April 2006
Drug-free ways to soothe aching joints, sore backs, and more
Before I even consider putting a patient on a prescription painkiller, I take between three and six months and work with him on using natural alternatives-what I call the “rational approach.”
First, the basics: diet and exercise. I know it gets boring to hear it over and over again. But it’s really the best way to give your body a solid foundation for good health. Without a solid foundation, even the best efforts at natural healing won’t produce the results you’re looking for. Plus, in this case-especially when it comes to arthritis pain-there are a couple of specific reasons for putting in the effort to eat right and get in shape.
Eating the right foods literally feeds your joints and keeps them strong and flexible. Foods like fish and walnuts or almonds contain essential fatty acids that lubricate those “rusty joints” in your knees, elbows, and knuckles. Plus, making that dietary shift to healthier foods will also help keep your weight in check. And that’s an absolutely critical part of relieving arthritis pain, since each pound of body weight equals 5 to 7 pounds of extra stress on your knees, with each step you take. So dropping just 10 pounds can lighten the load on your knees by 70 pounds.
But the best protection for your knees is strong thigh muscles, so strength training should be a part of everyone’s arthritis care plan. If you’re in too much pain to think about squats, try water aerobics. Not only does it keep weight off your knees and hips while you’re strengthening your leg muscles, but the water can also soothe aching joints.
From the ocean to the garden: Natural sources for safe pain relief
I know a lot of times, though, my patients need a little extra pain-relieving boost, at least in the beginning, to help them over the hump. And luckily, you have many, many safe options. Unless you eat fatty fish like salmon or sardines on most days, you’re simply not getting enough healthy omega-3 fats-or their anti-inflammatory benefits. You want to get two specific omega-3s in particular: EPA and DHA. The best source for both is fish oil. Aim for 1,000-3,000 mg total DHA and EPA. That’s three to nine capsules a day of most brands. One new patient of mine, an elderly active gentleman, told me his long-standing knee pain went away once he started taking a three-capsule per day dose.
Now comes a long list that starts with glucosamine and chondroitin, which have been shown to match or surpass the long-term pain relief of common NSAIDs, without the dangerous side effects. Glucosamine has also been shown to help rebuild the cartilage that has worn away in cases of arthritis. Funny thing, my wife’s a vet and they’ve been using both of these natural remedies for horses and dogs for decades with good results-so we know it’s not the placebo effect. Take 1,500 mg of glucosamine sulfate and 1,200 mg of chondroitin a day.
Methylsulfonylmethane (MSM), a sulfur-rich compound can be added to the mix too. Sulfur compounds like MSM are necessary building blocks for proteins, especially those found in the hair, muscles, and connective tissue of the joints. And at the same time it’s helping to strengthen the joints, it can also help alleviate inflammation and pain. For some people, it works by itself. It’s not as well studied as glucosamine, but it’s worth adding to your regimen if you’re not getting as much relief as you’d like. I usually recommend 500-1,500 mg a day, though I have seen a few cases where people have needed as much as 5,000 mg a day. You can get MSM in just about any health food store and even some supermarkets and pharmacies.
Another natural compound, called S-adenosylmethionine, or SAM-e for short, can also be quite effective, even though it’s more commonly know for its antidepressant effects. Like glucosamine, SAM-e supports and nourishes the cartilage that has been damaged due to wear and tear. In Germany, SAM-e is actually becoming more popular than glucosamine for arthritis relief. SAM-e may be as good as anything for arthritis, it’s just so darn expensive! But if you can afford it, it’s definitely worth a try (you’ll find it in most health food stores). Take 400 to 800 mg a day.
There are also a lot of useful herbal anti-inflammatories, including rosemary, curcumin, and ginger. I often recommend an excellent product from New Chapter called Zyflamend, which includes all of these herbs in addition to seven other herbs known for their joint supporting benefits. It’s available in vitamin shops and many on-line sources.
And finally, one formula that I’ve found can help, usually in combination with other remedies, is a German product called Wobenzym (I use it myself regularly). It includes two enzymes-papain from papaya and bromelain from pineapple. Like SAM-e, it is expensive, but it can be a big help in tough cases. The bottle says to take three tablets twice a day, but some people need up to eight tablets three times a day. You can find it in some health food stores, but it’s much cheaper to order it from the Internet.
I don’t have a problem with a patient using a drug now and then for a few days at a time if he’s suffering-as long as he’s still working with the safer options too.
