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Athritis



Arthritis

22 Remedies to Ease the Ache

Arthritis may be the oldest known ailment on earth. Mummies uncovered in Egypt had it, prehistoric man had it, dinosaurs had it. Close to 40 million Americans have it, and a million more will have it a year from now.

If you're reading this, perhaps you have it, or you may know someone who does. Though new books touting new treatments with potent drugs and surgery seem to pop up every day, we're not going to tell you about any new "miracle" cures here. What we are going to tell you is how to bring about pain relief without getting a prescription filled or making a trip to the doctor. There's a lot you can do on your own, at home, without a lot of expensive equipment or pain or risk. So let's get started. (Unless otherwise noted, the following tips are helpful for all types of arthritis.)

Lose weight, gain relief. "There's no one magic food or diet that's going to do away with arthritic pain," says Art Mollen, D.O., director of the Southwest Health Institute in Phoenix, Arizona. "But if you're overweight and you lose weight, it will reduce a significant amount of the stress and pain you feel in your spinal column, knees, hips, ankles, and feet."

Reason: The more overweight you are, the more stress and pressure you place on your joints. This increases the stress on the cartilage, which interferes with the bone, thus increasing the incidence of inflammation, swelling, and pain.

Solution: Work with your doctor or nutritionist to find a diet that works for you, and stick with it.

Stretch gently for strength and mobility. When it comes to arthritis, says Mary P. Schatz, M.D., a private practitioner in Nashville, Tennessee, "moving hurts, but not moving destroys. Incorrect moving harms, but intelligent moving heals."

Dr. Schatz keeps that philosophy in mind when prescribing yoga for her arthritic patients. "Yoga teaches movement with proper joint alignment," she says, "which helps bring deformed joints back to normal position as appropriate muscles are lengthened and strengthened."

Consider a private session with an experienced teacher or buying a book to learn the correct poses. But remember, "Smart yoga exercise is the key to restoring health to arthritic joints," says Dr. Schatz. Work within the limits imposed by the disease, but don't let yourself be immobilized by it.

Find relief through less stress. "If you are hurting and you tense up, you hurt more," says Beth Ziebell, Ph.D., a psychologist specializing in stress and pain management in Tucson, Arizona. "People who have things in their lives under control will be better pain managers than people who don't."

Recent research confirms the importance of psychological attitude on arthritis pain relief, something Dr. Ziebell has been preaching for years. Some of her specific attitude tips include:

Don't race—pace. "People with arthritis need to learn how to pace themselves and not try to do everything they can possibly do on the days when they're feeling good," she says. "All that does is make you tired and sore the next day. Try to do a little each day, whether you are having a flare-up or not."

Learn to relax. "Take a lesson from natural childbirth classes," Dr. Ziebell advises. "Childbirth is very painful, but women learn how to deal with that pain by learning how to relax." Books and audiotapes teaching relaxation techniques are available at many bookstores, she notes. Dr. Ziebell also believes idle joints can become painful joints. "If you focus on pain, it hurts more, but if you get busy doing other things that are important to you, you're not going to feel it," she says.

Try p.m. prevention for a.m. stiffness. "Almost 90 percent of the patients I see suffer from some type of morning stiffness," says Ilya Rubinov, M.D., a physician at the Arthritis Medical Center in Fort Lauderdale, Florida.

He advises them to apply a muscle ointment at night before going to bed. "It relaxes you and gives you a psychological boost as well," Dr. Rubinov says. The reason? "People with arthritis tend to feel much better all day if they aren't stiff when they wake up in the morning."

Float pain away. Studies have shown that floating in specially designed flotation tanks, also known as isolation or sensory deprivation tanks, can relieve arthritic pain.

"You usually spend about an hour in the tank," says Roderick Borrie, Ph.D., a Brooklyn, New York, psychologist. "The pain relief is produced by stress reduction. The body is relaxing, the muscles are relaxing, and this seems to stimulate a release of endorphins, the body's natural painkillers."

Water in the tanks is heated to precisely 93.5°F, the same temperature as the skin, and the surrounding air is warm and tranquil, leading to deep relaxation.

