Arthritis is a condition in which bone formation occurs outside the normal or desired ways and amounts as a result of an autoimmune disorder (such as rheumatoid arthritis) or damage resulting from trauma or overuse.
There are very efficacious drugs—mainly NSAIDs (non-steroidal anti-inflammatories) and corticosteroids—to treat arthritis, but along with the efficacy usually comes a multitude of side effects, many of which can be serious. Fortunately, there are a number of ways to treat arthritis—both osteoarthritis and rheumatoid arthritis—without drugs.
There are many substances available over-the-counter that are considered supplements that can be used to successfully treat arthritis. Most of these substances are polyphenols or contain polyphenols, which are responsible for a significant portion of the anti-inflammatory effects.
Curcumin is derived from turmeric and, when combined with an alkaloid supplement called piperine (typically derived from black pepper), acts as a very strong anti-inflammatory comparable to NSAIDs.
Boswelia resin, a.k.a. frankincense, is derived from a tree and works to reduce inflammation via a different pathway that involves suppression of 5-LOX (5-lipoxygenase) and pro-inflammatory leukotrienes, and is especially good for treating rheumatoid arthritis as well as osteoarthritis because of its mechanism of action.
Omega-3 fatty acids, such as those found in fish or flax seed oil, help reduce inflammation by their metabolism into prostaglandins (Prostaglandin E3), which are anti-inflammatory and block the formation of other pro-inflammatory prostaglandins (Prostaglandin E2). Prostaglandin E3 also reduces the production of inflammatory substances called cytokines, such as TNF-alpha (Tumor Necrosis Factor – Alpha) and IL-1b (Interleukin-1b). In addition, cartilage destroying (read: arthritis producing) enzyme activity is reduced in a dose-dependent manner when the active ingredients in omega-3 fatty acids, EPA (eicosapentaenoic acid) and DHA (docosahexaenoic acid), are present.
Resveratrol is a polyphenol made somewhat famous by its prevalence in red wines (because it is found in the skin of grapes used to make red wine) and the purported association with longevity. Its anti-inflammatory activity is well-documented via its suppression of prostaglandin E2 synthesis and inhibition of TNF-alpha and IL-1b-induced NF-kB activation.
Pycnogenol is an anti-inflammatory substance derived from tree (maritime pine) bark that contains multiple polyphenols that work to reduce activation of NF-kB (nuclear factor kappa-light-chain-enhancer of activated B cells). It is also a very potent antioxidant in and of itself while also working to potentiate the antioxidant activity of vitamins C and E.
Cat’s Claw is another anti-inflammatory substance derived from tree bark that contains multiple polyphenols that work to reduce activation of NF-kB while directly inhibiting production of TNF – alpha. It also inhibits the expression of inducible genes associated with inflammation.
Capsaicin, derived from chili peppers, when ingested reduces inflammation by inhibiting NK-kB, but also helps arthritis sufferers when used topically through its ability to blunt pain receptors.
Green tea extract has polyphenols called catechins that have an anti-inflammatory effect as well as an apparent ability to inhibit collagen breakdown in cartilage. As a side note, green tea extract also has mountains of evidence supporting its anti-cancer effect.
White willow bark, a natural source of the active ingredient in aspirin (a.k.a. acetylsalicylic acid) called salicin, is included in this list of non-pharmaceutical treatment options because it works like aspirin to reduce inflammation via inhibition of COX-1 and COX-2 pathways that result in production of inflammatory prostaglandins. However, use of white willow bark results in fewer side effects than aspirin.
Aside from chemical interventions, arthritis pain and inflammation can be treated with physical modalities such as application of cold to the affected areas or alternating heat and cold. This treatment will increase blood flow and therefore increase the removal of inflammatory products and depositing of anti-inflammatory products and nutrients to the area applied.
Exercise can work in a similar fashion to promote blood flow and nutrient and chemical exchange. Strengthening and flexibility exercises can also be used to reposition and stabilize arthritic joints to protect against pain and further damage.
Diet plays a major role in modulating inflammation in similar fashion to supplements in that consumption of foods and spices that contain flavonoids, proanthocyanidins, tannins, omega-3 fatty acids, etc. can help reduce inflammation. Foods highest in these anti-inflammatory substances are vegetables, thus a plant-based diet is ideal for arthritis. In addition, reduction in consumption of animal products containing saturated fat is recommended because saturated fats are converted to arachidonic acid and eventually inflammatory prostaglandins.
Lastly, there is definitely an association between intake of added/excess sugars and inflammation and pain, so limiting sugar intake is useful.
Of course, making sure one is generally healthy tends to reduce inflammation, so getting healthy amounts of regular exercise and sleep as well as reducing stress can reduce inflammation as well as the perception of pain.
Lastly, injection or infusion of mesenchymal stem cells, while not considered a supplement, are arguably not considered a pharmaceutical intervention either. Use of stem cells to treat arthritis has been very useful, and, in some cases, even miraculous. With use of stem cells we have seen dramatic reduction in inflammation as well as rebuilding of cartilage and even reversal of autoimmune diseases such as juvenile arthritis.
