By Dr Irwin Lim, Rheumatologist
What natural therapy can I take for my arthritis?
I get asked this question in some version by most patients when I discuss the diagnosis and management plan.
There's such an industry out there relying on this. Walk into any pharmacy or health food shop. The rows and rows of "natural" therapies coming in powders, creams/ointments, tablets, patches, oils, special teas to brew, etc.
Add to the mix magnetic jewelry to wear, special potions created by the naturopath, and the use of Chinese traditional medicine & Ayurvedic therapies.
Some of these have no scientific basis. Some just don't work. Some do work in reducing pain in some patients to a limited extent. Some seem to work well for individual patients for reasons that are hard to explain.
In general, I am happy for my patients to dabble.
But, what I find interesting is the lack of attention paid to the BIG 3 (I generalise a little of course).
Smoking is BAD for health. You know that. And it's also bad for inflammatory arthritis (read link). Smoking seems to cause disease in some, it leads to more severe disease, and it prevents our treatments working as well.
Alcohol. It's nice to have a drink or two. The problem in our society unfortunately, is that many don't stop at that. Gout is the most common inflammatory arthritis in our community and reducing the number of drinks would help. Patients rightfully worry about potential side effects of a number of medications rheumatologists use, and they should reduce this risk by reducing the drinking.
Everyone is aware than you should probably eat smaller proportions and more healthily. Whatever that means. But, there is a science to nutrition. Timing of eating, composition of foods, avoidance of certain foods help the rheumatic diseases we treat.
The obvious examples are diets for gout, and the whole problem of the metabolic syndrome to address (link). In most arthritis, weight control and weight loss for those overweight is a BIG factor (read "Your Fat Inflames").
Again, this needs to be addressed with purpose. Your busy daily run-around is not sufficient & you're not adequately exercising your body with housework or the lifting at work. In fact, those activities may be part of the problem.
I don't mean the usual advice of "just walk" either. For many, we need the exercise regime to be more personalised and targetted. Your specific biomechanical flaws need to be recognised, and then a specific program developed to more safety and gradually correct as much of these as possible. It usually takes years to develop these biomechanical factors, as in the example of knee osteoarthritis, so improvement takes time & a lot of effort, but the benefits are worthwhile and longer lasting. Apart from reducing pain & improving what you can do, the big aim is to slow down how quickly you're wearing out.
The above 3 considerations are really important. The rheumatology community is well aware of this but it's hard to engender change. Simply telling your patient to lose weight or to exercise is insufficient in my humble opinion for the majority of patients. It's why I work with skilled dietitians, dedicated exercise physiologists and physiotherapists.
When you are looking for natural therapies, do you properly address the BIG 3?Dr Irwin Lim is a rheumatologist and a director of BJC Health. You should follow him on twitter here. Arthritis requires an integrated approach. We call this, Connected Care. Contact us.