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Arthritis symptoms, arthritis treatment, arthritis supplements and herbs
updated on July 21, 2013
About Arthritis
The word arthritis actually means joint inflammation. The term arthritis is used to describe more than 100 rheumatic
diseases and conditions that affect joints, the tissues which surround the joint and other connective tissue. The pattern,
severity and location of symptoms can vary depending on the specific form of the disease. Typically, rheumatic conditions
are characterized by pain and stiffness in and around one or more joints. The
symptoms can develop gradually or
suddenly. There are different types of arthritis: childhood arthritis, fibromyalgia, general arthritis, gout, osteoarthritis,
rheumatoid arthritis and systemic lupus erythematosus (SLE or lupus). In this article, we focus on
osteoarthritis. [1]
Osteoarthritis (degenerative joint disease)

Osteoarthritis is a disease characterized by degeneration of cartilage and its underlying bone within a joint as well as bony
overgrowth. The breakdown of these tissues eventually leads to pain and joint stiffness. Thus, join pain and stiffness are
the key arthritis symptoms. The joints most commonly affected are the knees, hips, and those in the hands and spine. The
specific causes of osteoarthritis are unknown, but are believed to be a result of both mechanical and molecular events in
the affected joint. Disease onset is gradual and usually begins after the age of 40. There is currently no cure for
osteoarthritis. Treatment focuses on relieving arthritis symptoms and improving function, and can include a combination of
patient education, physical therapy, weight control, and use of medications.

Osteoarthritis is classified as: idiopathic (localized or generalized) or secondary (traumatic, congenital,
metabolic/endocrine/neuropathic and other medical causes). It has been estimated 13.9% of adults aged 25 and older in
the States suffered from osteoarthritis.[1]
Management / Treatment for Arthritis

In general, the focus of treatment for arthritis is to control pain, minimize joint damage, and improve or maintain function
and quality of life. According to the American College of Rheumatology, the treatment of arthritis might involve the
following: medication (e.g. pain killer), nonpharmacologic therapies (physical or occupational therapy, splints or joint
assistive aids, education and support and weight loss, surgery. [1]

Exercise is an important arthritis treatment. Exercise can improve mood and outlook, decrease pain, increase flexibility,
strengthen the heart and improve blood flow, maintain weight, and promote general physical fitness. Exercise is also
inexpensive and, if done correctly, has few negative side effects. The amount and form of exercise prescribed will depend
on which joints are involved, how stable the joints are, and whether a joint replacement has already been done. Walking,
swimming, and water aerobics are a few popular types of exercise for people with osteoarthritis. [2]

Osteoarthritis patients who are overweight or obese should try to lose weight. Weight loss can reduce stress on weight-
bearing joints, limit further injury, and increase mobility. [2]

Treatment plans include regularly scheduled rest. Patients must learn to recognize the body’s signals, and know when to
stop or slow down. This will prevent the pain caused by overexertion. Although pain can make it difficult to sleep, getting
proper sleep is important for managing arthritis pain. [2]

People with osteoarthritis may find many nondrug ways to relieve pain. Examples are heat/cold treatment, massage,
dietary (herbal) supplements and diets. [2]

[1] CDC website, August 2011 [2] www.niams.nih.gov
Recent Research Findings - Arthritis Treatments

Radon Spa Therapy A study of 681 patients  [mean age 58.3; female 59.7 %] in 7 health resorts in Germany and Austria
with chronic back pain, or osteoarthritis, or rheumatoid arthritis, and/or ankylosing spondylitis suggests that radon spa
therapy is able to offer beneficial analgesic effects to the patients suffered from rheumatic diseases and osteoarthritis up
to a certain period of time. [Annegret F et al, Rheumatol Int. 2013 Jul 18]

Molecular Hydrogen Rheumatoid arthritis is associated with an increased risk of atherosclerosis, which can result in
cardiovascular disease and mortality. The therapeutic goal is to control the systemic inflammation to obtain not only the
remission of symptoms, but also improve general state of health. On the other hand, it is known that reactive oxygen
species (ROS) play a significant role in the pathogenesis of Rheumatoid arthritis. Among the ROS, the hydroxyl radical is
the most harmful, and molecular hydrogen (H2) is a selective scavenger for this species. Recently, it has been shown that
H2 is useful when administered along with the conventional therapy in Rheumatoid arthritis as it acts to reduce oxidative
stress in the patients. [Ishibashi T. Curr Pharm Des. 2013 Jul 11.]

Agents blocking  interleukin-17A (IL-17A;  IL-17) Rheumatoid synovial tissue produces IL-17A, which causes cartilage
and bone degradation in synovial and bone explants. Overexpression of IL-17A induces synovial inflammation and joint
destruction in animal rheumatoid arthritis models. Several IL-17A blockers have been evaluated in clinical trials. Of these,
secukinumab offers a promising progress in rheumatoid arthritis. [Kellner H. Ther Adv Musculoskelet Dis. 2013 Jun;5(3):

High mobility group box chromosomal protein 1 (HMGB1) (a target for therapeutics) Significantly increased
HMGB1 levels were recorded in synovial fluid compared to blood samples from patients with juvenile idiopathic arthritis .
The amount of HMGB1 was highest in patients with early disease onset irrespective of disease duration. This warrants
further studies of HMGB1 as a target for therapy of juvenile idiopathic arthritis. [Schierbeck H, et al, J Rheumatol. 2013 Jul

Tanezumab Tanezumab, a monoclonal antibody, inhibits nerve growth factor and reduces chronic pain. In a study, 604
patients suffered from knee or hip osteoarthritis, were treated with diclofenac sustained release 75 mg twice daily
combined with intravenous tanezumab, resulting in significant improvements in pain, function and global assessments.
[Balanescu AR, et al, Ann Rheum Dis. 2013 Jul 12]

Avastin Avastin is the monoclonal antibody for vascular endothelial growth factor and Avastin exhibits similar effects to
Etanercept to relieve rheumatoid arthritis in rat model. [Wang Y et al, Inflammation. 2013 Jul 14]
Herbal Supplements and Products

I have reviewed many herbs and supplement products, and the those with scientific support for their potential benefits on
osteoarthritis are listed in the following table. Some of them have very limited support or no clinical support. Users must
consult with their medical doctor(s) before taking any supplements or herbal products.