Joint Pain - alternative therapies and remedies

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A look at natural treatments for the condition.

Joint pain and issues with joints are extremely common problems that many among us deal with daily. Most of this is due to aging, because aging leads to a decrease in the synthesis of collagen, plus the loss of glycosaminoglycans, which are responsible for the integrity and health of tissues.[1] Other reasons for joint deterioration or chronic pain are conditions like Osteoarthritis. Over time, there have been many attempts to ease the pain that comes with ageing or these types of conditions, ranging from ancient herbal remedies to chemically medicinal products in modernity. Though nowadays the latter is more common, writing off natural aids completely may not be the best course of action. Recently there has been a lot of research into the benefits of some natural products to ease joint pain. This includes ingredients such as collagen bioactive peptides, chondroitin sulphate, glucosamine, L-carnitine, vitamins, and minerals, among others which will be looked at in more detail.[1]

Treatments

One of the most common compounds used as a treatment for joint pain is glucosamine. It is produced in the human body and is an essential component of cartilage.[2] Supplements containing glucosamine are among the most commonly used products for joint pain conditions like osteoarthritis, as most research suggests that glucosamine sulfate can improve symptoms of pain related to the condition, as well as slow the disease’s progression.[11] The experiments done into glucosamine’s pain killing role have been relatively recent, and as a result it has only been a common ingredient in supplements for a short while. Possibly the most important aspect of using glucosamine for joint pain is because it has been shown to be safe (as well as effective) within long term clinical trials, which is promising for its use over large periods of time for people currently suffering with pain.[11] Consequently, overall glucosamine is an effective product to use in order to reduce joint pain. 

Another compound that is commonly used for joints (and often in tandem with glucosamine) is chondroitin. Like glucosamine, it is naturally occurring within the body, and the compound chondroitin sulphate is essential for the structural and functional integrity of the joints.[2] Among its suggested properties include helping to maintain the viscosity in joints, stimulating cartilage repair and inhibiting enzymes that degrade cartilage.[2] Chondroitin has many similar uses to glucosamine, and their use together is thought to be more effective and beneficial than using either substance on its own. This is because the use of glucosamine and chondroitin is believed to create a symptomatic and preventive approach (since these compounds have the ability to maintain and rebuild cartilage), creating beneficial consequences on chronic joint pain.[2] A great benefit for these two treatments in particular is that they are widely and easily available in comparison to the other most used treatment, anti-inflammatory drugs.[2] Chondroitin and glucosamine are considered to be better tolerated and safer as well.[2] The general view of physicians is set out in the European League Against Rheumatism recommendations for the management for osteoarthritis, which include glucosamine and chondroitin as ‘symptomatic slow acting drugs for osteoarthritis which may modify the structure of cartilage’ (in a positive way).[2]

DHA, as an Omega-3 fatty acid, is also known to be effective in treating joint pain. Omega-3 has long been known as a beneficial health supplement, and is a common sight in pharmacies all over the world. However, as with the other ingredients in this list, extensive research has only been conducted into the properties of Omega-3 fatty acids over the last 25 years. The findings from those studies include those related to treating joint pain. For example, the most up to date investigations show that EPA and DHA (Omega-3 acids) produce novel anti-inflammatory lipids.[10] It is arguably because of this that Omega-3 polyunsaturated fatty acids (ω-3 PUFAs) have been used to treat joint pain associated with several inflammatory conditions.[10] In terms of practical application, in studies involving different groups looking at the ingredient’s effectiveness, patients receiving ω-3 PUFAs fared better than placebo for painful and/or tender joints.[10] This supports the hypothesis that ω-3 PUFA supplementation improves pain outcomes, particularly patient assessed pain, duration of morning stiffness, and painful and/or tender joints.[10] Therefore, overall, EPA/DHA supplementation reduces patient’s joint pain intensity, morning stiffness, painful and/or tender joints, and NSAID consumption.[10] The latter statement is rather important, as dependence on NSAIDs such as Ibuprofen can develop into an issue for some patients.

Herbal remedies are also thought to help with joint pain, and one of those is ginger. Ginger has a long tradition of medicinal use and has been used as an anti-inflammatory agent for musculoskeletal diseases (including rheumatism) in Ayurvedic and Chinese medicine for more than 2,500 years.[4,5] Pharmacologically, ginger - similar to other plants - is a very complex mixture of compounds.[6] Zingiber officinale contains several hundred known constituents, among them gingeroles, beta-carotene, capsaicin, caffeic acid, and curcumin.[6] The beneficial properties of these compounds are thought to be the reason why ginger is such versatile ingredient when it comes to medicine. One of the recent studies on ginger’s specific effect on joint pain found that a highly purified and standardized ginger extract had a significant effect on reducing symptoms of osteoarthritis of the knee, including pain after walking.[3] In other studies, ginger was found to be generally well tolerated when compared with placebo and Ibuprofen. The adverse effects associated with short-term ginger treatment were considered mild and predominantly gastrointestinal in nature.[7] As a result, the majority of the evidence suggests that ginger is safe and effective at reducing the severity of pain, and improving functional capacity in individuals with osteoarthritis or joint pain.[7]

Turmeric is also an often used herbal remedy. It has an extensive history, and over the centuries it has been used in cooking, as a dye, and in medicine. As a dye it has been used to colour the robes of monks and priests. The plant is well-known in Asian countries and now among western health communities as a sort of ‘wonder product’, as it contains so many beneficial properties. Numerous studies have been conducted into its benefits, and there are almost too many to list sensibly. For example, one recent study found that turmeric extracts (TEs) from Curcuma longa L (turmeric) have been shown to have incredible biological activity, including antioxidant, anti-inflammatory, anticancer, antiarthritic, anti-aging, antimicrobial, and wound healing abilities.[9] Because of this, it is often featured in supplements geared towards aiding joint pain, as it actively helps to reduce inflammation around the joint, as well as combating the deterioration of the collagen around the joint. This is especially notable, as collagen deterioration is often the cause of the pain in the first place.

