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Types of Arthritis and Therapeutic Considerations Print E-mail
by Ron Kennedy, M.D., Santa Rosa, CA

Dr. Kennedy The condition of inflammation in a joint is called "arthritis," literally joint inflammation. There are several varieties. Osteoarthritis is, by far, the most common, affecting one out of every fifteen people in the U.S. and Europe. It affects women more often than men and may advance to destructive changes in the joints. Osteoarthritis is a degenerative joint disease in which the cartilage that covers the ends of bones in the joint is inflamed, causing pain which limits movement.

The causes of this disorder are poor nutrition, poor digestion, and low levels of exercise over a long period of time. The best treatment is a diet balanced in protein and carbohydrate (see Eicosanoid Balance and Essential Fatty Acids), relatively low in salt and sugar, and a regular program of exercise augmented with antioxidants. It is critically important to evaluate digestion in a case of arthritis, because disordered digestion is probably the major cause of arthritis. Also, coffee, including decaf is well known to exacerbate arthritis ans should be give up, perhaps in favor of tea.

Contrary to popular myth, milk products are not good for the joints (or bones), only bad for the entire body. There is more than sufficient calcium in a vegetable oriented diet. A hypercalcific, milk-centered diet promotes arthritis. I suspect that the addition of pesticides to growing foods plays a role in osteoarthritis as well. I strongly suggest that you eat only organically grown foods.

Symptomatic treatment of osteoarthritis should be undertaken, in my opinion, only after all natural methods of treatment (diet, treatment of digestive disorders, exercise, stretching, antioxidants) have been used and found not to provide complete relief. The ingestion of drugs which inhibit prostaglandins synthesis provide some relief for the inflammation of osteoarthritis but have been shown to cause joint degeneration over the long term. Also, it is possible to spend a fortune on some of these new drugs and they are in fact not better than aspirin.

What the drug companies are trying to keep from public awareness, is that the best prostaglandins inhibitor is inexpensive, safe, and has been around since 1899 — ordinary aspirin. There are no large profits for drug companies in trying to market a drug which has been around seventy years after its patent expired.

From a doctor's point of view, there is little to impress the patient by saying "Go take aspirin." Therefore, doctors prescribe drugs which are new, extremely expensive and do not work as well as aspirin. Children should not receive aspirin due to Reye's Syndrome (a type of encephalitis) which may be caused by aspirin. For adults and children, it increases slightly the time required for blood clotting (this quality also provides protection from heart attacks). If you are scheduled for surgery, take no aspirin for three weeks before surgery.

Another type of arthritis is rheumatoid arthritis. This is a much more debilitating illness, although mercifully, a much more rare disease, affecting about one out of every 240 people in the U.S. and Europe. It can be extremely painful. The classic picture of rheumatoid arthritis is that of red swollen fingers held in an abnormally flexed position, the small fingers being the most flexed and the index finger being the least flexed. The wrist also is held in a flexed position.

However, rheumatoid arthritis is a systemic disease affecting much more than the hands. It causes inflammation in connective tissue throughout the body and is accompanied by fever, weakness and fatigue as well as the deformity already mentioned.

Rheumatoid arthritis affects women much more than men and also affects children. There is a hereditary predisposition (if your parents have it, you are more likely to have it) and it may be made worse by repression of anger. It, too, has a strong relationship with digestive dysfunction, and a comprehensive digestive analysis should be part of every workup for rheumatoid arthritis. It is classified as an autoimmune disease which means that the body is making antibodies against its own tissues. The source of the allergen which stimulates the immune system to do this is usually food derived. Identification of these foods is possible through blood testing. Elimination of these foods from the diet is usually effective in treatment. Doctors who are experienced in this approach are those who practice nutritional medicine.

Orthodox treatment of arthritis is drug based and includes gold compounds, hydroxychloroquinone, penicillamine, and/or surgery. This approach in no way addresses the real cause of arthritis and is likely to fail miserably in the long run, after some initial symptom relief.

