients.

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Additional nutrients for natural arthritis management
Alpha lipoic acid is a powerful, natural antioxidant slowly becoming recognized as having some unique properties in the therapy and prevention of a broad range of diseases.
Omega 3 fatty acids, fish oils have anti-inflammatory activity and help improve circulation.
Vitamin C
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.

SAM-e is used also as an antidepressant, and helps with arthritis symptoms. Keep the dose low, no more than 100 mg a day.
Willow bark extract may not bring much relief. German researchers found that six weeks of treatment with the botanical failed to ease painful symptoms among patients with either arthritis or rheumatoid arthritis. 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. Two recent studies have suggested that willow bark extract may ease lower-back pain, while a two-week trial 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. 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.

There is some research available at the Lyprinol web page regarding its benefits.

Vitamin D
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.

Causes
The exact cause of arthritis joint pain 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.

Arthritis is the leading cause of disability in the United States, and impacts over 70 million Americans.
Obesity and stress on joints from excessive exercise and sports are potential causes of arthritis among younger men and women.

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. Four in 10 individuals will suffer from arthritic hands over a lifetime.
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.
Even though surgery to repair meniscal tears in the knee is common, increasing evidence is emerging that suggests meniscal surgery may be detrimental to the knee joint and cause arthritis in the future.

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.
   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.
   COX-2 inhibitors could trigger a chain of events potentially harmful to the cardiovascular system.

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.

Acetaminophen has limited benefits in patients with osteoarthritis.
Nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen, in some, raise blood pressure in patients with osteoarthritis.

Symptom and sign
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.

Magnetic therapy
Is a magnetic therapy knee support as good as chondroitin or glucosamine for osteoarthritis?
   I seriously doubt this. There is much more reliable research on these nutrients for osteoarthritis than there is for magnetic therapy.