Relieve Your Arthritis Pain At Home With These 3 Simple Tips!

What is it?

There are many forms of arthritis that can lead to the classic presentation of achy, swollen joints, however the form we tend to see the most of is Osteoarthritis or OA. OA is also know as the "wear and tear" type of arthritis. What this means is that over time the slippery cartilage that meet on each side of your joints and keep them gliding across one another painlessly has been damaged from an injury or worn out over time. Either way, what is left is a surface that is no longer smooth, and articulating bones that may now be exposed to one another. What results is pain and inflammation. 

Who is affected?

Due to the nature of OA, the population that is most commonly affected are those over the age of 65. This is simply due to the fact that this group of people have had more time for their joints to wear against one another throughout their lives. That being said, OA can affect people of any age and is seen more so in people who have previously injured the affected joint, obese individuals (from increased stress of additional weight on certain joints) and those who have overused a specific joint (think baseball pitchers or sprinters). 

What joints are affected?

Typically OA is a one sided condition where the pain and damage to the joints affects only one joint on one side of the body. This is not always true, multiple joints can be affected, however the distribution is usually not symmetrical. Symmetry in diseased joints may be indicative of other forms of arthritis, Rheumatoid arthritis being the most common of these. The joints that are usually involved in OA include the hips, knees, fingers, feet and spine.

What are the symptoms?

Pain and stiffness are the most commonly reported symptoms of OA. Particularly morning stiffness that improves with motion throughout the day is very common. Swelling, heat and redness around affected joints is also fairly common especially after prolonged use of the joint. Other symptoms include a grating sensation with audible crackling or popping sounds (referred to medically as "Crepitus"), bony growths at affected finger joints, and even difficulty grasping or holding objects due to weakness or pain. 

How can you help yourself?

Fortunately there are things you can do at home to help relieve some of the pain. Before any home treatments are initiated however, I do recommend confirming the diagnosis with your doctor and working together to treat the pain and prevent further erosion. That being said, here are my top 3 tips for helping resolve arthritic pain at home:

1. Reduce weight - If arthritis is affecting your hips, knees or feet and you are carrying around a few extra pounds, no other intervention will make as immediate an impact as a moderate reduction in weight. If done safely and slowly, it can take that extra stress off your joints, reducing pain and increasing your ability to begin and maintain a steady exercise routine. For more tips on weight loss read my 7 Tips For Successful Weight Loss.
2. Warm water pool exercises - Whether you're only able to walk or you can swim full lengths, nothing beats warm water pools as an effective pain relief method when it comes to arthritis. The buoyancy takes the weight and stress off your joints while the heat soothes and calms them. This, combined with gentle exercise to strengthen the surrounding muscles will have you feeling pain free and more mobile  in no time!
3. Castor Oil - When applied topically to the affected joint, castor oil is an excellent anti-inflammatory intervention. It is absorbed into the skin and provides pain relief that is comparable to NSAIDs [1] (the standard drug prescribed) without any of the harmful side effects. 

How can your naturopath help you?

In addition to these at home pain relief techniques, Naturopathic Doctors can use various modalities to suite your specific needs in accomplishing your pain management goals. Modalities such as acupuncture, hydrotherapy, nutraceuticals, botanical medicines and the ever emerging prolotherapy and PrP techniques can all offer additional and complimentary benefits to the treatments you may already be undergoing. Remember not to try to tackle any condition without the help of a registered professional, instead, work with them in coming up with a treatment that works best for you!

Rob Raponi CISSN, B.Kine,
Naturopathic Graduate
www.msknaturopathic.com

1. Medhi, B., et al. "Comparative clinical trial of castor oil and diclofenac sodium in patients with osteoarthritis." Phytotherapy research 23.10 (2009): 1469-1473.

How Sugar Can Help With Your Pain - Prolotherapy

What do arthritis, tendinitis/tendinosis, and low back pain have in common? Well aside from low back pain they can affect many different areas of the body and they are all quite difficult to effectively treat. Currently, the standard of care for most of these is a watch and wait approach (wait around and see if it gets better on it's own), corticosteroid injections (which effectively deal with pain management but little else), or physiotherapy (helpful, but has it's limitations). The majority of these approaches are effective at dealing with pain in these conditions but do not really help in the healing of the damaged tissues. Even the pain management seems to be somewhat short lived.