Relief that stands the test of time
So far, we’ve been talking mainly about arthritis pain. The same approach applies to most types of back pain. As for headaches, that’s a topic that really requires its own article. But in the meantime, the over-the-counter remedies we talked about last month (Tylenol, Advil, etc.) can work great-but we’re talking about infrequent, intermittent use as needed. Take ‘em for more than a few days a week, and you risk making your headache problem worse-not to mention creating a whole new set of problems to go along with it.
If your doctor objects and says there aren’t good, randomized, controlled trials demonstrating benefits of the rational (natural) approach, you can point out that these other remedies are molecules that people have been ingesting for hundreds-even thousands-of years and that before you start turning your body into a life-long chemistry experiment with man-made molecules, you’d like to try the safe route first. If he’s still not willing to help you, it may be time to look for a doctor who is more open to natural alternatives instead of-or at the very least, in addition to-drugs. For help finding one, contact the American College for Advancement in Medicine at (800)532-3688 or visit their website at www.acam.org. ACD
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5 fast ways to get a head start on pain relief
1) Up your intake of fatty fish and nuts, especially walnuts and almonds. They’re great sources of omega-3 fatty acids, which ease inflammation and help keep your joints flexible.
2) Start a strength-training program: Stronger muscles = stronger joints. If you’re in a lot of pain, water aerobics are great, low-impact way to start building stronger muscles.
3) Consider trying a natural arthritis-reliever like:
” fish oil with a total of 1,000-3,000 mg EPA plus DHA
” 1,500 mg glucosamine sulfate
” 1,200 mg chondroitin
” 500-1,500 mg MSM
” 400-800 mg SAMe
Some supplement companies combine a few different natural pain-relieving ingredients into a single formula. I like JointGuard from Perque (which you can get from a company called Beyond Health by calling 800-250-3063 or visiting www.beyondhealth.com) and Natural Relief and Arthromax from the Life Extension Foundation (www.lef.org or 800-544-4440).
4) Herbal formulas can also help speed along pain relief. Some of the best ones I’ve come across are rosemary, boswellia, curcumin, and ginger. There’s a combination formula I recommend called Zylfamend contains all three plus a handful of other joint-supporting herbs. Wobenzym is another effective plant-based product that I’ve had some success with. It’s made from pineapple and papaya enzymes. Take three to five capsules twice a day. They’re both available in vitamin shops and from numerous on-line retailers (just do a quick search for either one on google.com and you get dozens of sources).
5) If you do use an over-the-counter pain reliever like acetaminophen or ibuprofen, make sure you’re taking the smallest dose possible (for some general guidelines, see last month’s issue)-and don’t use them for more than a few days, two weeks max!
Putting the “home” back in homeopathy: Simple cures you can use today
Homeopathy seems to intimidate a lot of people, but it’s really just a fancy term for probably one of the simplest forms of medicine there is. Homeopathic remedies date back all the way to the late 1700s, when medical treatments included much more severe methods, such as bloodletting.
It was created by Samuel Hahnemann, an eccentric genius German doctor. You’d have to be eccentric to get the idea to treat malaria with cinchona bark, which provokes malaria-like symptoms. But it worked. And homeopathy has developed from there, branching off into several different types.
Some homeopathic cures-especially vaccines-are actually diluted versions of the virus or bacteria itself. The idea is that these extremely small doses of a potentially harmful microorganism stimulate the immune system so the body can heal itself. Other homeopathic remedies just contain diluted doses of minerals or substances from plants or animals.
The idea of diluting preparations came long after Hahnemann’s original experiment with cinchona bark. But eventually scientists figured out how to take specific extracts from plants, animals, or minerals and successively dilute and shake them in water many times, often till there’s no molecule of the original substance left.
But the water retains an imprint of the original substance. This imprint is reflected in the water’s molecular arrangement which then guides the body’s own healing mechanisms.
Diluted formulas offer benefits that are anything but watered down
There’s nothing wrong with the over-the-counter homeopathic formulas-like Calms Forte and ColdEeze-available now. They’re a far cry better than most of the drugs they’re sitting next to on the drugstore shelf anyway. But the best kind of homeopathy is individualized. There are actually practitioners, called homeopaths who specialize in these treatments. First visits usually last an hour or more. Homeopaths want to learn all about the patient before selecting a remedy. They’re very interested in patients’ emotional make-up as well as their physical symptoms. Based on what he learns during the initial visit, the homeopath will then put together a treatment regiment for you and formulate the exact herbs or other substances you’ll need to take.
