PART 1
Perhaps more than any other problem, I am frequently asked about arthritis. “Is there anything you can do to help me with my arthritis?” “Is arthritis curable?” “Is arthritis related to diet?” “I’ve been told that arthritis is normal when you get to be my age, is that so?” An incredibly common disorder, it is found in people of all ages, varying both in type and severity. It is also one of many chronic disorders for which conventional drug therapy holds few answers beyond temporary alleviation of symptoms.
So, to begin with, let’s state unequivocally: Yes, there is a lot that can be done for the great majority of arthritic conditions. Depending on the severity, some can be absolutely eliminated, others can be reduced significantly, some respond moderately, and a certain per cent remain unresponsive to treatment. Again, depending on the severity and history of the condition, improvement can be quick and straightforward with the majority of symptoms disappearing in a matter of days — or it can be very slow and complicated taking months or years.
There are many different types of treatment available for arthritis ranging from fasting, diet and nutrition, to intestinal cleansing, herbology, physical manipulation, acupuncture, homeopathy, qigong, yoga, ... You name it and that system will have an angle of how to approach arthritis. Sometimes one type of therapy will be adequate to deal with the condition. Oftentimes, it will be a combination of complimentary modalities that prove most effective.
We have been bandying the word around easily enough, but what exactly is arthritis? Literally, it means joint (arthro-) inflammation (-itis). The word by itself is an umbrella term which covers several different syndromes related to pain, swelling and possible deformation in the joints. Modern medicine recognizes the following major types of arthritis:
Osteoarthritis (Degenerative arthritis). Estimated to afflict about 16 million people in this country, it is said to be the result of wear and tear on the joints.1 The cartilage at the ends of the bones becomes rough, and the friction of the bone surfaces causes pain, stiffness. Accompanying this is a weakening of the connective tissue which holds the joint together. Mostly a phenomena of advancing age, statistics show that women with osteoarthritis outnumber men by about three to one, and it commonly runs in families.
Rheumatoid Arthritis . An autoimmune disease in which the body’s own immune system begins to attack the connective tissue in the joints and surrounding connective tissue. Destruction of tissue and the build up of scar tissue lead to pain, stiffness, deformation, and fusion of the joints. This is a severe disorder affecting over two million people in the United States, with women outnumbering men by about two to one.
Juvenile Rheumatoid Arthritis (Still’s Disease). This is a type of rheumatoid arthritis that is found in children. About seventy thousand children are diagnosed with the condition. It is more prevalent in girls than in boys by a ratio of six to one, and is most commonly found in children under the age of four. Depending on the severity it can lead to stunted growth and deformities.
Ankylosing Spondylitis. A variety that affects the joints of the spine. The inflammatory process causes rigidity and can lead to fusion of the vertebrae. Over three hundred thousand people are affected by it, with men outnumbering women by about two to one.
Seronegative Arthritis. 2 This is a group of arthritic disorders where the blood test are negative for rheumatoid arthritis. It is usually associated with other inflammatory processes in the body such as psoriasis (psoriatic arthritis), gastroenteritis (inflammation of the bowels), and other autoimmune diseases like systemic lupus erythematosus.
Infective Arthritis (Septic Arthritis). This type usually arises from the invasion of bacteria into joints. The bacteria either originate in the bloodstream or from a nearby wound. Other kinds of infections like chickenpox, rheumatic fever or urethritis can also cause infective arthritis.
This classification of the different types of arthritis shows what kind of symptoms are associated with it and provides an overview of the syndrome as a whole. Yet, it does little to explain the reason or reasons why it occurs. Even the cause of osteoarthritis, which supposedly arises from ongoing usage, is not adequately explained by that assumption alone. There must be at least one other factor that influences the condition to explain the fact that women are affected three times more than men.
Not only is the cause of arthritis not well understood through the perspective of conventional medicine, but it is essentially untreatable. Drugs are used to calm down the inflammatory processes, but they are only temporary in effect. People treated with milder analgesics, nonsteroidal anti-inflammatory drugs or even steroids either find that their condition remains essentially unchanged after the drugs wear off or that they need increasingly stronger doses or stronger drugs. Sometimes, they may end up with gold injections into the joints or taking very toxic drugs used for chemotherapy in cancer. As the treatments escalate, so do the deleterious side effects. Another route, in certain cases, is the surgical removal of the joint and replacement with an artificial prosthesis.
