Drug-free pain relief for osteoarthritis

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Alternative therapies for arthritis relief

Drs. Siegel and Samadi on new approaches

Osteoarthritis is the most common joint disease affecting over 20 million individuals in the US alone. The Centers for Disease Control and Prevention (CDC) estimates the annual health care costs of the disease is upwards of $128 billion. In recent years this figure has grown, mostly due to the increasing age of the population. The CDC projects that an additional 8 million people will be diagnosed in the next decade.

Arthritis refers to a group of conditions that result in joint pain. Most often, people are referring to osteoarthritis (OA) when they discuss arthritis. OA or degenerative joint disease is characterized by changes in the cartilage that normally sits between bones at the joint. Cartilage acts as a cushion between the bones, but as the cartilage wears away, the space between the bone narrows until the underlying bone is exposed. Pain eventually results from wear on the naked bone, as well as increased stress and fatigue of the muscles that support the joint.

Other types of arthritis include: rheumatoid arthritis, septic arthritis or crystal-induced arthritis. Rheumatoid arthritis is an autoimmune disorder, characterized by an irregular attack on the immune system on the lining of the joint.  As a result, the joint becomes inflamed and fluid builds up resulting in pain. This chronic disease can also result in damage of other organ systems.  Early treatment is key to preventing disability from this disease.

Similarly, septic, or infectious, arthritis benefits greatly from early diagnosis and treatment, how it represents a much more acute process. When a joint becomes infected, bacteria can quickly cause permanent damage to the tissue.

Crystal-induced arthritis, gout and pseudogout, is caused by crystal deposits within the joint which cause an inflator response and pain. Although the attacks are temporary at first, overtime, the deposits can result in permanent joint damage.

There is no single cause of OA, but rather, the condition is due to the accumulation of various stresses. For instances, those who are obese are at an increased risk. Not only does the extra weight translate into an increased load on your joints, but recent research suggests that body fat produces chemicals which appear to further harm the joint. Moreover, many individuals with chronic joint pain can usuallyrecall a specific injury or a history of overuse. Some jobs, like athletics, manual labor, machine operators and typists, have an increased risk of developing joint problems.

Thankfully, there are many ways to prevent damage and ease the pain of existing injury. Although pain medication can be helpful, I recommend non-pharmacologic interventions as first line treatment. Chronic use of over the counter pain medications can have consequences for your liver, kidneys and stomach, while not getting to the root of the problem.

Weight-loss, on the other hand, can greatly reduce the development of OA, as well as lessen pain. Research has shown that in obese patients, a 5 percent reduction in body weight significantly improves disability from OA.  The results are even better when combined with exercise. Despite the common perception that exercise worsens arthritis, in the absence of frank joint injury, this isn’t the case.  Particularly exercises like yoga, which incorporates physical stretching with deep breathing, help focus on the tendons and ligaments and are key to preserving joint health.

In addition to weight loss, changing your diet can help decrease systemic inflammation. For instance, studies have found ginger and turmeric to have powerful anti-inflammatory properties, while being very safe ingredients. At the same time cutting back on refined sugars can also reduce inflammation.

For pain relief, I advocate the use of acupuncture, as does the American College of Rheumatology. A popular Chinese medical practice, acupuncture is based on the principle of restoring balance by stimulating specific acu-points. In actuality, these acu-points are located near nerves. When stimulated a message is sent to the central nervous system resulting in the release of endorphins, a neurotransmitter that blocks the sensation of pain.  As with any therapy, however, it is important that acupuncture is performed by a qualified practitioner.

Dr. David B. Samadi is the Vice Chairman of the Department of Urology and Chief of Robotics and Minimally Invasive Surgery at the Mount Sinai School of Medicine in New York City. He is a board-certified urologist, specializing in the diagnosis and treatment of urological disease, with a focus on robotic prostate cancer treatments. To learn more please visit his websites RoboticOncology.com and SMART-surgery.com. Find Dr. Samadi on Facebook.