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Arthritis Treatment List - Dietary

Supplements which may be useful for arthritis treatment and osteoarthritis treatment include:

Antioxidants, including vitamins C and E in both foods and supplements, provide pain relief from osteoarthritis.

Chondroitin sulphate. A meta-analysis of randomized controlled trials found no benefit from chondroitin.

Hydrolyzed collagen (hydrolysate) (a gelatin product) may also prove beneficial in the relief of osteoarthritis symptoms, as substantiated in a German study by Beuker F. et al. and Seeligmuller et al. In their 6-month placebo-controlled study of 100 elderly patients, the verum group showed significant improvement in joint mobility.

Ginger (rhizome) extract - has improved knee symptoms moderately.

Glucosamine: A molecule derived from glucosamine is used by the body to make some of the components of cartilage and synovial fluid. Supplemental glucosamine may improve symptoms of osteoarthritis and delay its progression. However, a recent large study suggests that glucosamine is not effective in treating osteoarthritis of the knee.

Methylsulfonylmethane (MSM): A small study by Kim et al. suggested that MSM significantly reduced pain and improved physical functioning in osteoarthritis patients without major adverse events (Kim et al). The authors cautioned that although this short pilot study did not address the long-term safety and usefulness of MSM, they suggest that physicians should consider its use for certain osteoarthritis patients.

S-adenosyl methionine: small scale studies have shown it to be as effective as NSAIDs in reducing pain, although it takes about four weeks for the effect to take place.

Selenium deficiency has been correlated with a higher risk and severity of osteoarthritis, therefore selenium supplementation may reduce this risk

Vitamins B9 (folate) and B12 (methylcobalamin, sublingual, not cyanocobalamin) taken in large doses significantly reduced osteoarthritis hand pain, presumbably by reducing systemic inflammation.

Vitamin D deficiency has been reported in patients with osteoarthritis, and supplementation with Vitamin D3 is recommended for pain relief.

Other nutritional changes shown to aid in the treatment of osteoarthritis include decreasing saturated fat intake and using a low energy diet to decrease body fat.

Lifestyle change may be needed for effective symptomatic relief, especially for knee osteoarthritis. Reducing sugar, processed foods, fatty foods and nightshade vegetables have helped many. According to Dr. John McDougall a low fat vegetarian diet can reduce arthritis symptoms. A macrobiotic diet has been known to reduce symptoms as well.

Systemic Arthritis Treatment

Included in the medication regime for most cases, a mild pain reliever may be sufficiently efficacious. In more severe cases, NSAIDs are usually prescribed which can reduce both the pain and inflammation quite effectively. These include medications such as diclofenac, ibuprofen and naproxen. High doses are often required. All NSAIDs act by inhibiting the formation of prostaglandins, which play a central role in inflammation and pain. However, these drugs are rather taxing on the gastrointestinal tract, and may cause stomach upset, cramping diarrhoea, and peptic ulcer.

Another type of NSAID, COX-2 selective inhibitors (such as celecoxib, and the withdrawn rofecoxib and valdecoxib) reduce this risk substantially. These latter NSAIDs carry an elevated risk for cardiovascular disease, and some have now been withdrawn from the market. Another medication, acetaminophen (tylenol/paracetamol), is commonly used to treat the pain from OA, although unlike NSAIDs, acetaminophen does not treat the inflammation. Application of heat — often moist heat — eases inflammation and swelling in the joints, and can help improve circulation, which has a healing effect on the local area.

Most doctors nowadays are loath to use steroids in the treatment of OA as their effect is modest and the adverse effects may outweigh the benefits. For severe pain, narcotic pain relievers such as tramadol, and eventually opioids (hydrocodone, oxycodone or morphine) may be necessary; these should be reserved for very severe cases, and are rarely medically necessary for chronic pain.

Arthritis Treatment - Topical

"Topical treatments" are treatments designed for local application and action. Some NSAIDs are available for topical use (e.g. ibuprofen and diclofenac) and may improve symptoms without having systemic side-effects.

Creams and lotions, containing capsaicin, are effective in treating pain associated with osteoarthritis if they are applied with sufficient frequency.

Severe pain in specific joints can be treated with local lidocaine injections or similar local anaesthetics, and glucocorticoids (such as hydrocortisone). Corticosteroids (cortisone and similar agents) may temporarily reduce the pain.

Arthritis Treatment - Surgery

If the above management is ineffective, joint replacement surgery may be required. Individuals with very painful osteoarthritis joints may require surgery such as fragment removal, repositioning bones, or fusing bone to increase stability and reduce pain.

Other Arthritis Treatment Approaches

There are various other modalities in use for osteoarthritis:

Rotational Field Quantum Magnetic Resonance (“RFQMR”) has been claimed to be effective for regeneration of cartilage in the knee joints. A three-year trial of this method involving 500 patients has been conducted at the Indian Airforce's Institute of Aerospace Medicine, Bangalore (India). RFQMR Technology is claimed to utilize sub-radio and near-radio frequency electromagnetic radiation focused onto tissues to alter proton spin inside and outside cells, generating streaming voltage potentials resulting in stimulation of cartilage growth. The treatment is said to be painless and is claimed to be safe. Pre and post 3 months MRI showed significant increase in cartilage growth.
Low level laser therapy ; this is a light wave based treatment that may reduce pain. The treatment is painless, inexpensive and without risks or side effects. Unfortunately, it may not actually have any real benefits.

Prolotherapy (proliferative therapy); this is the injection of an irritant substance (such as dextrose) to create an acute inflammatory reaction. It is claimed to strengthen and heal damaged tissues including ligaments, tendons and cartilage as part of this reaction. The injection is painful (like corticosteroids or hyaluronic acid) and may cause an increase in pain for a few days afterwards. The only other significant risk is the rare possibility of infection.
Radiosynoviorthesis: A radioactive isotope (a beta-ray emitter with a brief half-life) is injected into the joint to soften the tissue. Due to the involvement of radioactive material, this is an elaborate and costly procedure, but it has a success rate of around 80%.

Thes are most of the arthritis treatments available today.

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