Within a day or so of taking the remedy, some patients feel worse. This is called an aggravation. It’s actually a good thing: A sign the remedy is taking hold.
Then many folks start feeling better over several days, as though they are getting well on their own. Sometimes, there’s a total resolution of the problem. Other times, it’s just a noticeable improvement. Either way, you’ve spurred your immune system into action and helped your body heal itself without harsh drugs.
Deeper problems, such as chronic pain, will probably take a lot longer to resolve. Your homeopath may want you to use several remedies sequentially over a few days, weeks, or even months.
But acute conditions, such as muscle strain and bruises, sprains, fevers, or nausea, often respond to single remedies known to work for the specific conditions. Here are a few I suggest you consider:
ARNICA MONTANA For bruises and muscle strain. Try it when your muscles get sore from exercise or to relieve post-surgical pain and soreness. (You’d be surprised how many surgeons have their patients take it after surgery.)
BELLADONNA For sudden onset of fever and the flushing that accompanies it during viral illnesses. It also works for throbbing headaches.
COFFEA CRUDA For nervous insomnia. Give it a try before you go to bed or if you wake up in the middle of the night and have trouble falling back asleep.
HYPERICUM PERFORATUM Great for banged up fingers or toes or the pain of shingles.
IPECACUANHA For nausea. It’s especially effective if your nausea is the persistent kind that’s not relieved by vomiting or when it’s associated with violent spasmodic cough.
NUX VOMICA Good for hangovers with a headache. This is my top pick for those of you who are hard driving, fastidious, and impatient. Some remedies just seem to work better for certain personality types, although we really don’t know why.
RUTA GRAVEOLENS For tendonitis and joint sprains. I also recommend it for tennis elbow and knee strains.
All of the above remedies are widely available wherever homeopathic remedies are sold, including many drugstores. And you can feel safe treating yourself at home for most minor problems. But it’s a good idea to see a homeopath for more involved, longer-lasting conditions.
Most homeopathic remedies are small tablets or pellets that you take orally. Get a 12C or 30C potency (which are the most commonly found) and take one, two, or three and let them dissolve under your tongue every two or three hours until you notice improvement.
For strains, pains, and bruises, you’ll need to take the oral remedies for up to seven days, if necessary three or four times a day.
If you want to read more about homeopathy, two of the best books I’ve found on the subject are Healing With Homeopathy: The Complete Guide by Wayne Jonas M.D. and Jennifer Jacobs M.D, MPH and Homeopathy in Primary Care by Dr. Bob Leckridge. Check your local library for copies. If it doesn’t have them, they’re available in book stores and from online sources like amazon.com.
To find a homeopath in your area, check with the National Center for Homeopathy by calling (703)548-7790 or visiting www.homeopathic.org. ACD
10 smart and easy exercises that will change your life
I’m what other doctors call loose-jointed. On its own, that’s not a bad thing. But when you combine it with things like rowing, which is one of my favorite hobbies, it does mean that I’ve got to be extra careful. The problem is, sometimes I’m not. So, truth be told, I’ve had just about every injury and problem under the sun, including knee surgery just last month!
But I’m from the “practice what you preach” school of thought, so I really don’t like to take drugs to relieve my pain. I use a lot of the supplements I told you about in the feature article in this issue. But I’ve also worked with physical therapists, sports docs, and some of the country’s leading personal trainers to come up with the following exercises that can prevent and relieve muscle and joint pain. And, let me tell you, these simple, easy little movements work if you do them regularly.
1. Triple Neck Restorer
This one’s great for sore, stiff necks. Tilt your head back slightly, and slowly turn it side to side. Next, tuck your chin in toward your chest, then slowly tilt it back, so that you’re looking up and slightly back. Finally, without twisting your neck, tilt your head side to side, pressing your ear toward your shoulder. Stand up tall and keep your spine straight. You want to use pressure, but don’t force it.
2. Safe Hamstring Reach
I always feel invigorated when I do a few of these stretches. Start by placing your hands on a chair, bed, bureau, or table. Stand up as straight and tall as you can (what physical trainers call “lengthening the spine”) then bend at the waist, keeping your legs straight. You should feel the stretch in your hamstrings and through your back, arms, and neck. Hold the stretch for 3 to 5 seconds, relax, breathe, and repeat it.
