What Alternative Therapies Work Best For Osteoarthritis?

A recent review article appearing in Medscape (Evidence for the
Efficacy of Complementary and Alternative Medicines in the Management
of Osteoarthritis. Vijitha De Silva; Ashraf El-Metwally; Edzard Ernst;
George Lewith; Gary J. Macfarlane) shed light on a rapidly growing but
mysterious – at least to traditional practitioners- method of medical
treatment. That is the field of complementary, better known as,
alternative therapies. In our practice, most patients will readily
talk about alternative therapies they are trying or hope to try in the
future. Often, they ask my opinion and ask about which types of
alternative therapies I would recommend. One of the biggest shortfalls
of treatment today in rheumatology is the lack of effective treatment
modalities for osteoarthritis. All therapies currently considered
"conventional" are designed to alleviate symptoms. They do absolutely
nothing to control the progression of disease. Osteoarthritis is not a
benign disease in that it is a key cause of disability in adults and a
leading cause of missed days from work. So… one argument raised by
many patients is this… 'Why should I take a chemical pain killer with
all the potential side effects when I can take an alternative therapy
that does the same thing without the side effects?" And I have no good
response to that question other than, "You have a good point."
Nonetheless, it is nice to have a review article that has examined the
therapies and provides some evidence, albeit sparse, that some
therapies work while others are still, in the drawing board phase. The
article mentioned above exhaustively examined numerous studies. They
concluded that capsaicin gel and S-adenosyl methionine (SAMe) had
credible data supporting their use in osteoarthritis. They also felt
there was sufficient evidence to possibly support the use of
frankincense, MSM, and rose hips. Unfortunately, there was not enough
clinical trial data to advocate the following: ASU, CMO, green-lipped
mussel, pine bark extracts, SKI 306XI, vitamin B complex, ginger and
homeopathy. One flaw is that there are few well-controlled studies
looking at these types of therapies. The major reason is that it is
extremely difficult to secure funding to look at therapies that are
not produced by a pharmaceutical or biotech company. As the director
of a leading arthritis research center, I can vouch for the difficulty
in obtaining any type of grant that is not tied to a drug in
development. One key point, the authors made in the above referenced
review is that there were very few side effects associated with these
alternative therapies. These included heartburn, gastrointestinal
upset, and heartburn. There is a dilemma here because many alternative
therapies have, over time, proved their worth. These include
chiropractic, acupuncture, massage therapy, hypnotherapy, and the
like. On the other hand, there are alternative therapies where the
evidence is lacking. For every treatment that eventually proves its
worth, there are probably ten that are bogus. But how do you tell? In
all honesty, you can't. And that is why you have to rely on your
doctor as well as your own response to the treatment. Remember… the
placebo response for arthritis remedies can approach forty per cent.
That isn't all bad if the aim is to get symptom relief. Nonetheless,
if it is a treatment with potential harm associated with it, be very
wary. Published at:
http://www.isnare.com/?aid=837025&ca=Medicines+and+Remedies