Arthritis is defined as inflammation in the joints, usually leading to symptoms of pain, swelling and disability of varying degrees. The two most common forms of arthritis are Rheumatoid Arthritis (RA) and Osteoarthritis (OA). Although both of these conditions lead to similar signs and symptoms, the causes and mechanism of development of each condition is quite different.
Rheumatoid Arthritis (RA) is a chronic autoimmune disease that leads to joint inflammation and destruction, usually involving the peripheral joints such as the wrists and fingers (1). RA affects approximately 1% of the population, in favour of women, most commonly between the ages of 35 and 50 years old (1).
In contrast, Osteoarthritis (OA) is a degenerative joint disease leading to loss of cartilage with increasing pain and stiffness (2). This is the more common form of arthritis that tends to be present to some degree in all men and women by the age of 80 years old (2). The onset of symptoms tends to start in the 5th and 6th decades of life and can be asymptomatic in about half of diagnosed patients (2).
Despite the differences in these two common types of arthritis, there are many overlapping natural modalities that help to support the overall health of joints. The herbs and nutrients listed below offer a great alternative to the common conventional approach of non-steroidal anti-inflammatory drugs (NSAIDs) such as aspirin, ibuprofen, and naproxen. Although these prescription and over-the-counter medications can offer some great temporary relief for those suffering from joint pain, there is a concern of safety with their frequent and long-term use. Long-term use of NSAIDs is associated with an increased risk of gastrointestinal ulcers and bleeds as it irritates the gut lining and can also be harsh on the liver (3).
Boswellia serrata, more commonly known as Frankincense, is an ayurvedic herb that is often used to address pain and inflammation in the musculoskeletal system as it has powerful anti-inflammatory, antirheumatic, and analgesic properties. Boswellia is thought to have the most notable decrease in symptoms of osteoarthritis compared to other natural treatment modalities. /> A few studies have shown benefits of joint relief in both pain and stiffness in those diagnosed with OA even after only 1 to 6 months of use (4) (5) (6) (7). This was assessed in men and women aged 45 to 64 years old, often in populations of obese patients, which is a risk factor for OA (4) (5) (6) (7). The evidence for the use of Boswellia for the treatment of Rheumatoid Arthritis, seems to be less convincing than that of OA. However, if Frankincense acts on reducing the inflammatory burden in the body, particularly in relation to joints, we can extrapolate that a similar benefit would be seen in this other common type of arthritis as well. One study did in fact show some promise for the reduction of pain, morning stiffness, grip strength and disability compared to placebo (8). It is worth noting that in this particular trial, frankincense was supplemented in conjunction with other nutrients such as ashwagandha, zinc, and turmeric (8). It is therefore hard to elucidate the magnitude of effect of the Boswellia alone at this time.
Turmeric is a root that is native to India and is well-known for its bright yellow-orange colour. The active component of turmeric is curcumin, which is thought to be primarily responsible for its anti-inflammatory effects. Often added to curries for its flavour and medicinal properties, supplementation is usually necessary to treat arthritic conditions, as dietary sources are not concentrated enough to be at a therapeutically effective dose for treatment. Curcumin supplementation appears to have a notable magnitude of effect in reducing systemic inflammation, pain and symptoms of osteoarthritis. Specifically, studies have shown great improvement in OA of the knee, one of the more commonly affected joints, comparable to daily doses of ibuprofen (9) (10). This effect was seen after only 4 to 6 weeks of use. Once again, the research on rheumatoid arthritis is still more in the preliminary stages compared to osteoarthritis but appears to be promising. In this case, turmeric shows promise at reducing RA symptoms of pain, morning stiffness, walking time and joint swelling (11).
Fish oil is a common go-to when it comes to addressing conditions of pain and inflammation. However, it is hard to obtain an adequately effective dose simply from foods in the diet. The Standard American Diet contains a higher ratio of omega-6s compared to omega-3s, when the reverse is needed to encourage more anti-inflammatory pathways in the body. Research conducted in patients diagnosed with RA, showed a significant decrease in the duration of morning stiffness and the number of tender joints (12). This effect was present with fish oil supplementation alone or in conjunction with naproxen but also led to a reduction in the need and use of NSAIDs in patients (12). This is an important finding considering the long-term and sometimes life-threatening risks that NSAID use can pose on patients.
These are only 3 of the more frequently used and effective herbs and nutrients for the natural treatment of arthritis. However, it is important to remember that these should be used in conjunction with additional support and in consultation with your healthcare practitioner. Other lifestyle and dietary modifications should be recommended in addition to these herbs and nutrients such as an anti-inflammatory diet, moderate exercise (within pain tolerance), topical treatments, and physical medicine such as acupuncture. The world of naturopathic medicine has much to offer in the way of primary and/or adjunct treatments for arthritic conditions and offers a worthwhile alternative to conventional treatment.