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Arthritis Natural Pain Relief and Supplements for Inflammation

Pain is one of the most common health complaints seen in healthcare practices and every day life.

There is a high probability that pain will affect you many times during your life. There are many options for arthritis natural pain relief and supplements for inflammation to reduce pain. Controlling pain effectively with natural methods is poorly understood by the majority of the population. It would be helpful if more healthcare practitioners would be able to offer more Functional Medicine treatments.

The most common way to control pain in our modern era is by the use of acetaminophen (Tylenol), and nonsteroidal anti-inflammatory drugs (NSAIDs). Unfortunately, Acetaminophen and NSAIDs comes with a risk of liver failure with chronic use or high doses. The use of NSAIDs increases the risk of cardiovascular events including heart attacks and strokes. The FDA outlines an increase in risk of NSAIDs for both heart attack and stroke even if only taken for a few weeks. NSAIDs deplete prostaglandins which provide a protective stomach lining. Depletion of this normal prostaglandin lining results in a higher risk of stomach ulcers. NSAIDs can worsen blood pressure control, and result in kidney failure. Narcotic pain medications such as oxycodone, hydrocodone, propoxyphene, morphine, and hydromorphone are useful for cancer pain and postoperative pain. These medications are frequently abused with dangers associated with addiction such as motor vehicle accidents. Some of the common side effects of narcotic pain medications include respiratory depression, confusion, and constipation.

The widespread use of acetaminophen and NSAIDs should no longer be necessary with the research available on Integrative Medicine and Functional Medicine options. Many of these natural treatments for pain published in randomized controlled trials are more effective than placebo for controlling pain and inflammation. Pain may be due to a variety of reasons such as arthritis, muscle strains, muscle sprains, tendonitis, back pain, shoulder pain, sciatica, neck pain and countless other painful musculoskeletal conditions. There are many options available to address these causes of pain other than standard medication which has significant risks. These risks are often unknown by the uneducated buyer.

There is a major difference between taking Tylenol and NSAIDs vs supplements for pain and inflammation. The difference is that a natural method takes more time to work (days to weeks), but once it does, the solution becomes more permanent. Tylenol and NSAIDs work more quickly (minutes), but masks the pain. This gives the patient a false sense of security that it is OK to use the affected joint or body part. In doing so, the pain worsens once the pain medication wears off. For acute strains, sprains and recent onset of pains, RICE is suggested (rest, ice, compression, and elevation), followed by starting the desired supplements.

Acupuncture for Arthritis Natural Pain Relief

Acupuncture for arthritis natural pain relief often succeeds to control pain even after years of failing many different pain medications. Acupuncture may be considered for treating a wide variety of pain from many medical conditions. Acupuncture used to treat neck pain, low back pain, osteoarthritis pain, and lithotripsy pain has strong evidence of benefit in well-designed research studies. Acupuncture may also be beneficial for many other disease conditions and different types of pain.

The Anti-Inflammatory Diet for Arthritis Natural Pain Relief

Arthritis natural pain relief and supplements for inflammation includes the need for dietary changes. Inflammation in the body results in higher levels of inflammation markers in the blood. These inflammation markers include C-reactive protein, homocysteine, interleukins, and erythrocyte sedimentation rate. Diseases directly linked to inflammation include infections, heart disease, cancers, autoimmune diseases, and dementia. However, inflammation can be controlled with diet.

Adam O et al (14) found that changing a standard Western diet in the Unitied States to a diet low in arachidonic acid significantly improved inflammation and pain in those with rheumatoid arthritis. An anti-inflammatory diet also improves the ability of omega 3 fatty acids to control pain in those with rheumatiod arthritis. Foods high in arachidonic acid include pork, beef, lamb, dairy, eggs, seafood, and meats from organs.

An anti-inflammatory diet, such as a Mediterranean diet or Dr. Andrew Weil’s diet may help lower the intensity of pain. Both of these diets contain mostly fruits and vegetables, healthy spices (turmeric, ginger, cinnamon and garlic), omega 3 oils, moderate amounts of protein, healthy oils such as olive oil, nuts, low sugar, plus supplements. Including legumes may also improve inflammation. A legume-based diet resulted in a significantly higher reduction in C-reactive protein (CRP) and complement (C3), both inflammatory markers (16).