1 Balch, J. and Balch, P., “Prescription for Nutritional Healing”,pg. 96 Avery Publishing, Garden City, NY, 1990
2 American Medical Association, “Home Medical Encyclopedia”, pg. 132 Random House, New York, 1989
PART 2
Arthritis is such a prevalent problem in our society that one wonders whether it is a product of modern living. Or, perhaps it has always been part of the human condition — a result of inevitable stresses on our bodies, or a flaw in our physical structure and design.
The evidence shows that this illness has been around for a long time. Close examination of mummies and other remains of ancient peoples has shown that arthritic-like conditions existed in antiquity.1 It has been said that even fossils of ancient reptiles have revealed similiar evidence of arthitis. So, this is a problem that humankind has needed to grapple with a long time before the advent of modern medicine.
The medical systems originating in other eras and distant cultures have understood and treated it in ways that are distinctly different from our commonly held present day perspective. Many of the ideas and approaches of these systems are,in fact, very revealing and effective if we take the time to examine them.
"Bi Jeng" is a several thousand year old chinese term that literally means "obstruction syndrome". In traditional oriental medical jargon, this is roughly equivalent to arthritis. For the practitioner of this type of medicine, the essential nature of the human body is a network of energy paths that tranverse the body in very specific patterns. These are the "meridians" of acupuncture, and through them flows life's energy, otherwise called "chi". The symptoms associated with ‘bi jeng’ are a result of these paths becoming obstructed so that this energy no longer courses smoothly on its way. Instead, it becomes stuck at certain places and creates discomfort where it is blocked.
What causes the disruption of energy flow? Traditionally, the chinese recognized seven "external factors" which are the cause of much disease. These factors are environmental influences which stress the body. They 'invade' the body — and the meridians — when it is weakened or the enviromental conditions are overwhelming.
Of the seven, four are considered to be involved in the obstruction syndrome. They are: heat, cold, humidity and wind. Therefore, in the literature we find the terms "heat obstruction", "cold obstruction", "humidity obstruction", and "wind obstruction". To make it more interesting, there can also be combinations of these factors, such as "damp heat obstruction" or "cold damp wind obstruction".
Each type has associated with it a particular nature and a complex of symptoms. The nature of cold obstruction is very sharp pain that does not let up. It is relieved by the application of heat and worsened in cold weather. Heat obstruction is characterized, naturally, by the heat that accompanies the condition. The joints are swollen, painful, aggravated by pressure, and feverish. Damp obstruction is very deep and immobile. It becomes fixed in particular spots without movement to other areas. On the other hand, wind obstruction is a wandering pain that jumps from place to place. The pain is less intense, best described as a type of soreness.
For the person reading this description who suffers from arthritis, it might sound more like an interesting fantasy than a medical explanation. But the fact of the matter is that using this way of thinking, oriental medical practitioners have treated arthritic conditions for centuries with a good rate of success.
Instead of having the same regimen for every person, they differentiate which type of syndrome and which particular meridians are obstructed an any individual case. Using acupuncture, they stimulate the related meridians so that the obstruction is removed. They prescribe herbs that will warm the cold, cool the heat, dry the damp or disperse the wind. Furthermore, appropriate foods are suggested which enhance the cooling, warming, drying or dispersing functions of the herbs, while at the same time instructing the patient to avoid other types of foods which are detrimental to the cure.
An equally ancient, if not even older, tradition of healing is the practice of ayurvedic medicine in Inda. Along with conventional medicine and homeopathy, it is still one of the major forms of medicine in that country today. According to ayurvedic theory, arthritic complaints are the result of improper digestion.
When food is not fully digested or if toxic residues remaining from the digestive process are not eliminated properly, a substance called "ama" is created in the system.2 As the ama accumulates, it begins to build up in the connective tissues, especially the joints. Treatment is effected by strengthening the digestion with herbs and modifying the diet to eliminate the production of ama. Herbs and other cleansing regimens like oil baths are also used to eliminate the ama that already has accumulated throughout the body.
