Arthritis

DISEASE DESCRIPITON

About 50 million people in the United States suffer from some form of arthritis. For more than 20 million of these people, the symptoms are severe enough to cause them to seek medical attention.

Arthritis is not a single disease. The name arthritis means an inflammation of one or more joints. Arthritis is an inflammation of the joints usually caused by wear and tear; injury, or infection. Some are genetic. Its causes and consequences are many and varied. The inflammation is often accompanied by pain, swelling, redness and motion limitation. X-rays may show horrifying damage to the joints of people who feel no pain at all, or they may show relatively little damage in people who feel great pain.

There are more than 100 types of arthritis. There's osteoarthritis, rheumatoid arthritis, gouty arthritis, psoratic arthritis, juvenile rheumatoid arthritis, bursitis, systemic infectious arthritis, arthritis associated with a venereal disease and many others. The most common types of arthritis are osteoarthritis, rheumatoid arthritis, and gout.

Osteoarthritis, also known as degenerative arthritis or wear-and-tear-arthritis, refers to the pain and inflammation that can result from the systematic loss of bone tissue in the joints. It is the most common form of arthritis especially in the elderly.

Rheumatoid Arthritis, also known as rheumatism or synovitis, tends to affect people over 40. Women get this two to three times as frequently as men. It is characterized by inflammation and pain in the hands, especially the knuckles and second joints, as well as in the arms, legs and feet, and by the general fatigue and sleeplessness. Organs such as the eyes and lungs may become inflamed as well.

Gout usually occurs in men over 40 and is caused by the elevated blood levels of uric acid, which forms crystals in the joints. The immune system reacts to these crystals as if to a foreign invader. The joint, as a result, becomes inflamed and painful.

Signs and symptoms of Arthritis

The four "cardinal signs" of arthritis are:

Pain
Swelling
Redness and
Limitation of motion.

All four don't have to be present at once, although they may be. Other possible warning signs of arthritis include:

Early morning stiffness
Warmth in a joint
Weakness combined with joint pain
Increased pain when the weather changes
Unexplained fever
"Cracking" sounds when moving joints

Types of Arthritis

Osteoarthritis:

Joint pain that is made worse by movement.
Stiffness in the morning
Knobby growths on the joints of the fingers
Pain and progressive stiffness without noticeable swelling, chills, or fever during normal activities probably indicate the gradual onset of osteoarthritis.

Rheumatoid arthritis:

Painful, red, swollen joints that may feel warm.
Low fever, loss of appetite, and weight loss; feeling "sick all over".
Stiffness in the morning.
Skin lumps, usually on the elbows, fingers and buttocks.
Dry eyes and mouth.
Painful swelling, inflammation, and stiffness in the arms, legs, wrists, or fingers in the same joints on both sides of the body, especially on awakening, may be signs of rheumatoid arthritis.

Gout:

Severe, sudden pain in a joint, often the wrist, big toe, or knee.
Redness, swelling around joint.
Fever.

Infectious Arthritis: Fever, joint inflammation, tenderness, and sharp pain, sometimes accompanied by chills and associated with an injury or another illness, may indicate infectious arthritis.

Juvenile Rheumatoid Arthritis: In children, intermittent fever, loss of appetite, weight loss, anemia, or blotchy rash on the arms and legs may signal juvenile rheumatoid arthritis.

Causes of Arthritis

Arthritis is caused by a variety of factors, including:

Joint instability
Age-related changes
Altered biochemistry
Hormonal factors
Genetic predisposition
Environmental factors
Psychological factors
Stress - Stress disrupts the body's hormonal balance. Stress- induced cortisone deficiency can be a factor in some forms of arthritis. When stress occurs, body systems release adrenalin and cortisone, a process that weakens the immune system. As a result, bacteria and other detrimental organisms such as Candida albicans spread throughout the body.
Arthritis And Dental Amalgams - Arthritic symptoms are often found to be associated with mercury dental amalgams. It was found that once the amalgams are removed, the symptoms of arthritis usually disappear.

Standard Medical Treatment Osteoarthritis afflicts the weight-bearing joints: the knees, hips, and spine. It causes the cartilage in the joints to degenerate. It often manifests after an injury or from repetitive physical tasks that place excess stress upon joints. Rheumatoid arthritis is the most severe type of inflammatory joint disease. It is an autoimmune disorder in which the body's immune system attacks and damages joints and surrounding soft tissue. There is no cure for arthritis, especially if the bone or cartilage has deteriorated. While arthritis medications may help many people, they can have severe side effects, including immune system suppression, intestinal bleeding, nausea, abdominal pain, diarrhea, depression, headaches and elevated blood pressure.