To summarise, since joint pain is such a common issue, having a range of options for treatment is essential. In addition to the often-referred-to remedies like NSAIDs and other man-made chemical products, the fact that there are natural ingredients that aid joints as well is of great importance. For those looking to delve into natural remedies, the ones laid out here are a great place to start. Essentially, glucosamine and chondroitin (along with turmeric, ginger, and DHA) deserve a prominent place amongst the very important non-drug measures to be considered in a patient presenting with painful and possibly osteoarthritic joints, not only to relieve symptoms but also to limit the long-term impact of the disease.[2]

References

1) Czajka A, Kania E, Genovese L, Corbo A, Merone G, Luci C et al. Daily oral supplementation with collagen peptides combined with vitamins and other bioactive compounds improves skin elasticity and has a beneficial effect on joint and general wellbeing. Nutrition Research [Internet]. 2018 [cited 24 May 2021];57:97-108. Available from: https://www.sciencedirect.com/science/article/pii/S0271531717311508?casa_token=g_LKYFpRodcAAAAA:SCs5WRlpJ_Rb4KnDpjhoc_p1WytnsfGWzTLmv8zdkxYHXK708w62ptuKdMWbJknYVhOt0IBR

2) Huskisson E. Glucosamine and Chondroitin for Osteoarthritis. Journal of International Medical Research [Internet]. 2008 [cited 24 May 2021];36(6):1161-1179. Available from: https://journals.sagepub.com/doi/abs/10.1177/147323000803600602

3) Altman R, Marcussen K. Effects of a ginger extract on knee pain in patients with osteoarthritis. Arthritis & Rheumatism [Internet]. 2001 [cited 24 May 2021];44(11):2531-2538. Available from: https://onlinelibrary.wiley.com/doi/full/10.1002/1529-0131%28200111%2944%3A11%3C2531%3A%3AAID-ART433%3E3.0.CO%3B2-J

4) Awang DV. Ginger. Can Pharm J. 1992 Jul;125(7):309-11.

5) Tschirch A. Handbuch der Pharmakognosie [A handbook of pharmacognosy]. Leipzig: Verlag CH Tauchnitz. 1917.

6) Schulick P. Ginger, common spice and wonder drug. Herbal Free Press Ltd. 1996;.

7) Leach M, Kumar S. The clinical effectiveness of Ginger (Zingiber officinale) in adults with osteoarthritis. International Journal of Evidence-Based Healthcare [Internet]. 2008 [cited 24 May 2021];6(3):311-320. Available from: https://onlinelibrary.wiley.com/doi/full/10.1111/j.1744-1609.2008.00106.x?casa_token=fvLjxuauKlwAAAAA%3ASrhHvFaabIxsJOiYaykDHFPwwFm2C3wi6l_TKU29tif67jfqriCu1_wLlVToCSwwTbouy5ifrIDEHg

8) Calderón-Pérez L, Llauradó E, Companys J, Pla-Pagà L, Boqué N, Puiggrós F et al. Acute Effects of Turmeric Extracts on Knee Joint Pain: A Pilot, Randomized Controlled Trial. Journal of Medicinal Food [Internet]. 2021 [cited 24 May 2021];24(4):436-440. Available from: https://www.liebertpub.com/doi/full/10.1089/jmf.2020.0074

9) Aggarwal BB, Yuan W, Li S, Gupta SC. Curcumin‐free turmeric exhibits anti‐inflammatory and anticancer activities: Identification of novel components of turmeric. Molecular nutrition & food research. 2013 Sep [cited 24 May 2021];57(9):1529-42. Available from: https://onlinelibrary.wiley.com/doi/abs/10.1002/mnfr.201200838

10) Goldberg R, Katz J. A meta-analysis of the analgesic effects of omega-3 polyunsaturated fatty acid supplementation for inflammatory joint pain. Pain [Internet]. 2007 [cited 24 May 2021];129(1):210-223. Available from: https://www.sciencedirect.com/science/article/pii/S0304395907000413?casa_token=Hg2IMWlMnHAAAAAA:SxwYkaBSi00__pjLcboZoR8pTkZ2Ni2P0YcmUlwWGxFC96RRLxJ2Qvy08uNRcXeFtCZgb7DA

11) Gregory P, Sperry M, Friedman Wilson A. Dietary Supplements for Osteoarthritis. American Family Physician [Internet]. 2008 [cited 24 May 2021];77(2):177-184. Available from: https://www.aafp.org/afp/2008/0115/p177.html

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