3. Sucking in Stomach
Turns out this does more than make you look slimmer in your slacks: It also helps build support for a weak back. And that can help you avoid that pain that usually comes after you lug the Christmas ornaments back up to the attic or spend the day traipsing up and down a stepladder washing windows during spring cleaning. And it couldn’t be easier: As you exhale, contract your stomach and back muscles. Keep your shoulders squared, your chin in slightly, and the back of your neck relaxed. Hold it for 3-5 seconds. This one’s also great because you can repeat it throughout the day wherever you are-in the supermarket or in your easy chair.
4. Static Wall Squat
Strong legs protect your knees, and squats are the best way I know of to strengthen your legs. These are a bit easier to do because you’re leaning against a wall for support. From there, you just slide down the wall until your thighs are parallel to the floor. Make sure your shins are perpendicular to the ground, and press down with your heels. Your shoulders should be square and relaxed. Hold the tension in your thighs and stay in this position for 10-30 seconds.
5. Russian Trunk Curl
This isn’t your average crunch-it does double duty by working your hamstrings along with your abs. Start by lying down, with your hands crossed on your chest and your feet flat on the floor (your knees will point up towards the ceiling). Curl your trunk and raise your shoulders off the ground, focusing tension on the muscles in the upper part of your stomach. At the same time, contract your hamstrings and keep your feet firmly in place on the floor. Make sure to keep your neck relaxed and your eyes toward the ceiling. Hold it for 3 seconds, then repeat.
6. Hula Hoop
This one’s easy and is a very safe and effective way to loosen up your back and hips. You don’t need an actual hula hoop to do it, just move as though you were using one: Stand with your feet shoulder-width apart and make big circles with your hips. Do a few circles in one direction, then switch and move the other way.
7. Headache Buster
I’m one of those lucky people who don’t get headaches very often (though my wife says I cause them from time to time). However, folks tell me this stretch works great to relieve them. Sit down and turn your head a little to the right, as if you’re trying to touch your chin to your collarbone. Then place your right hand on the back of your head. Apply slow pressure for a gentle stretch and take a few deep breaths in through your nose and breath out through your mouth. Hold it for 3-5 seconds, and repeat it a few times. Then switch sides.
8. Wall Hold
Good posture is one of the keys to getting rid of all sorts of pain: back, neck, etc. And this movement is an easy way to build better posture. Stand with your back against a wall. Your feet should be facing forward, about shoulder-width apart. Keep your shoulders square, and tuck in your chin very slightly, so that the back of your head is also against the wall. Keep your knees and the back of your neck relaxed and tilt your pelvis forward just a tad. Hold this position for a minute or so. I recommend doing this every morning when you get out of bed and every night right before you get back in. You want to get used to the feeling and remind yourself of it throughout the day.
9. Shake It Loose
This one just helps get all of the tension and worry out of your system. Stand in one place and relax all your muscles, including your neck and jaw. Then, gently twist your torso back and forth while swinging and wagging your arms. Keep going for about a minute. Take plenty of deep slow breaths, exhaling fully.
10. Mindful Walking
The way you walk is a part of your overall posture, and both play a big role in how much tension-and how much pain-you feel in your body. Pay attention to how you walk throughout the day. It should be like a moving version of the Wall Hold I described in #8. Your chin should be slightly tucked inward, the back of your neck, your knees, and your buttocks should be relaxed, your shoulders should be gently squared, and
your pelvis should be just slightly tilted forward. Your arms should swing comfortably at your sides. With every step, you want to land on your heel and then roll the pressure forward to the balls of your feet.
The only rule is there are no rules
I know what you’re thinking: “10 exercises a day? You must be joking!” But you don’t have to do them all at once. Pick two or three to start, based on your needs. Fit more in through the day when you can. Once you try them, you’ll see that a lot of them don’t really seem like “exercise” anyway.
How often should you do these exercises? Well, there’s no hard-and-fast answer, but I always tell my patients that something’s better than nothing: three days a week, five days a week, every day-take your pick. Personally, I take Mondays and Fridays off.
There are a few guidelines you do need to follow, though.
The first is to breathe deeply through your nose, and out through your mouth as you’re doing each of the exercises described above.
The second guideline is to stay relaxed. “No pain, no gain?” What masochistic idiot thought that up? If you learn to relax when you exercise, you’ll learn to relax all the time, and that goes a long way in building better health overall.
The final guideline is to take it slow, but take it. You’re in charge here. It’s your life. The movements I described above are pleasant, fun, relaxing, and rewarding, but they’re certainly not the be-all, end-all of beneficial exercises. They do dovetail nicely with more extensive strength training and aerobic programs, but that’s a topic for another issue.