Standard Western medical treatment for arthritis consists of:

Nonsteroidal anti-inflammatory drugs (NSAIDs), such as aspirin, Advil (ibuprofen) and Orudis (ketoprofen).
Oral steroids, such as prednisone and hydrocortisone.
Powerful painkillers, such as codeine, and synthetic narcotics, such as Vicodin.
Antirheumatic medications, such as gold injections, an immune system suppresser named Methotrexate and an antimalaria drug called Plaquenil. (See details below.)
Ultrasound.
Heat therapy.
Surgery to "clean up" ends of bones.
Supervised exercise program: For mild to moderate arthritis, a supervised exercise program may be prescribed to improve joint function without aggravating the situation.
Injection of synthetic corticosteroids into the most affected joint spaces. This helps to minimize the use of oral forms of these drugs, which have a greater risk of causing such systemic effects as fluid retention and suppression of adrenal and immune function.
Joint-replacement surgery: If destruction progresses to the point that pain or lack of mobility becomes unbearable, joint-replacement surgery may be recommended.
For rheumatoid arthritis, alternating applications of heat and cold, alternating rest and exercise therapies, and splints and other assistive devices may be prescribed
Methotrexate (Rheumatrex) is a cancer chemotherapy drug that inhibits the synthesis of DNA, thus interfering with cell replication, particularly in fast-growing cells. Why it helps people with rheumatoid arthritis is not known, but it can be effective within about a month of treatment, sometimes highly so.
Caution:

Methotrexate is highly toxic. It can cause bone-marrow suppression, liver damage, and severe lung damage, and other serious side effects. Its use must be very closely monitored by a physician experienced with this kind of therapy.
Gold salts: These are most often administered by injection. They are sometimes used to treat rheumatoid arthritis if other drugs have failed.
Examples:

aurothioglucose (solganal) gold sodium thiomalate (Myochrysine) auranofin (Ridaura). Mode of action is unknown. About half the people who receive this treatment experience improvement, but they rarely improve completely, and side effects are not uncommon.
Caution:

This may cause side effects such as suppression of the bone marrow resulting in blood abnormalities, kidney damage, liver damage, lung damage, colitis, rashes, skin pigment changes, itching, nausea, and nerve damage.
The antimalarial drug hydroxychloroquine (Plaquenil) also is used in some cases of rheumatoid arthritis. The reason for this drug's effect on rheumatoid arthritis is not understood. It results in improvement in fewer than half the cases treated and can take up to 6 months for effect; however, it is considered less toxic than some other drugs used for this condition.
Side effects:

skin rash, itching, hair loss, skin pigment changes, nausea, weight loss, blood abnormalities, and irreversible vision damage.
Penicillamine (Cuprimine, Depen) - A chelating agent that may be prescribed for some people with severe rheumatoid arthritis.
Side effects:

Side effects are common. Up to half of those who take penicillamine may experience adverse effects, including blood abnormalities, kidney damage, autoimmune disorders, rashes, mouth ulcers, and loss of the sense of taste.
Sulfasalazine (Azulfidine) is a common second-line drug tried for rheumatoid arthritis due to its potential toxicity. Blood counts should be taken frequently, as blood abnormalities are frequent.

Experimental treatments deliberately aimed at suppressing the immune system:

These involve the use of such agents as cyclophosphamide (Cytoxan) or chlorambucil (Leukeran). These are cancer chemotherapy drugs with extremely powerful and serious effects. Side effects can be severe, including blood abnormalities, bone-marrow suppression, serious lung disease, and cancer.
Fish-oil and oral cartilage supplements.
Some women experience arthritic symptoms around the time of menopause. If this happens to you, consult with your gynecologist or other health-care practitioner. Often, balancing a woman's hormones can quickly reduce these aches and pains.

Recommended Nutrition for Arthritis

Beta carotene. Plenty of beta carotene from yellow and orange vegetables and fruits and green leafy vegetables. At least one serving of a beta-carotene-rich food every day.
B complex. Use one that contains 50 mg of the major B vitamins. Take twice a day. B vitamins can also be found in whole grains, dried beans and legumes such as split peas and lentils.
Niacin. 25 mg of this form of vitamin B3, three times a day. Food sources include barley, buckwheat, split peas and whole grains.
Vitamin C. Up to 1,000 mg three times a day with meals, to start. Good sources of vitamin C include citrus fruits, cantaloupe, broccoli and Brussels sprouts.
Vitamin E. 400 mg of vitamin E in the form of D-alpha tocopherol with breakfast, and the same with lunch. Vitamin E can also be found in wheat germ, nuts and green leafy vegetables.
Selenium. 200 micrograms a day. Selenium is also found in almonds, barley and oranges.
Zinc. 220 mg of zinc sulfate a day. Take twice a day if arthritis is flaring up. Sources of zinc include turnips, corn and oysters.