It is interesting to note that the word "rheumatic" comes from the greek "rheuma" — which means "a watery mucous discharge".3 Originally, in the west rheumatic complaints were also thought to originate from an excess of a substance similar to the ama of ancient India.
Next time, we'll look at some other ideas about arthritis.
1 De Vries, Jan. "Arthritis, Rheumatism and Psoriasis", pg. 18 Mainstream Publishing, Edinburgh. 1986 2 Dash, V. D. "Ayurvedic Treatment for Common Diseases", pg 127 Delhi Diary, Delhi. 1979 3 American Heritage Electronicl Dictionary. Houghton-Mifflin Company. 1991.
PART 3
Wes was a behemoth of a man who made his living climbing poles for the telephone company. Around 6'5" and well over 300 pounds, it was hard to imagine him shimmying up so high on those skinny poles. But that's what he did until arthritis began to spread uncontrollably throughout his body . At first non-steroidal anti-inflammatory drugs controlled the symptoms. Then increasing doses had less and less effect. He graduated to steroids which were equally ineffective after a period of time. When he came to see me, Wes had just completed a round of gold injections which proved to be of no use at all.
Wes ate as one might expect a man his size. He loved his deserts, his drink, his meats, fast food, fried food, ... He even owned a few head of cattle so he could have an abundant, inexpensive supply of beef. It was clear from our first meeting that working with Wes meant working on how he ate. After listening to my ideas, he agreed to give it a try. Fortunately, he had a partner who was committed to following through with a new dietary regimen. She learned to cook in ways that neither of them had ever known before. When his will power began to falter, she was there to renew his determination.
The herd of cattle were sold. Wes loss upwards of 70 pounds, giving up many of what he considered his greatest sensual joys in life. Along with herbs and acupuncture, this diet change was the central part of his road to recovery. Over two years, step-by-step, mouthful-by-mouthful, and pound-by-pound, Wes made slow, continual progress. By the time treatment was discontinued, he looked and acted a different person. Not 100% cured, but let's say ninety-something percent.
Although conventional medical theory rarely correlates arthritis with dietary imbalances or problems with the digestive processes, other medical traditions commonly make this connection. Last week, the concept of "ama" that comes from the ayurvedic tradition of India was introduced. Ama is thought to be the toxic residue from incomplete or improper digestion which builds up in the body. As it accumulates in the connective tissue, muscles and joints become stiff and painful.
Naturopathic physicians in this country and Europe have articulated similar ideas since the beginning of this century as well. Some have maintained that acidic conditions in the body caused by an overabundance of animal products, nightshades, processed foods and sugars are responsible for arthritis. Others emphasize the toxicity of meats and dairy foods which build up in the system.
There are those who feel that the problem lies less in what is taken in than in the weakness of various parts of the digestive mechanism. Some subscribe to the use of digestive enzymes to aid the stomach and small intestine to break down the food more completely. Some believe that the build up of toxicity is centered in the large intestine and design programs to clean it.
A variation on this theme is that certain people are actually suffering from allergic reactions to certain foods which induces inflammatory processes in the connective tissue. That accounts for the fact that some people can eat all the "wrong foods" without ever suffering from adverse effects while others pay for every morsel.
A nutritional approach suggests that people suffering from arthitis may be deficient in certain vitamins, minerals or other substances that assist in the complete digestion and elimination of food, as well as enhancing natural anti-inflammatory mechanisms of the body. This might be the result of diets long on convenience and short on nutrition. Or, it could be the result of long-term soil depletion that has robbed much of our produce of trace minerals and other vitamins.
Most practitioners subscribe to a combination of the above reasons. In many ways, these are all different perspectives on essentially the same phenomenon. That is, these are all variations, to one degree or another, of "You are what you eat".
Certainly, diet and digestion have a profound influence on arthritic syndromes. People like Wes can never make real improvements in their condition unless they changed what they eat. Some arthritics change their diets and/or clean out their digestive tracts through various means to find themselves totally relieved of all symptoms. It seems miraculous to them. These are the easier cases where the individual is very vital, just a bit toxic from inappropriate habits.
