A Holistic Approach to Treating Joint Pain – by Dr. Shah, ND
Joint pain is extremely common and almost everyone has experienced some degree of joint pain at least once in their lives, whether it be due to an injury or another illness. Often, the onset of cold weather can worsen joint pain in many people making this a timely topic to discuss. Joint pain can often be accompanied with inflammation within the joint capsule – inflamed joints are known as “arthritis” (arthr- for joint and –itis for inflammation). If the inflammation persists, it can lead to chronic joint pain, impact mobility, and negatively affect activities of daily living as well as result in deformed joints. This is why it is important to attend to an injury involving one or more joints as soon as possible to repair the tissues and strengthen any ligaments involved and reduce any inflammation present – physiotherapy, acupuncture, naturopathic medicine and chiropractic care can work synergistically to help alleviate the pain and repair the tissue.
This is the common form of arthritis typically found in the elderly due to age-related changes in the ability to restore and repair normal joint structures (1). It can also occur from an untreated injury to the joint. It usually manifests in the big joints like the shoulder, hip, and knee. Osteoarthritis involves the destruction of cartilage at the end of two bones in a joint capsule leading to bone on bone grinding which results in clicking sounds as you move the joint. This generates inflammatory cytokines to the joint space creating inflammation, pain and swollen joints. Over time, there can be bone spurs that form at the joint creating deformed joints and movement restriction (1).
Pharmaceutical therapy usually aims at reducing the pain and inflammation but is not doing anything to help stop cartilage destruction and rebuild the cartilage. In order to treat the cause and help re-generate the cartilage, there are lots of joint care supplements on the market.
There are many natural treatments that can help but the most common ones are glucosamine, chondroitin (commonly known as shark cartilage), MSM, turmeric, collagen, and reducing weight if one is overweight or obese. As always, it is best to consult with a healthcare practitioner such as a naturopathic doctor to find out what the best treatment is for you.
Autoimmune means that your immune system makes antibodies that recognize ‘self’ (molecules that your body produces as part of normal physiology) on joints, tissues, and organs. This results in an immune attack creating inflammation, swelling, destruction of tissues and joints, and/or pain. Unlike OA, which affects the large joints in the body and can be unilateral, RA and other autoimmune arthritis tend to affect both sides of the body symmetrically and affect the smaller joints in the body like hands, wrists, spine, and feet. They may affect the large joints as well.
While supplements that help in OA may be beneficial in autoimmune-mediated arthritis, a naturopathic approach would really be targeted at reducing the inflammation, modulating the immune system, and addressing the whole body including gut health.
Immune modulation is important to shift the immune system away from favouring autoimmunity to lower the antibodies produced. MDs typically prescribe corticosteroids like prednisone or TNF-a inhibitors which suppress the immune system to reduce the production of inflammatory cytokines which will stop the inflammation. While these are needed for some people if the autoimmune condition is severe or the person is in a lot of discomfort, being on immunosuppressants long term can increase your risk for other infections if your immune system is not functioning due to suppression. Corticosteroids may also increase your risk of osteoporosis and diabetes and contribute to obesity if used long-term.
Another key component is to treat and heal the gut. Research has shown that the type of bacteria in our digestive tracts is essential to control and minimize rheumatic diseases, specifically ankylosing spondylitis and rheumatoid arthritis (2). Probiotics are just one of the elements required for maintaining good gut health. A study by Vaghef-Mehrabany et al (2014) found that when people with rheumatoid arthritis took a probiotic supplement, the disease activity and inflammatory status was significantly reduced. As there are many probiotic supplements on the market, it is important to consult a regulated healthcare professional to determine which is right for you.
Aside from adding good bacteria to the gut, healing the gut is very important as leaky gut can be common in autoimmune conditions which will result in bacteria, toxins, food proteins reacting with the immune system and can contribute to joint pain. Healing the gut can take a minimum of 3 months to 6 months or even a year depending on the extent of damage. Consulting with a naturopathic doctor will help guide you on an individualized healing the gut protocol.
The first step is to decrease gut inflammation by removing YOUR inflammatory triggers (food sensitivities, pathogenic bacteria, or treating bacterial overgrowth). Once this is achieved, gut repair can begin.
Possible signs “Leaky Gut” may be present:
- Loose stools / diarrhea
- Heartburn / acid reflux
- Nausea / vomiting
- Feeling unwell after consuming certain foods
If you are tired of living with joint pain and want relief naturally or simply have any digestive symptoms that may indicate “leaky gut”, book an appointment for an initial assessment.
International Centre for Nutritional Research Inc. (2012) Glucosamine sulphate: effective osteoarthritis treatment. Natural Medicine Journal. Retrieved on Oct 16 2015 from http://www.icnr.com/articles/glucosamine-sulfate-for-osteoarthritis.html
Bedaiwi MK, and Inman RD. (2014 Jul) Microbiome and probiotics: link to arthritis. Curr Opin Rheumatol. 26(4):410-5.
Vaghef-Mehrabany E, Alipour B, Homayouni-Rad A, Sharif SK, Asghari-Jafarabadi M, Zavvari S. (2014 Apr) Probiotic supplementation improves inflammatory status in patients with rheumatoid arthritis. Nutrition. 30(4);430-5.