Keep your joints flexible For all types of arthritis, regular exercise is important to keep the joints mobile. The exercises can be as simple as walking or riding a bicycle. Other simple exercises include lifting your arms above your head several times to the front and several times to the sides, rotating your arms in circles at your sides, twisting at the waist from side to side and reaching over to touch your knees or toes. Many simple but beneficial exercises can be done while sitting in a chair or lying in bed. Yoga also helps to improve flexibility.

Massage. A gentle massage with some warm oil over the affected joints once or twice each day for a few minutes can help relieve pain,

Vitamin C. Some experts believe vitamin C can help heal arthritis. Try taking about 500 mg. over the course of the day for a week or so, preferably not on an empty stomach, and see if it helps. If you feel it might be aggravating your condition, discontinue.

Visualize your joints move Use the power of the mind/body connection to "see" your pain go away. Practice "seeing" yourself healthy for 20 minutes, three times a day.

Relax. Pain tends to worsen with stress and tension. Most pain can be lessened by relaxing.

Sit with eyes closed and take five slow, deep breaths.
Keep your eyes closed and allow your breathing to return to normal, but follow it with your attention, "watching" the inhalation and exhalation.
Sit quietly watching the breath for 10 to 20 minutes. Open your eyes but sit another minute or two before standing up.
Wash painful areas with apple cider vinegar water. Mix 1 part apple cider vinegar to 6 parts water.
Spread quark on the painful area and cover with gauze.
Heat coarse salt in a frying pan (no oil), put in cotton cloth and place warm on the painful area.
Mix three boiled potatoes (in skin) with 2 tbsp. bran. Place on joints for fifteen minutes.
Cornmeal porridge is excellent as a poultice since it remains hot for a long time. Apply as hot as you can bear it.
Mix clay with hot water to make a thick paste and place on the painful area for thirty minutes.
Fill a soap dish with water, and place in the freezer to make an ice-block to rub on painful areas.
Diet plays an important role in arthritis. A diet high in proteins and saturated fats aggravates arthritis. A vegetarian diet is often beneficial for arthritis sufferers.
Food allergies and sensitivity to environmental toxins are problems in individual arthritis cases. Avoid toxins of all kinds including alcohol, cigarettes and coffee.
Some people find that copper bracelets are effective against rheumatoid arthritis.
With osteoarthritis, do gentle exercises to strengthen muscles to hold joints in place.
At night use a linen comforter (duvet) cover filled with equal parts of dried thyme, hyssop, sage and rue. Do not sleep in feather beds. Feathers do not breathe, and retain dampness. Use sheep fleece to line the mattress. Use sheep wool for comforters. Wear fleece- lined (sheepskin) slippers to fend off dampness

TMC

Acupressure

Stiff, achy joints can be relieved with daily acupressure treatments. Acupressure improves blood circulation for rheumatic conditions. To soothe discomfort in the neck and lessen the general irritability that arthritis pain can cause, use your thumbs to press both GB 20 points. These points are situated below the base of the skull, two inches out from the middle of your neck. Press for one minute. Work on these points regularly, several times each day, in combination with other therapies. The GB 20 point is a good overall pain-relieving point and is one of the several anti-inflammatory points. (other points are given below.)

Acupressure Points For elbow and wrist pain: LU 5, PC 3, HT 7, PC 7, LU 9, TW 10, LI 11, LI 5, TW 4 For ankle pain: SP 5, KI 3, ST 41, UB 60

Acupuncture Points

For arthritis of jaw: ST 7, SI 19, TW 17, LI 4

For arthritis of vertebrae: M-BW-35 (yiayi) corresponding to area of pain, UB 51, UB 40, GV 26

For arthritis of shoulder: LI 15, TW 14, M-VE-48 (yianneiling), SI 11, TW 3, GB 34

For arthritis of elbow: LI 11, TW 10, LI 4

For arthritis of wrist and metacarpal fingers:TW 5, 11 10, 11 5, TW 4

For arthritis of lumbosacral: GV 3, M-BW-25 (Shigizhuixia), UB 30, UB 26, UB 40, UB 60

For arthritis of sacroiliac: UB 27, UB 28, local sore points

For arthritis of hip: GB 29, GB 30, GB 34, GB 39

For arthritis of knee: M-LE-27 (heding), M-LE-15 (xixia), ST 35, ST 34, ST 36, GB 34, SP 9

For arthritis of ankle: ST 41, GB 40, GB 41, K 3, UB 60, GB 35, K 8

For arthritis of metatarsophalangeal: M-LE-41 (shangbafeng), SP 4, UB 65, GB 38, SP 5

Ear points: Sympathetic NeurogatePoints of tenderness corresponding to region of pain in body.