Dr. Borrie says there are about 200 tank centers located throughout the nation. For more information, contact the Flotation Tank Association, P.O. Box 1396, Grass Valley, CA 95945.

Mix oil and water. "I have rheumatoid arthritis in my hands," says Donna King, a massage instructor at the Atlanta School of Massage. "I've taken courses in hands-on arthritis treatment, and I've also figured out what works on me—so I know this treatment works."

Her recommendation: Heat and eucalyptus ointment, in the form of a thick, oil-based product called Eucalypta-Mint, work for both osteoarthritis and rheumatoid arthritis. It's available from Therapeutic Supply and Services Company, 1924 Cliff Valley Way, Atlanta, GA 30329.

"I use that in conjunction with moist heat when I'm feeling stiff or having pain," she says. Simply rub it on and wrap the joint in plastic wrap. "The moist heat can be applied with warm towels, or you can soak your hands or feet in warm water."

Work wonders with watercise. Ask a dozen doctors about the merits of any arthritis treatment and you'll get a dozen different opinions. But ask them about exercising in water and a strange thing happens—they all agree.

"Water exercises are excellent," says Dr. Mollen, echoing the sentiments of many. "Your pain will be significantly reduced in the water, and you become much more flexible in water than you are in air. I can't say enough about water exercises!"

The beginning exercise techniques are easy for anyone to follow. They consist of waving, walking, and bending motions performed in chest-deep water. The more advanced movements look like aquatic dance steps designed to take advantage of water's natural resistance and gentle buoyancy.

The Alternate Route

The Case for Copper

Sometimes longevity confers respect along with age. Artifacts that were rarely noticed in their day take on new meaning and value as they persist throughout time. Such is the case with the copper bracelet, which for decades has been worn for arthritis relief and remains popular today.

Studies have shown that some people with arthritis seem to have difficulty metabolizing copper from the food they eat, leading to increased pain. That observation led Helmar Dollwet, Ph.D., of the University of Akron to theorize that arthritis sufferers may need to get their copper from another source. "The dissolved copper from [a copper] bracelet bypasses the oral route by entering the body through the skin," he wrote in his book, The Copper Bracelet and Arthritis. Dr. Dollwet thought this might be the only way arthritics ever receive the copper their bodies need—copper that studies have shown can indeed relieve pain.

Physicians remain somewhat skeptical about bracelets but don't entirely dismiss them, either. "I see people wearing copper bracelets, and they're wearing them because it helps them," says Elson Haas, M.D. "I think copper may have a role. It's possible that a copper deficiency does increase joint inflammation, and it doesn't seem that supplementing copper in the diet has the same effect as wearing it."

Does that make Dr. Haas a believer? "I don't necessarily supply copper bracelets to people, but I don't discourage them from wearing one either."

Get your spouse involved. Though it's only natural for a husband or wife to do whatever's possible to help a mate who's hurting, such help can often do more harm than good. "When a wife tries to do everything herself and is constantly asking her husband how he feels, she is reinforcing his pain," says Judith Turner, Ph.D., a psychologist with the Pain Center at the University of Washington.

Her advice: Don't be attentive and supportive only when your spouse is in pain, but also when he or she is feeling good and being active. "That's the time to say, 'Gee, I'm really happy to see you doing things,' " Dr. Turner says. "Praise is really important and something people tend to forget to do."

Use ice to prevent pain. "I recommend cold treatments for those times when a joint's been stressed from overuse or overwork," says King. She uses a gel pack on her clients but notes that ice in a plastic bag or a bag of frozen peas will do just as well. Apply for 15 to 20 minutes, then remove for 10 to 15 minutes. "That can be repeated for hours at a time," she says, "if needed."

Use heat to reduce pain. When joints become hot, swollen, and tender, heat is the best solution, says King. "Cold would make them very painful."

Don't baby your joints. "I like people to follow an aerobic exercise program for arthritis," says Dr. Mollen. "I recommend walking, bicycling, or swimming because they don't traumatize the joints. But do whatever type of exercise you can tolerate that will elevate the pulse rate to at least 120 beats per minute and give you a beneficial effect on the heart and lungs."