Enter prolotherapy. In short, it is an injection based therapy where a solution of sugar (hypertonic dextrose) is introduced into the area of pain. From here on out the exact reason for how this works is a bit unclear but the strongest theory is that this causes inflammation to the area which then in a way, forces the body to begin to heal a part of itself in which it essentially has forgotten about. Now this isn't the same type of inflammation you get during an allergic reaction or cut on your skin, rather it's quite mild and only serves to reactivate the healing process.

So here we have an alternative to the current standards of care but how does it stack up when compared against them? Quite well actually. Research has shown that not only is prolotherapy comparable to corticosteroid injections for reducing pain, but it can also return the individual to proper function and strength quicker. Additionally, the effects it has last over a longer period of time than any of the comparable treatments! So it works as effective or better than the current treatments, and it's effect lasts longer.. too good to be true? No, not really. I mean as long as you're ok with needles, the only side effect seen after treatment is some soreness at the site of injection. That's pretty incredible considering the alternatives. And just to be clear, I'm not against the standards of care in any way, they are the standards for a reason. I just think it's important to have choice and know all the options before receiving a treatment.

So why is prolotherapy not more widely known and used? Well, if you live in Ontario or many other provinces and states across North America, prolotherapy is not actually allowed to be practiced by Medical or Naturopathic doctors. Because the research coming out is so new and the participant sizes in the studies are relatively small, many governing bodies are hesitant to allow prolotherapy to flourish... for now. With a growing body of research supporting it's uses and relatively no negatives against it, it may only be a matter of time before it makes it's way into more of North America.

Who knew sugar could be so good?

Rob Raponi, CISSN, B.Kine,
Naturopathic Intern
www.msknaturopathic.com


For those interested in learning more, feel free to read up on some of the research:

References

1. Rabago, David, et al. "Hypertonic dextrose and morrhuate sodium injections (prolotherapy) for lateral epicondylosis (tennis elbow): Results of a single-blind, pilot-level randomized controlled trial." American journal of physical medicine & rehabilitation/Association of Academic Physiatrists 92.7 (2013): 587. 
2. Bernard, BP. Musculoskeletal disorders and workplace fractures: a critical review of the epidemiological evidence for work-related musculoskeletal disorders of the neck, upper extremity and low back. National Institute for Occupational Safety and Health; Washington D.C.: 1997. NIOSH Publication 97-141 
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17. Green S, Buchbinder R, Barnsley L, Hall S, White M, Smidt N, et al. Non-steroidal anti- inflammatory drugs (NSAIDs) for treating lateral elbow pain in adults. Cochrane Database Syst Rev. 2001;(4):CD003686. 
18. Smidt N, Assendelft WJ, van der Windt DA, Hay EM, Buchbinder R, Bouter LM. Corticosteroid injections for lateral epicondylitis: a systematic review. Pain. 2002;96:23–40. 
19. Bisset L, Paungmali A, Vicenzino B, Beller E. A systematic review and meta-analysis of clinical trials on physical interventions for lateral epicondylalgia. Br J Sports Med. 2005;39:411–22. 
20. Chang, Wen-Dien, Ping-Tung Lai, and Yung-An Tsou. "Analgesic Effect of Manual Acupuncture and Laser Acupuncture for Lateral Epicondylalgia: A Systematic Review and Meta-Analysis." The American journal of Chinese medicine 42.06 (2014): 1301-1314. 
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22. Røe, C., et al. "[No effect of supplement of essential fatty acids on lateral epicondylitis]." Tidsskrift for den Norske laegeforening: tidsskrift for praktisk medicin, ny raekke 125.19 (2005): 2615-2618. 
23. Chesterton, Linda S., et al. "Transcutaneous electrical nerve stimulation as adjunct to primary care management for tennis elbow: pragmatic randomised controlled trial (TATE trial)." BMJ 347 (2013): f5160. 
24. Buchbinder, Rachelle, et al. "Systematic review of the efficacy and safety of shock wave therapy for lateral elbow pain." The Journal of rheumatology 33.7 (2006): 1351-1363. 
25. Rabago, David, Andrew Slattengren, and Aleksandra Zgierska. "Prolotherapy in primary care practice." Primary Care: Clinics in Office Practice 37.1 (2010): 65-80. 
26. Maynard JA, Pedrini VA, Pedrini-Mille A, Romanus B, Ohlerking F. Morphological and biochemical effects of sodium morrhuate on tendons. Journal of Orthopaedic Research. 1985;3:236–248. 
27. Jensen, Kristina T., et al. "Response of knee ligaments to prolotherapy in a rat injury model." The American journal of sports medicine 36.7 (2008): 1347-1357. 
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