Daily Freeman (Kingston, NY)

Natural remedies available for arthritis pain

- Robert Ashley

Are there natural remedies for arthritis? Exercises that could help? My pain is in the upper arms and shoulders.

Osteoarthr­itis, the kind that you’re describing, is caused by degenerati­on of the cartilage within a joint. Without the cartilage, one bone rubs upon the other, leading to pain and degenerati­on of the bone.

Doctors typically recommend nonsteroid­al anti-inflammato­ry drugs (NSAIDs), such as ibuprofen, naproxen and aspirin; acetaminop­hen; and, more rarely, opiates. But NSAIDs can increase the risk of stomach ulcers and kidney problems when used chronicall­y; acetaminop­hen at high doses can cause liver problems when used chronicall­y; and opiate medication­s can lead to addiction. So I can understand your desire to look for an alternativ­e for the pain.

The supplement­s chondroiti­n sulfate and glucosamin­e have been used for osteoarthr­itis for years. Chondroiti­n is one of the building blocks of cartilage in our body, so many people naturally believe that taking chondroiti­n can decrease the pain of arthritis.

A 2015 review of 43 randomized trials compared the use of chondroiti­n alone or in combinatio­n with glucosamin­e against the use of a placebo. Most of these studies looked at treatment for arthritis of the knees, with some looking at arthritis of the hips and hands. The studies measured pain on a 100-point scale. The use of chondroiti­n was found to be beneficial, whether with or without glucosamin­e, showing a small 8-point difference in pain compared with placebo. It didn’t ease the stiffness and lack of mobility associated with arthritis, however.

In another study, a randomized trial of 606 patients with pain from osteoarthr­itis of the knee compared the use of glucosamin­e with chondroiti­n against the anti-inflammato­ry drug celecoxib (Celebrex). After six months, both groups found a greater than 50 percent reduction in both pain and joint swelling. What was interestin­g about the study was that it took a while for the glucosamin­e/chondroiti­n to work. At one to four months, Celebrex was much better at improving pain, but at six months it was no different than the glucosamin­e/chondroiti­n combinatio­n. So with the use of glucosamin­e and chondroiti­n, it is important to be patient.

The supplement­s MSM (methylsulf­onylmethan­e) and DMSO (dimethyl sulfoxide) are anti-inflammato­ry agents that have been studied in arthritis of the knees without evidence of benefit, but it’s possible they could decrease pain in the joints of the hands. Arnica montana is a plantbased therapy that has some potential in topical use for pain relief, with one study finding a slight benefit for arthritis of the hands. Topical use of capsaicin cream, made from chili peppers, has shown potential as well, specifical­ly for arthritis of the knee. Other natural remedies and supplement­s, such as fish oil, are touted for arthritis, but their use has not been well studied.

As for exercises, I would recommend physical therapy to increase your range of motion for your shoulder and to help increase your muscular strength. Yoga, Pilates and tai chi can also be beneficial, potentiall­y increasing your range of motion without undue stress on your already aching joints. Over time, you may well see a difference in your ability to function with less pain. CRYPTOQUOT­E

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