Osteoarthritis is a degenerative disease of the joints associated with aging. The disease mostly affects the spine and large weight-bearing joints, and is often characterized more by degeneration of the articular cartilage than by inflammation. The absolute first thing to do is to make sure the digestive system is working properly, especially in the elderly. Look for signs like poor digestion, low appetite etc.

I have found the herb devil’s claw root (Harpagophytum procumbens) helpful in many cases of arthritis with inflammation and pain, taken either by itself or as part of a combination formula, about 2 grams twice a day as a crude powder, or 60 drops of tincture 3 times per day.  Boswellia gum is also very effective. Both of these are free of the side effects caused by many NSAIDS because they do not cause bleeding.

Herbs from the blood-nourishing group are also essential to slow, and hopefully reverse, joint degeneration. They act on the structural components of ligament and bone.  TCM doctors frequently use raw rehmannia root, dang gui root, shou wu root, millettia stem, eucommia bark (du zhong or E. ulmoides), drynaria rhizome (gu sui bu or D. fortunei), psoralea seed (bu gu zhi or P. corylifolia) and deer antler.

Glucosamine sulfate is extraordinarily effective in most cases so I always use it to treat this disease. This substance is an amino-sugar extract derived from the exoskeletons of shrimp, lobsters and crabs.  As people age, they lose the ability to manufacture their own supply of glucosamine sulfate.  More than 300 scientific investigations and 20 double-blind studies have shown that patients treated with this nutrient experience an improvement rate between 72% and 95% in various forms of osteoarthritis (reported in Murray 1996). The recommended dosage is 750 mg twice per day. It takes up to six weeks to see results, at which point patients often experience pain relief that exceeds the results from aspirin treatment. Japanese research shows that it works better when combined with MSM.

Glucosamine sulfate is not a painkiller—it literally repairs the joint tissue.  This translates into dramatic and long-lasting results. However, in spite of the treatment’s effectiveness, we must remember that it does not reverse or cure the underlying degenerative process that causes the disease.

Traditional Ayurvedic medicine (TAM) doctors consider osteoarthritis (sandhigatavata) to be a degenerative process caused by any food, behavior or condition which results in poor blood circulation, dryness (Vata) or low nutrient supply to the joint.  Their treatments emphasize use of the following strategies:

• Gentle and slow oil massage (do not disturb the joint), using the standard tonic oil narayana taila, which contains wild asparagus root as a main component.
• The oil massage is followed by application of a warm compress soaked in a warm decoction made from bala, using gentle range-of-motion manipulation.
• The well-known tonic yogarajaguggulu, which contains guggul gum, is a standard Ayurvedic medicine for osteoarthritis, used for several months.
• A second general tonic should also be prescribed to supply nutrition, such as the ones mentioned in the immune/longevity group.
• Use the diet to reduce wind, along with carminative (gas-expelling) spices, especially celery seeds. Other carminatives include cloves, caraway, and fennel (Bajracharya, 1979).

To control arthritic inflammation (as opposed to degeneration), it is often important to use herbs from the heat-reducing group.   TCM doctors use phellodendron bark and scute root to control inflammation, in combination with other herbs like myrrh gum, fang feng root (Ledebouriella species), and qin jiao root (Gentiana macrophylla).  They also use a relative to boswellia gum called ru xiang gum (B. carterii).

Except for short term use, beware of NSAIDs—aspirins and aspirin-like compounds including acetaminophen.  Unlike many natural anti-inflammatory herbs, these pharmaceutical products cause damage to mucosa, kidney and heart, and worsen progression of damage to cartilage and joints. One would therefore expect that herbs containing salycilate compounds would cause the same problems. Interestingly, I have used the European prescription herbal tincture Phytodolor--which contains three such herbs, common ash bark (Fraxinus excelsior), aspen leaf/bark (Popuolus tremula), and goldenrod aerial portions (Solidago virgaurea), and it does not seem to cause stomach upset or bleeding, as correctly stated in the promotional literature. This may be because of the slow onset of action (several days) creates less concentrated action on the stomach mucosa. Another trick is to use DGL licorice to protect the mucosa.

Most herbal anti-inflammatories do not cause stomach problems.  Turmeric root, for example, has not been reported to cause bleeding, nor has boswellia gum, even in high doses. Such medicines seem not to damage the mucosa because they work in a different biochemical way.

A good base herbal anti-inflammatory formula might start with boswellia gum, myrrh gum, scute root and turmeric root. Add other herbs as discussed, and adjust as follows:

• If the patient tends toward coldness, try adding ginger root or prickly ash bark.
•  If heat and inflammation are severe, add phellodendron bark.

Thus our typical osteoarthritis treatment program consists of:

1. Glucosamine sulfate/MSM supplements: 750 mg, twice per day.
2. An herbal formula for inflammation.
3. Additional nourishing tonic herbs and basic vitamins to slow degeneration.
4. A healthy diet, bodywork, oil/herb massage, exercise and vitamin supplements.

The relative proportion of the formula that tonifies and the formula that reduces inflammation depends on signs and symptoms. In elderly patients, for example, tonification and digestion are usually emphasized.

The following therapies can also be useful additions to your treatment protocol.

• Some patients, especially those over the age of 60, require digestive aids to ensure proper absorption of nutrients. Digestive herbs like bromelain, white atractylodes, and ginseng root can be added to the formula in these cases.
• Essential fatty acids (EFA’s) are essential to control deficiency-based inflammation, so I use fish oils along with borage oil or evening primrose oil.
• Acupuncture can help alleviate pain and stimulate natural healing powers.
• Women must remain aware hormonal changes that can affect arthritis and bone loss. In cases of hormone involvement, collateral treatment may be necessary

You can also treat bursitis and Sjogren’s syndrome with these same methods.