Additional dietary modifications to assist in arthritis natural pain relief includes avoidance of nightshade vegetables. Common nightshade vegetables include peppers, tomatoes, and potatoes. This includes spices such as cayenne pepper, chili powder, curry and paprika. Nightshades are known to contain alkaloid toxins (including solanine and others) that may result in pain and inflammation (16). They also contain a metabolite of vitamin D3 named calcitriol which may contribute to an excess of calcification leading to arthritis and excess calcium deposits in organs (16).

Gluten has been implicated as a cause of inflammation. Hafström I, et al (18) randomized 66 patients with rheumatoid arthritis (RA) either to a gluten-free vegan diet or a well-balanced non-vegan diet. The patients were assessed at 3, 6 and 12 months and data was used from those who completed the diet. Symptoms were checked for improvement using a scale designed by the American College of Rheumatology. It was found that over 40% of the RA patients significantly improved, but only 4% of the non-vegan diet group improved.

Bromelain for Arthritis as a Natural Pain Relief Supplement

Bromelain is an enzyme produced by the pineapple plant family commonly used as arthritis natural pain relief and a supplement for inflammation. The most evidence for the use of bromelain is seen in studies which outline the treatment of osteoarthritis. For osteoarthritis of the knee, bromelain was used in studies at a dose of 540 to 1890 mg per day (6-8). Several studies did show equivalence to diclofenac, an NSAID, for osteoarthritis. Adverse effects of bromelain were mainly confined to mild gastrointestinal symptoms. Tablets with an enteric coating helps to reduce these side effects. Bromelain may have the potential to cause GI bleeding due to reduced prostaglandin synthesis much like NSAIDs. It may increase risk of bleeding and should not be taken by those with bleeding disorders or medications such as NSAIDs (ibuprofen and naproxen), warfarin (Coumadin), heparin, Plavix, ticlodipine, and aspirin.

Omega-3 Fish Oil for Arthritis Natural Pain Relief and Inflammation

Fish oil may improve arthritis natural pain relief as well as inflammation. Omega 3 fatty acids added to the diet results in a significantly lower number of tender and swollen joints in rheumatoid arthritis (14). Maroon and Bost (9) evaluated the questionaire results of 125 subjects to assess how well fish oil compared to non-steroidal anti-inflammatory drugs (NSAIDSs) can control of their neck and back pain. Patients took omega-3 fish oil at doses of 1200-2400 mg daily for an average of 75 days. Out of the subjects that responded, 59% stopped taking NSAIDSs, 60% noted lesser degree of joint pain, 60% had lower pain overall,  and 80% expressed they had favorable results. A total of 10 studies were reviewed by Villani AM et al (10) to determine potential serious adverse effects of fish oil at a dose of under 1.86 grams per day. It was found that there were no serious adverse effects reported in 994 adults over 59 years of age and other non-serious adverse effects were not significantly different from placebo (5).

Fish oil may contain harmful contaminants such as heavy metals including mercury, dioxins, and polychlorinated biphenyls (PCBs). This risk can be reduced by purchasing fish oil that has undergone a purification process specified on the label (approved by the FDA, EPA, or US Pharmacopeia) (11). The label should state “purified or distilled to remove mercury and PCBs.” Consumption should be avoided when taking anticoagulants like aspirin, warfarin, or ticlopidine because of the potential increased risk of bleeding. Read more about omega 3. Vegetarians may use flax seed oil in place of fish oil but the benefit may not be as significant. Flax seed oil is known to reduce C-reactive protein and has anti-inflammatory benefits (15).

Ashwagandha for Arthritis as a Natural Pain Relief Supplement

Ashwagandha may be beneficial for arthritis natural pain relief as a supplement for inflammation control. Ramakanth GS et al (12) studied the use of Withania somnifera (Ashwagandha) for knee pain in a randomized, double blind placebo controlled study. Sixty subjects with knee pain were randomized to 125 mg of Ashwagandha aqueous extract, 250 mg of Ashwagandha aqueous extract, or a placebo.  The groups were tested after 12 weeks with the Western Ontario and McMaster Universities Arthritis Index (WOMAC) and the Knee Swelling Index (KSI). After 12 weeks, both of the Ashwagandha groups had lower amounts of pain, stiffness, and disability. The response to the treatment was seen the earliest in the group taking the 250 mg dose of Ashwagandha at 4 weeks. There were no gastrointestinal side effects in the study.