Research by Susan Perlman, M.D., of Northwestern University Medical School, has shown that vigorous exercise can even be safe for patients with rheumatoid arthritis and often results in both physiological and psychological improvements. To see if symptoms such as fatigue and depression were the result of poor physical conditioning, she decided to put 54 patients through a low-impact aerobics program.

The result? The vigorous exercise did not result in joint inflammation, but it did improve the walk time, physical activity, and health status of the participants, while reducing their joint pain and swelling, as well as their general pain.

Get off addictive drugs. Sleeping pills, tranquilizers, and narcotic painkillers can become part of life for a person with arthritis—unfortunately. "It's not that these drugs don't work," says Nelson Hendler, M.D., assistant professor at the Department of Neurosurgery at Johns Hopkins University School of Medicine. "They do—but for most people they are needed in ever-increasing amounts and end up creating many more problems than they solve."

Though it may require professional help, Dr. Hendler believes such drugs should be slowly replaced with biofeedback or other forms of therapy, or occasionally, with nonnarcotic pain relievers such as aspirin or ibuprofen.

Those Sometimes Helpful Herbs

The word is out about relieving arthritis pain with herbs, and the word is a strong "maybe." Some may help, but the majority probably don't.

"In the long run, the most beneficial herb probably is willow bark," says Varro E. Tyler, Ph.D., professor of pharmacognosy at Purdue University and author of The Honest Herbal. "That's simply because it contains salicin, which is similar to aspirin. But to treat arthritis properly, you would need a lot of bark."

Another possible arthritis herb is pokeweed berries, an Indiana favorite that's been used since pioneer times. However, Dr. Tyler cautions, there's been no research showing how pokeweed berries work or if there's any lingering toxicity.

Fish for relief. "Some people do indeed respond to fish oil," observes Elson Haas, M.D., the director of the Marin Clinic of Preventive Medicine and Health Education in San Rafael, California. "Not everyone, but some."

A report published by researchers at the Albany Medical Center in New York confirms that observation. It showed that patients with rheumatoid arthritis who took fish-oil capsules showed improvement in joint tenderness and fatigue.

Though fish oil has received plenty of press in the last few years, the active ingredient in fish oil—omega-3 fatty acids—has been around in the form of cod-liver oil for years. Studies have shown that 1 teaspoon per day of cod-liver oil may help alleviate symptoms of rheumatoid arthritis by providing the body with substantial amounts of vitamins D and A. Vitamin D is important for bone growth, while vitamin A may have anti-inflammatory effects. Fish oils also compete with other types of fatty acids that are believed to trigger arthritis inflammation.

Please note, both vitamins D and A can be toxic in large amounts, so limit your intake of cod-liver oil to only a teaspoon a day. Also, too much of these vitamins can cause liver damage over time. Consult with your physician if you think you need fish-oil supplements or supplemental vitamin D. Or, instead of using supplements, try a low-fat diet that includes fish such as mackerel or salmon, which contain omega-3's.

Master massage. When it comes to massage for arthritic pain, hands-on expert King offers the following advice. Work the muscles that are attached to the tendons leading to your painful joints.

"For example, if you have arthritis in your hands," she explains, "then work the forearms from the wrists to elbows, using a compression technique."

To do this, use either the heel of your hand, your thumb, or your elbow to press down on the muscle and hold it for several seconds, then release. For arthritis in the ankle or foot, work the calf and front of the leg.

Boost your vitamin C intake. "Studies have shown that people with rheumatoid arthritis are deficient in vitamin C," says Robert H. Davis, Ph.D., professor of physiology at the Pennsylvania College of Podiatric Medicine.

Dr. Davis's medical models have shown that a lack of vitamin C can aggravate rheumatoid arthritis and that strong doses of vitamin C can bring about regression of the disease.

"Vitamin C is definitely a good home remedy for someone with rheumatoid arthritis," he says. "The toxicity of vitamin C is virtually zero, and if a person took about 500 milligrams spread throughout the day, which is not excessive, that would get enough of the vitamin through to do some good." Before trying vitamin C therapy, get an okay from your doctor.

Practice food avoidance. "I think I've seen the most dramatic results when my rheumatoid arthritis patients avoid foods from the nightshade family and milk products," says Dr. Haas. The nightshade plant family consists of white potatoes, tomatoes, eggplant, tobacco, and all peppers except black pepper.

