ask the doctor

Sound Consumer | March 2002

by Bobbi Lutack, N.D.

Answers to your health concerns

See below:

Can arthritis be treated naturopathically?

The answer to the question posed by the headline is a qualified yes. But let's start with some defining. There are actually multiple types of arthritis. The two most commonly known are osteoarthritis (OA) and rheumatoid arthritis (RA). Although they're different, the common denominator is inflammation.

OA is also known as degenerative joint disease. It's a "wear and tear" phenomenon. Basically, the cartilage between joints (as in the hip or knee) is wearing away and can even result in bone-on-bone rubbing, because there is no cartilage cushion left. The result is inflammation, pain and stiffness causing a decreased range of motion. If the joint is seriously deteriorated, an artificial joint replacement is a distinct possibility.

RA is a so-called autoimmune disease. "Autoimmune," meaning the body turns against itself, creating complexes that collect in joints and cause pain, swelling and decreased rom. "So-called" because there is evidence now suggesting an infectious aspect of the disease.

Pain, inflammation and decreased rom can be treated with naturopathic methods, homeopathy, acupuncture, manipulation and therapeutic massage.

Who gets OA and RA?
Both males and females get OA fairly equally. It is diagnosed more often in senior citizens than in the younger population, but in recent years, there has been an increase in occurrence among people in their 30s or 40s. This is a result of increased use of joints (as in avid athletes). After all, it is a disease of "wear and tear."

RA is not an equal opportunity disease. It is more common in women, occurring most frequently in women of childbearing age. There is even a form of RA called juvenile RA, affecting pediatric patients.

Exercise or not?
Absolutely! Exercise is good for you. It increases blood flow to joints, helping them get nutrition and oxygen-rich blood. If you exercise frequently and your joints take a lot of pounding (for example, from running), consider taking preventive action for your joints, especially if the illness runs in your family. Both OA and RA have familial links. Use shoe inserts, avoid hard surfaces such as cement, and take a little glucosamine sulfate and some essential fatty acids.

How do you treat OA & RA?
I advocate a multiple treatment approach:
Diet: Remove anything that can cause more inflammation (such as food sensitivities and/or allergies). Increase nutrient-dense foods and lose empty-calorie foods (soda, candy, etc.).

Exercise: "Use it or lose it." Gentle aerobic exercise, yoga and stretching increase range of motion of joints, keep blood flow moving, enhance the immune system and increase natural endorphins for pain relief and as a natural antidepressant. Exercise 30 minutes six times a week.

Supplements: The right supplements help increase cartilage strength and decrease stiffness and pain. To name a few: essential fatty acids (such as cod liver oil or flax/borage oil, 1 tablespoon per day), glucosamine sulfate with chondroitin (500 mg three times per day) and bromelain and curcumin, as directed.

I also include a whole body-mind approach that may include constitutional homeopathy, acupuncture, massage or other bodywork such as Rolfing and manipulation.

As an N.D. who practices integrative medicine with other N.D.'s and an M.D. partner, I believe any treatment modality can be naturopathic — it depends on why and how you use it. Conversely, naturopathic medicine can be practiced in an allopathic way, i.e. just treating the symptoms. Treat the cause with the least invasive, most healthful measures and with the patient's best interest at heart and you are treating naturopathically.

Dr. Lutack is a naturopathic and homeopathic doctor, practicing as a primary care physician in Seattle's Ravenna neighborhood.

Popular arthritis medications under fire
Lawsuits filed against the makers of Vioxx® claim the popular COX-2 inhibitor and arthritis medications put patients at increased risk of heart attack and other serious health complications.

The court cases come on the heels of recent letters from the Food and Drug Administration (FDA) to Merck, the makers of Vioxx, that some of its promotional materials are "false, lacking in fair balance or otherwise misleading" in violation of federal law. The FDA also says Vioxx promotions understate the risk of cardiovascular complications and claim falsely that Vioxx can be effective against cancer.

COX-2 inhibitors such as Vioxx and Celebrex arrived in the marketplace in the late 1990s. Proponents claimed the drugs were more effective than common anti-inflammatory drugs such as aspirin and ibuprofen. But questions about their cardiovascular safety have emerged. In addition, The Lancet reported last June that they can also harm the kidneys.

Consumers, meanwhile, should be aware of alternatives that are available at PCC (see sidebar). If you'd like to learn more about arthritis, including both conventional and alternative treatments, you can access our extensive Healthnotes reference at kiosks in the health and beauty departments at PCC stores, or online at Healthnotes.

Healthnotes, a PCC partner, is a health advisory service. It offers recommendations for several nutritional supplements and herbs people may use to deal with rheumatoid arthritis and osteoarthritis. It also suggests possible lifestyle changes people may make, and warns against possible side effects from various treatments. Healthnotes offers practical advice for dozens of medical conditions.

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