Turmeric and Curcumin for Arthritis as a Natural Pain Relief Supplement

A study evaluated 45 people with rheumatoid arthritis. The subjects received 8 weeks of curcumin at a dose of 500 mg daily. This treatment resulted in the same reduction of swelling and pain as the prescription drug diclofenac sodium at a dose of 50 mg (13).

Cat’s Claw for Arthritis as a Natural Pain Relief Supplement

Cat’s claw is available as a preparation from 2 species, Uncaria tomentosa and Uncaria guianensis and is used in arthritis natural pain relief and supplements for inflammation. Uncaria guianensis has the greater antioxidant potency. Rosenbaum’s literature review (12) described the use of Cat’s claw for osteoarthritis. The study included 45 men who randomly received 100 mg daily or placebo for 4 weeks. For those taking cat’s claw, significant improvements were found compared to placebo for pain on activity, overall patient pain assessment, and overall physician pain assessment. No significant differences were found for pain at rest or for pain at night.

Glucosamine Natural Pain Relief as a Supplement for Inflammation

Glucosamine is promoted for arthritis natural pain relief and is in supplements for inflammation. A study by Mehta K et al (19) included glucosamine sulfate at a dose of 1500 mg per day for 8 weeks. Subjects were assessed using the Western Ontario and McMaster Universities Arthritis Index (WOMAC) which uses five different scores to rate pain and stiffness.  By 8 weeks, 89% of the subjects taking this supplement experienced at least a 20% reduction in pain scores.

Boswellia for Arthritis Natural Pain Relief and Supplements for Inflammation

Several health products are available which contain Boswellia extracts for arthritis natural pain relief and supplements for inflammation. Ammon HP (20) reviewed the scientific basis for potential therapeutic effects of Boswellia extract. Boswellia plant species contains a resin extract which contains boswellic acids. These acids possess anti-inflammatory effects by reducing the production of leukotrienes and prostaglandins. Boswellic acids have been found in research to lower markers of inflammation including C3 complement, interleukin-1,interleukin-2,interleukin-6, interferon gamma, and tumor necrosis factor. Boswelia extracts have been studied to show promise in asthma, rheumatoid arthritis, osteoarthritis, ulcerative colitis, and Crohn’s disease. The rate of side effects was reported to be low. These include gastrointestinal symptoms and rare allergies.