Frequency of Treatment: Daily treatment is required if you are suffering from acute arthritis. For chronic problems, treatment may be given every other day.

Types of Arthritis from Oriental Medicine Perspective

Xing Bi. With this "migratory" arthritis, the pain moves around the body. It's caused by wind, dampness and cold invading and obstructing the chi (energy) and blood circulation. The patient is often thin, dislikes wind and has a white coating to the tongue.
Tong Bi. In this "painful" type of arthritis, severe pain stays in place at one or more joints. It's caused by excessive cold, which slows the circulation of chi and blood. It's made worse by cold and lack of movement, but feels better with heat. There is typically no inflammation or redness at the afflicted joint.
Zuo Bi. This is a "fixed" type of arthritis characterized by dampness and internal stagnation, in which the afflicted parts of the body become heavy and numb. The tongue typically has a greasy white coating, and the pain is worse on rainy and cloudy days.
Re Bi. Caused by the conversion of pre-existing problems into heat, this "hot" arthritis produces swelling, tenderness and sharp pain in one or more joints. The patient's tongue is typically covered with a dry yellow coating, and the pulse is "slippery" and fast.

TREATMENT

Ashi points together with the local and distal along the yang meridians supplying the diseased areas

Treatment based on pattern

Pattern	Symptoms	Treatment
Wind Bi (Wandering Bi)	Mild pain of joints and muscles that is wandering or moving Some limited motion Chills and fever Aversion to wind Stiffness and tightness in muscles T: Thin white coat P: Floating	Expel wind, open channels, dispel cold, transform damp Treat using reducing method Pts: LI4, GB20, UB12, DU14 + local pts Upper Body GB20, Lower Body GB31 Upper Limbs SJ5, Lower Limbs UB60 Formula: Fang Feng Tang
Cold Bi (Painful Bi)	Pain and severe soreness of joints and muscles Fixed location Limited range of motion Pain worse with cold, better with heat T: Thin white coat P: Tight, wiry	Warm the channels, dispel cold Use moxa, use deep needle insertion and prolonged retention of needles; if severe pain indirect moxa with ginger Pts: Moxa REN4, REN6, UB 23, DU4 + local pts Formula: Wu Tou Tang
Damp Bi (Fixed Bi)	Pain is severe, constant, fixed, with heavy sensation Numbness and heaviness of the joints Heavy sensation in the skin and muscles Swelling Limited range of motion T: Greasy white coat P: Thin and soggy	Drain damp, open channels, dispel wind & cold Moxa or warming needle or tapping plus cupping Pts: ST36, SP5 +local pts Upper Limbs SP9, Lower Limbs SJ3 Formula: Yi Yi Ren Tang
Heat Bi	One or more joints will be red, swollen, hot, painful Limited range of motion Pain worse with heat and pressure, better with cold Aversion of heat Fever Thirst T: Dry yellow coat P: Rapid Slippery	Clear heat, open channels, expel wind & damp Treat using reducing method Pts: DU 14, LI11 + local pts Formula: Bai Hu Jia Gui Zhi Tang

Ashi points together with local and distal points along yang meridians for the purpose of eliminating wind, cold and damp.

After determining the "type" of arthritis, the Oriental medicine practitioner tries to relieve the symptoms and to strengthen the body. A combination of herbs and spices, diet, acupuncture, "ear acupuncture" and other therapies are used, as necessary.

Herbs and Spices

A variety of herbs and spices are used. The actual herb used and the quantity and frequency will depend upon the condition of the person being treated. Dried ginger is a popular herb in oriental medicine. It is a hot substance that warms the intestines while toning the stomach, lungs and spleen.

Very often combinations of herbs are used. Some of the herbal formulas that are useful to treat arthritis

Diet

The following foods are useful for arthritis:

Black soybean - increases blood circulation. Useful for rheumatoid arthritis.
Cherry - useful to treat rheumatism.
Grape - Increases energy while strengthening the lungs, spleen and kidneys.
Papaya - Useful for rheumatoid arthritis
Royal jelly - Useful for rheumatoid arthritis.

ArthritisLinda MarinoApril 18, 2014