Is there a natural remedy for my joint pain?
I AM 67 and have suffered from osteoarthritis since I was 40, mainly due to my profession as a carpenter, which was hard on my joints.
Standard painkillers, such as aspirin and ibuprofen, give me heartburn and an upset stomach. This, alongside my osteoarthritis, makes everyday life very uncomfortable. I’ve tried lots of supplements such as glucosamine, chondroitin and cod liver oil, with no luck. Do you know of a clinically proven natural alternative without unpleasant side-effects? Terence Oliver, Storrington, W. Sussex.
Your story illustrates a common problem. osteoarthritis is seen in many of us, yet is still poorly understood, with no curative treatments available. of course, when a large joint is involved, joint replacement can relieve the pain. However, in many patients a number of joints are affected.
This is particularly disabling when it’s the numerous small joints of the hands, or the facet joints of the neck or lower back (which link the spine’s vertebrae together).
simple painkillers, or nonsteroidal antiinflammatory drugs such as naproxen or diclofenac, don’t tackle the root of the problem and frequently cause distressing sideeffects — and potentially danger as a result of the gastric bleeding linked to their use.
osteoarthritis has always been thought to be part of the normal process of ageing. It occurs when the cartilage that lines the end of the joints and helps bones glide over each other is damaged.
The traditional view is that this is the result of wear and tear, hence the common term for it is ‘degenerative joint disease’. However, the modern view is that osteoarthritis is due to a complex combination of genetic factors, the force put on the joint, and processes in the body which first erode cartilage and inhibit repair.
PARTICULARLY puzzling is the relationship between exercise and osteoarthritis. It appears that exercise and physical stresses may both cause and prevent the condition.
For example, we no longer believe that running regularly causes knee damage, though research studies show an increased risk of osteoarthritis after much heavy lifting, such as your work as a carpenter might have entailed.
also, when a joint is damaged — such as through ligaments tearing, as I have seen in footballers — osteoarthritis may eventually develop.
There are other treatments besides medications that mustn’t be ignored. arthritis in the loadbearing joints (such as the hips and knee) is linked to obesity and even modest weight loss is proven to reduce pain and lower the risk of further damage.
Physiotherapy to teach exercises that improve lost flexibility and strengthen the muscles that support the joints is helpful, and studies show that people who exercise regularly have less pain and better function than those who are inactive. However, do avoid activities that worsen pain.
Glucosamine and chondroitin are popular dietary supplements, but the only positive research I have seen is that these may achieve a modest reduction in the pain from osteoarthritis of the knee, and not other arthritic joints.
But I have seen a number of studies supporting the use of rose hip extract. It must be taken for at least four weeks, three capsules twice daily, before any f i rm conclusion about its benefit can be reached.
you have everything to gain and nothing to lose by trialling this — I know of no sideeffects, and you can get a suitable preparation, such as Gopo, from your pharmacy. I WAS diagnosed with dystonia (muscle contractions that cause abnormal posture) four years ago and have joined an online forum for sufferers.
Most of us attend Botox clinics every three months, but the consultants have so many patients that there isn’t adequate time to work out where the injections should go.
If they are in the wrong place, we suffer for three months and other muscles are unnecessarily weakened. Our GPs tell us to ask our neurologists about any concerns, and our neurologists tell us to ask our GPs. We’re all desperate for help.
Beverley Bills, by e-mail. I am more sorry for you than I can say. I had a patient, a man in his 20s, who suffered from dystonia of his neck muscles when I was a junior hospital doctor. I worked then on a psychiatric unit, and there was a wide view at that time that the disorder was psychological, which we now know not to be the case.
Forty years ago, the doctors seemed baffled and the poor man suffered severely, unable to function adequately in society. your letter indicates that understanding and treatment of this group of muscle movement disorders has hardly changed.
DYSTONIA is a condition where constant or bouts of muscle contractions result in abnormal movements or postures.
sometimes i t can begin in childhood and is often hereditary. It may not occur until later in life. We do not know what causes it although it’s thought to be linked to problems in an area of the brain that ultimately controls muscle movement.
The diagnosis is based on the doctor’s observations, rather than tests or scans.
There are various types of dystonia, affecting particular parts of the body, such as the neck, hand, or face. apart from the young man I described, my main experience as a GP has been with writer’s dystonia, also known as writer’s cramp: this is an involuntary spasm of the hand and arm muscles which interferes with the ability to write.
Treatment is about trying to reduce the symptoms as there is no cure. The medication options include levodopa, a synthetic form of the brain chemical dopamine, which can eliminate symptoms in some cases, though regular doses must be continued.
Trihexyphenidyl and procyclidine — drugs that block certain chemical messengers in the brain — are also used, though sideeffects such as dizziness, confusion and sedation limit their value.
The relaxant tranquilliser clonazepam, and the sleeping pill, zolpidem, have also been used, but there is little published evidence confirming their effectiveness.
But Botox is also a mainstay treatment. This is derived from botulinum toxin, and works by paralysing a muscle when injected into that site.
It is useful, but as you described, correct identification of which muscle to inject is vital, and injections must be repeated as the benefit wears off; this is a skilled task.
There does not seem to be a consensus about how to target the i njections, whether by sight, electromyography — which involves monitoring patterns of electrical activity in the muscles — or by ultrasound scan. If none of these treatments work, then neurosurgery may be offered: here, electrodes are implanted to stimulate specific regions in the brain.
The most important thing is to be under the care of a specialised dystonia unit, or at least a neurologist with a declared interest in this condition. your current predicament is a difficult one, but I’d suggest it’s the specialists you must talk to, as they are the experts administering the injections.