George, a full time waiter, asks if there is anything he can add to his protocol of turmeric, boswellia, ginger, chondroitin, and willow bark to alleviate arthritis pain in his foot. Osteoarthritis (OA) is a painful condition of the joints that occurs when the cartilage that cushions them breaks down. The progression of osteoarthritis includes local inflammation that accompanies wear and tear that comes with age, overuse, injury, skeletal misalignment, or chronic, systemic inflammation. There is often a strong genetic component to OA. The good news is that you’re off to good start with your current protocol, which includes herbs that are systemically and locally anti-inflammatory and analgesic. Just make sure that the preparation you’re using includes a small amount of black pepper (piper nigrum) and some fat to assist in adsorption of turmeric compounds. If your preparation does not contain fat, take it with meals that do. An herbal protocol should be part of a larger strategy that includes diet and lifestyle modifications. We’ll discuss herbs and dietary factors below. You may want to have a discussion with your physician about relevant lifestyle factors; one important thing to consider is whether being on your feet as a full time waiter is a trigger for inflammation. We want to consider a long term strategy as well as strategies to address acute pain. Long term we want to focus on the following: · Reducing inflammation since there are several relevant inflammatory mediators in OA · Supporting peripheral circulation and micro circulation to help bring nutrients the tissues · Supporting the body’s natural detoxification and elimination systems Some herbs to consider adding to your protocol include the following: · Prickly ash (Zanthoxyllum clava-herculus) to enhance circulation of blood and lymph · Devils Claw (Harpagophytum procumbens) for additional anti-inflammatory action · Gotu kola (Centella asiatica) to support microcirculation · Ginkgo biloba to support microcirculation · Nettle leaf (Urtica dioica) to support elimination · Dandelion leaf (Taraxacum officinale) to support elimination For several reasons acute pain relief in OA can sometimes be tricky, especially for the smaller joints. Consider combining the willow bark you’re already taking with meadowsweet (Filipendula ulmaria), just be aware that willow can sometimes cause stomach upset. A topical preparation could provide great relief. Look for one that contains cayenne or capsaicin, which relieves pain by interrupting the transmission of pain signals. In terms of diet you’ll want to explore the possibility of food sensitivities. Sensitivity foods from the Solanaceae family – tomatoes, potatoes, eggplant, and peppers – are typical culprits for triggering inflammation in OA, but sensitivity to dairy, wheat, and soy are worth investigating too. Food sensitivities are typically by an elimination diet, you’ll find a detailed description of how to do an elimination diet in this article by naturopathic physician Bryan Walsh. Minimize simple and refined carbohydrates like pasta and breads and be sure to eat lots of veggies and fruits in the whole rainbow of colors, they’re loaded with anti-inflammatory and antioxidant compounds. Make this at least half of your plate at each meal. Regularly eat foods rich in anti-inflammatory omega-3 fatty acids. The best food sources are fatty fish like: · Tuna · Salmon · Herring · Sardines Plant sources include · Flax seed · Chia seeds · Walnuts Hope this Helps George. Have a question? AskTheHerbalists! Renata is a clinical herbalist with a private practice in Greenbelt, MD. She helps women build a solid foundation of wellness while working together to address their unique health concerns so they can live life with vibrance and vitality. She has a BS in Chemistry from University of Maryland, a MS in Therapeutic Herbalism, and a Post Masters Certificate in Clinical Herbalism from Maryland University of Integrative Health. Find her at renalynn.com and on Facebook @renatalynnclinicalherbalist
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