Arthritis also can be caused by gout. The classic picture is an obese person with a red, swollen, painful big toe, although gout also is a disease affecting connective tissue throughout the body. The treatment is a diet high in complex carbohydrates, relatively low in salt, sugar, fat and protein. Gout is caused by the deposition in the joints of the breakdown products of protein.

Rheumatic fever also can account for arthritis. The presentation is similar to osteoarthritis and the treatment is penicillin. Rheumatic fever is the body's own immune reaction to the streptococcus bacterium.

In addition to joint damage, rheumatic fever also can result in damage to the heart valves (particularly the mitral valve) and to the kidneys (glomerulonephritis). Prevention rests on the prompt treatment of streptococcal infections. Most strep infections occur in the throat, so while you may think of a throat infection as not so important, you could live to regret that point of view. Strep also is the most common cause of bacterial dermatitis.

Ankylosing spondylitis is a disease sharing many characteristics of rheumatoid arthritis. The disease attacks the lower back, eventually fusing together the lumbar vertebrae. It may extend higher, in severe cases, to the thoracic or even cervical vertebrae. It has a strong association with Klebsiella infection (a bacterium) and this should always be looked for.

Doctors are just beginning to realize that all of the arthritides, tend to be related to digestive disorders. The importance of this aspect of the evaluation cannot be overemphasized. If you have an arthritis and your doctor has not evaluated you for digestive dysfunction, call this to his or her attention. Some doctors are not informed in this area and you may need to find a new doctor to get the treatment you deserve.

Joint pain serves as the symptomatic tip of the ice berg for a more deeply rooted problem. The idea that arthritis is a incurable life-long condition — which you will see expressed in conventional medicine — is utter nonsense, but left untreated it is likely to progress.

As mentioned above, the three most prevalent forms of arthritis are osteoarthritis, and rheumatoid arthritis. Other causes include systemic lupus erythematosis and scleroderma, both so-called collagen vascular diseases. These are commonly recognized as auto-immune diseases, diseases caused by the production of antibodies to the body's own tissues.

Traumatic arthritis is due to injury, is self-limiting and will clear up on its own unless there is also ligament damage. When ligament tissue is damaged it repairs slowly (if at all) if left untreated. If this is the case you should investigate Prolotherapy.

Osteoarthritis is related to another condition called Fibromyalgia. The fundamental causes are the same for both disorders and which symptom complex shows up first depends on the individual's constitution, that is to say whether the person's joints or muscles are less resistant to these changes. In Fibromyalgia, widespread pain affects the muscles and attachments to the bone.

Rheumatoid arthritis is recognized, even by traditional medicine, as an autoimmune disease. The joint lining becomes inflamed because the immune system is making antibodies meant for food and/or micro-organisms which are attacking the joints. This is a biological case of mistaken identity.

The difference between the way arthritis is treated by conventional and nutritional medicine is dramatic. For purposes of treatment conventional medicine defines the symptoms as the disease itself and gives medication, does surgery, etc. to make the symptoms go away. Of course, as soon as the drug is discontinued the symptoms come back. This, of course, keeps the patient coming back to the doctor. In nutritional medicine we look for the cause of the problem and attempt to correct that. In this way the symptoms go away and do not come back. The causes will include allergic disorders and/or nutrient deficiencies. One of the most powerful treatment of arthritis ,and also of fibromyalgia, is intravenous Chelation therapy which also has the benefit of decreasing the load of toxic heavy metals, and clearing the vascular system of excess calcium. For sever arthritis, juice fasting can deliver significant relief. This should only be done under the supervision of a doctor who practices nutritional medicine.

The approach used in homeopathy is to attempt to restore the balance of the system using dilute solutions of natural substances specific to the disorder.

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The information in this article is not meant to be medical advice.�Treatment for a medical condition should come at the recommendation of your personal physician.

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