References for Arthritis Natural Pain Relief and Supplements for Inflammation:
1.Trinh K, Graham N, Gross A, Goldsmith C, Wang E, Cameron I, Kay T. Acupuncture for neck disorders. Spine (Phila Pa 1976). 2007 Jan 15;32(2):236-43.http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD004870.pub3/abstract
2.Brinkhaus B, Witt CM, Jena S, et al. Acupuncture in patients with chronic low back pain: a randomized controlled trial. Arch Intern Med 2006 Feb 27;166(4):450-7.http://www.ncbi.nlm.nih.gov/pubmed/16505266
3.Witt CM, Jena S, Brinkhaus B, Liecker B, Wegscheider K, Willich SN. Acupuncture in patients with osteoarthritis of the knee or hip: a randomized, controlled trial with an additional nonrandomized arm. Arthritis Rheum. 2006 Nov;54(11):3485-93.http://www.ncbi.nlm.nih.gov/pubmed/17075849
4.Kwon YD, Pittler MH, Ernst E. Acupuncture for peripheral joint osteoarthritis: a systematic review and meta-analysis. Rheumatology (Oxford). 2006 Nov;45(11):1331-7. Epub 2006 Aug 27.http://www.ncbi.nlm.nih.gov/pubmed/16936326
5.Manheimer E, Linde K, Lao L, Bouter L M, Berman B M. Meta-analysis: acupuncture for osteoarthritis of the knee. Annals of Internal Medicine 2007; 146(12): 868-877. http://www.ncbi.nlm.nih.gov/pubmed/17577006
6.Brien S, Lewith G, Walker A, Hicks SM, Middleton D. Bromelain as a Treatment for Osteoarthritis: a Review of Clinical Studies. Evid Based Complement Alternat Med. 2004 Dec;1(3):251-257. Epub 2004 Oct 6. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC538506/
7.Klein G, Kullich W, Schnitker J, Schwann H. Efficacy and tolerance of an oral enzyme combination in painful osteoarthritis of the hip. A double-blind, randomized study comparing oral enzymes with non-steroidal anti-inflammatory drugs. Clin Exp Rheumatol 2006;24:25-30. http://www.ncbi.nlm.nih.gov/pubmed/16539815
8.Cirelli MG, Smyth RD. Effects of bromelain anti-edema therapy on coagulation, bleeding, and prothrombin times. J New Drugs 1963;3:37-39.
9.Maroon JC, Bost JW. Omega-3 fatty acids (fish oil) as an anti-inflammatory: an alternative to nonsteroidal anti-inflammatory drugs for discogenic pain. Surg Neurol. 2006 Apr;65(4):326-31. http://www.ncbi.nlm.nih.gov/pubmed/16531187
10.Villani AM, Crotty M, Cleland LG, James MJ, Fraser RJ, Cobiac L, Miller MD. Fish oil administration in older adults: is there potential for adverse events? A systematic review of the literature. BMC Geriatr. 2013 May 1;13(1):41.http://www.ncbi.nlm.nih.gov/pubmed/23634646
11.Bays HE. Safety considerations with omega-3 Fatty Acid therapy. Am J Cardiol. 2007;99(6A):S35-43. http://www.ncbi.nlm.nih.gov/pubmed/17368277
12.Ramakanth GS, Uday Kumar C, Kishan PV, Usharani P. A randomized, double blind placebo controlled study of efficacy and tolerability of Withaina somnifera extracts in knee joint pain. J Ayurveda Integr Med. 2016 Jul – Sep;7(3):151-157. https://www.ncbi.nlm.nih.gov/pubmed/27647541
13.Chandran B, Goel A. A randomized, pilot study to assess the efficacy and safety of curcumin in patients with active rheumatoid arthritis. Phytother Res. 2012 Nov;26(11):1719-25. http://www.ncbi.nlm.nih.gov/pubmed/22407780
13.Rosenbaum CC. Antioxidants and anti-inflammatory dietary supplements for osteoarthritis and rheumatoid arthritis. Alternative Therapies in Health and Medicine. 2010 Mar-Apr;16(2):32-40. https://www.ncbi.nlm.nih.gov/pubmed/20232616 
14.Adam O, Beringer C, Kless T, Lemmen C, Adam A, Wiseman M, Adam P, Klimmek R, Forth W.Anti-inflammatory effects of a low arachidonic acid diet and fish oil in patients with rheumatoid arthritis. Rheumatol Int. 2003 Jan;23(1):27-36. Epub 2002 Sep 6. https://www.ncbi.nlm.nih.gov/pubmed/12548439
15.Lemos JR, Alencastro MG, Konrath AV, Cargnin M, Manfro RC. Flaxseed oil supplementation decreases C-reactive protein levels in chronic hemodialysis patients. Nutr Res. 2012 Dec;32(12):921-7. https://www.ncbi.nlm.nih.gov/pubmed/23244537
16.Hermsdorff HH, Zulet MA, Abete I, Martinez JA. A legume-based hypocaloric diet reduces proinflammatory status and improves metabolic features in overweight/obese subjects. Eur J Nutr 2011 Feb;50(1):61-9. Epub 2010 May 25. http://www.springerlink.com/content/9m645tr105424g3n/?MUD=MP
17.Garrett Smith. Nightshades. The Weston A. Price Foundation. 
18.Hafström I, Ringertz B, Spångberg A, von Zweigbergk L, Brannemark S, Nylander I, Rönnelid J, Laasonen L, Klareskog L. A vegan diet free of gluten improves the signs and symptoms of rheumatoid arthritis: the effects on arthritis correlate with a reduction in antibodies to food antigens. Rheumatology (Oxford). 2001 Oct;40(10):1175-9. https://www.ncbi.nlm.nih.gov/pubmed/11600749
19.Mehta K, Gala J, Bhasale S, Naik S, Modak M, Thakur H, Deo N, Miller MJ. Comparison of glucosamine sulfate and a polyherbal supplement for the relief of osteoarthritis of the knee: a randomized controlled trial [ISRCTN25438351]. BMC Complement Altern Med. 2007 Oct 31;7:34. https://www.ncbi.nlm.nih.gov/pubmed/17974032
20.Ammon HP. Boswellic Acids and Their Role in Chronic Inflammatory Diseases. Adv Exp Med Biol. 2016;928:291-327. https://www.ncbi.nlm.nih.gov/pubmed/27671822
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