Dr. Haas suggests that arthritis sufferers develop their own personalized diet by utilizing a "food-avoidance testing plan." One testing plan worth trying calls for removing all forms of a food you crave from your diet, under the theory that you may be literally addicted to the foods you're allergic to.

If, for example, you really crave tomatoes, remove all traces of that food from your diet for a week. Make sure there is no tomato in anything you eat—which means checking labels on processed foods as well as avoiding tomatoes in their raw form. If your symptoms get worse over the next three to four days, you may have an allergy to that food, because a worsening of symptoms can be a sign of addiction. By the fifth or sixth day without the food, you should feel better. If so, this may be a good time to make an appointment with a physician for a complete allergy screening.

Cut back on vegetable oil. There's no question that vegetable oils are generally beneficial to most people, says George Blackburn, M.D., chief of the Nutrition/Metabolism Laboratory with the Cancer Research Institute at New England Deaconess Hospital in Boston. But, he cautions, studies show that people with arthritis may be a special case and may need to minimize their intake of vegetable oils while increasing their intake of oils rich in omega-3's.

That doesn't mean doing without vegetables, he says, but it does mean cutting back on oil-containing products like salad dressings, fried foods, and margarines. These foods contain high levels of omega-6 fatty acids, which have been shown to cause inflammation in those with rheumatoid arthritis. Two oils that are low in omega-6's are canola oil, made from rapeseed, and olive oil. Dr. Blackburn says these two oils can be used in moderation, noting that it's best to keep the overall level of fat in your diet at less than 30 percent of total calories.

Carry on with carrot juice. A vegetable-juice fast significantly reduces pain for many patients with rheumatoid arthritis at Dr. Mollen's clinic. "I started prescribing this type of fast several years ago and have found it very beneficial," says Dr. Mollen.

Carrot juice, celery juice, cabbage juice, or tomato juice can be used. Dr. Mollen suggests fasting on nothing but the vegetable juice for one day during the first week to get started. Follow that by alternate fasting for two days during the next week (i.e., Monday and Wednesday) and three days during the third week (Monday, Wednesday, and Friday). Don't attempt any type of fasting without a doctor's supervision, however.

PANEL OF ADVISERS


George Blackburn, M.D., is chief of the Nutrition/Metabolism Laboratory with the Cancer Research Institute at New England Deaconess Hospital in Boston, Massachusetts.

Roderick Borrie, Ph.D., is a Brooklyn, New York, psychologist who uses flotation tanks, in conjunction with more conventional psychotherapy methods, as a means of inducing deep relaxation and pain relief.

Robert H. Davis, Ph.D., is a professor of physiology at the Pennsylvania College of Podiatric Medicine in Philadelphia.

Elson Haas, M.D., is the director of the Marin Clinic of Preventive Medicine and Health Education in San Rafael, California, and author of the book Staying Healthy with the Seasons.

Nelson Hendler, M.D., is an assistant professor at the Department of Neurosurgery at Johns Hopkins University School of Medicine in Baltimore, Maryland.

Donna King is a massage instructor at the Atlanta School of Massage in Georgia. She also suffers from arthritis in her hands.

Art Mollen, D.O., is an osteopathic physician who is the founder and director of the Southwest Health Institute in Phoenix, Arizona, where he emphasizes proper nutrition and exercise to improve health, physical and mental fitness, and weight loss. He is the author of two books, The Mollen Method: A 30-Day Program to Lifetime Health Addiction and Run for Your Life.

Ilya Rubinov, M.D., is a physician at the Arthritis Medical Center in Fort Lauderdale, Florida.

Mary P. Schatz, M.D., is a private practitioner in Nashville, Tennessee, who views yoga as a valuable tool in the fight against arthritis pain.

Judith Turner, Ph.D., is a psychologist with the Pain Center at the University of Washington in Seattle.

Varro E. Tyler, Ph.D., is a professor of pharmacognosy at Purdue University in West Lafayette, Indiana, and the author of The Honest Herbal. He also serves as a Prevention magazine adviser.

Beth Ziebell, Ph.D., is a psychologist specializing in stress and pain management in Tucson, Arizona.