In the meantime, I hope you enjoy these exercises as much as I do. Let me know how you do! ACD
The answer to your prayers
We’ve known for a long time that quitting smoking, meditating, and maintaining supportive, loving relationships all have positive health benefits. These things can certainly occur in the absence of regular churchgoing. But it seems like active spirituality, faith, and membership in a worship community helps reinforce these healthy practices.
Speaking from personal experience, I’ve seen lots of cases where, when someone’s health is falling apart, it’s their faith that keeps things together. Many folks call on their spiritual beliefs in times of need. The comfort it offers can have a positive impact on health-no matter what the specific illness. And it’s not just a placebo effect.
Research supports the role of spiritual and religious commitment in all sorts of aspects relating to health, from immune function to depression to overall longevity. Let’s look at some of the latest findings, many of them from Duke University School of Medicine:
1) Improve immune function
Weekly churchgoers were half as likely to have elevated levels of IL-6, an immune system protein elevated in a variety of age-related diseases.
2) Recover from depression
Hospital patients who demonstrated strong religious beliefs and faith were associated with quicker recovery from depression.
3) Prevent high blood pressure
Risk of high blood pressure was 40 percent less among people who both attended weekly religious services and prayed daily.
4) Live longer
In one study done at Dartmouth, elderly patients in the hospital were 14 times less likely to die following surgery if they remained socially involved and continued to find comfort in their faith.
In fact, attending church more than once a week has even been associated with up to seven years increased life span. Another study that tracked 21,000 adults from across the nation showed that religious attendance was a strong predictor for living longer, even when other important were taken into account. Nothing to lose, everything to gain, I’d say. ACD
Your Questions Answered
The nutrient your taste buds might be missing
Q.I have noticed a loss of taste over the last few years. It has been gradual, but now I just don’t enjoy my food the way I used to. I still have a good appetite and have not lost any weight. I am 62 years old. My diet is mostly vegetarian and includes some dairy and occasional fish. I’m not on any drugs and lead an active, healthy lifestyle. What is causing this problem and how can I fix it?
–R.G., Cadiz, OH
A.There are lots of possible causes for this problem. I know you mentioned you’re not on any drugs, but they’re usually the most common culprits. Lunesta (the new sleep medication), ACE inhibitors (especially captopril), angiotensin receptor blockers like Diovan (valsartan) and Avapro (irbesartan), calcium channel blockers (especially nifedipine), and antihistamines like Allegra and Claritin can all affect taste. It’s quite a list! For any other readers who might be having similar problems and are on one of these medications, rest assured that taste disturbance from drugs usually improves once the drug is stopped, but don’t expect overnight miracles: It can take days or weeks for full recovery.
A sluggish thyroid can also diminish taste. But, next to drugs, the most common cause is zinc deficiency. Over 73 percent of Americans aren’t getting enough. The RDA is 15 mg, and if you’re not getting that amount, over time it can lead to some pretty serious problems-loss of taste is just one of them. Zinc insufficiencies are also associated with slow wound healing, dandruff, reduced appetite, and skin disorders such as acne and psoriasis. Adequate zinc also helps prevent age-related macular degeneration.
Anytime I suspect that one of my patients has a zinc deficiency, I have them start by focusing on eating more foods that contain it. Zinc is found in abundance in oysters, beef, and lamb. Other good food sources include pecans, walnuts, almonds, Brazil nuts, split peas, egg yolks, rye, oats, peanuts, and lima beans.
I also suggest a multivitamin as cheap insurance. Widely available brands that have tested out well include Centrum, Vitamin World, Puritan’s Pride, Nature Made, and Nutrilite. Megafood and New Chapter offer once-daily multivitamins that have added nutrients derived from foods, which enhance uptake and utilization of the vitamins and minerals they contain. So these are two of my staple recommendations.
The15-mg per day RDA from supplements should be enough for most of you. You do need to be careful not to take too much: Excess zinc can cause a copper deficiency and depressed immune function. Toxic effects include dizziness, vomiting, and lethargy. Zinc taken alone on an empty stomach can cause nausea. But all of the multivitamins include copper, so none of these potential problems should be a big concern if you stick with one of them.
I actually don’t recommend routine blood testing of zinc levels because they often show up “normal” even though the patient doesn’t get enough zinc. Taking a good multivitamin and eating more foods that contain zinc is safe enough to try without testing anyway.
The text contained herein does not constitute medical advice. America’s Country Doctor advises that you consult your own physician before acting on any recommendations contained within this publication.
Posted in Newsletter.