But that can't be the entire picture. How about people who develop arthritis almost from birth? What accounts for the autoimmune factors that play an important role in many types of arthritis? What about people who become arthritic after an infection or other disease? What about people who follow extremely narrow diets and still find no relief? There must be other factors that play into the syndrome. More next week...
PAIN 4
Every once in a while we hear about a new cure for arthritis. It might be publicized in the newspaper, reported on TV, advertised on the radio, or spread by word of mouth. Usually, there is some sort of convincing personal testimonial involved that makes us more ready to believe in the product and perhaps more inclined to use it — or at least, think about using it.
These types of cures range from special diets to vitamins and mineral supplements to herbal tonics, from topical liniments to exercise regimens. Personally, they are all very intriguing. And I am inclined to accept the truth of many, if not most, of the claims made for them with one important caveat. That is, most of these treatments can help some people sometimes. Some can actually cure some people, others take away their pain. But there always is a good percentage for whom a particular cure will not be effective.
Take shark cartilage, for instance. Starting last year, the use of specially processed shark cartilage has not only been touted as a potent anti-carcinogenic, but also effective in psoriasis and arthritis. It has received national television publicity twice and been the subject of many newspaper articles. Some people might know that in our immediate area there is a major distributor of the product.
My experience with shark cartilage is somewhat limited. Amongst those people known to me who are using it, I am monitoring several that are taking it for arthritic complaints. For some of these people it has worked superbly and for others there is no effect whatsoever. How could that be?
Simply put, it is a matter of individuality. No two people are the same and no two cases of arthritis are exactly the same, either. Whatever the supplement, whatever the therapy, it must fit the person. The characteristics of each case of arthritis and the nature of each person who is arthritic varies immensely. This concept, of course, is not limited to just arthritis. It applies to any condition — and it is the most important cornerstone to any truly wholistic approach to medicine.
Practicing wholistic medicine is not merely a matter of substituting shark cartilage for cortisone. It is not just an attempt at finding a natural substance to take the place of a synthetic one. The concept of wholistic medicine is based on understanding and treating unique individuals who have unique situations.
That is why it is impossible to find a single diet that is universally effective for arthritis. Or a single miracle elixir... What works for one person won't for the next. The science — and art — of wholistic medicine lies in the individualization of treatment.
There is another perspective that is also important to keep in mind. An old axiom of the East Indian ayurvedic physicians, consisting of three words, translates into something like: "Cleanse, regulate, nourish". It is meant to describe the three basic processes necessary to return a sick person to health. First, the body must be rid of stored up toxicity. Second, the nervous system, organs and metabolic process must be restored to a state where they function smoothly and efficiently. Finally, the body must be given the proper nourishment to regain strength and vitality.
In a particular individual, any combination of these three processes will be necessary for effecting a cure. For some, a simple cleansing through restricted diet or use of special herbs is enough to restore them to health. For others, supplementation of one or more missing nutrients will be enough to recover. Inevitably, these two types of cases are the ones in which "miraculous" cures take place. These are the people whose testimonials claim that "after one month of using brand X my arthritis completely disappeared!"
But regulating the nervous system and metabolism is not quite as simple. Even more difficult are cases where the patient is in need of regulation as well as either cleansing or nourishment, or both. This is because imbalances of this sort are usually the result of accumulated stresses combined with a particular disposition.
These are the cases where, for example, a person may have suffered so much personal grief that he or she turns inward to protect themselves from the pain of the outside world. Or the situation where a person has a large residue of anger due to an accumulation of any number of life experiences. Unexpressed or unresolved, this emotion will also turn inward and inflame the body. Over time, strong emotions inevitably manifest on the physical plane. The grief, anger or whatever emotion somaticizes as rigidity, stiffness and pain.
These situations are not so easy to do away with. Diet alone is not a satisfactory answer. It is here that some combination of "energetic medicine" such as various forms of bodywork, acupuncture, or homeopathy, perhaps in combination with therapy, will effect the best results.
No magic potions will eliminate the problem. Instead, a slow process that entails resolving the emotions and addressing the underlying energetic imbalances which result from them is the only means to cure.