The traditional view is that both conditions are caused by wear and tear. However, more recent evidence suggests that inflammation and chronic pain (even after an injury has healed) may be linked to an immune system response.

According to work presented by Dr Joyce DeLeo, a neuropharmacologist at Dartmouth Medical School, at the annual meeting of the American Association for the Advancement of Science in Philadelphia (February 16, 1998) there is a large biological overlap between the immune system and the central nervous system. Dr DeLeo’s paper suggested that some forms of chronic pain persist and become even more intense after healing is apparently complete. This could be because a persistent barrage of nerve signals from a site of nerve or tissue damage may sensitise the nervous system and may even alter the way it functions.

Dr DeLeo and her colleagues believe the immune system is intimately involved in the initiation and maintenance of pain through the production of proteins called cytokines. Their studies have identified at least three proteins interleukin-1, interleukin-6 and tumour necrosis factor alpha which were produced by cells in the spinal cord as a result of nerve injury. One of these, interleukin-6, was shown to generate pain even in the absence of injury. Cytokines were first described in relation to their activities in the immune system. Their actions are known to be complex and affected by the presence of hormones and inflammation. Dr DeLeo now suggests they also have an essential role in the development and survival of the nervous system.

The immune system theory dovetails neatly with more well founded ideas such as inflammation being caused by allergy (which also involves an immune system response). Anyone suffering from bursitis or tendonitis should certainly rule out both food and chemical sensitivities before considering aggressive conventional treatments such as prednisolone, ibuprofen or the more radical “solution” of surgery.

Nutritional therapy has a great deal to offer bursitis sufferers. In one study of 40 patients with bursitis (mostly sub deltoid type), 1000 mcg daily of B12 for seven to 10 days, tapering off to three times weekly for two to three weeks, then one to two times weekly for two to three weeks (depending on rate of progress), all but three patients improved. They experienced rapid relief of pain and subjective symptoms, sometimes within a few hours. Follow up x-rays of cases of calcific bursitis showed considerable reabsorption of calcium deposits (Indust Med Surg, 1957; 26: 20-2). A combination of vitamin C with bioflavonoids, 200 mg three times a day, may ease subpatellar bursitis. In one case, symptoms were all but gone within 72 hours (AM J Digest Dis, 1955; 22: 41-45). Vitamin E also protects against inflammation (J Vitaminol, 1972: 18: 204-9). In addition, low zinc levels may result in the accumulation of free radicals which can cause inflammatory disease. Supplementation may help (Agents Actions, 1986; 18: 103-6).

The omega-3 fatty acids can reduce inflammation by altering the balance of pain producing prostaglandins and leukotrienes (Wein Klin Wochenschr, 1986; 98: 104-6, N Eng J Med, 1985; 312: 1217-23). Omega-6 fatty acids in the form of either borage oil or blackcurrant oil may also help reduce inflammation (Am J Clin Nutri, 1992; 55: 39-45).

WDDTY panellist Harald Gaier has found that Urarthone (available from the Nutri Centre, Tel: 0171-436 5122) is quick and effective in alleviating joint problems. It’s a mixture of some 18 different natural ingredients, which should be taken in water twice a day.

Another of our panellists, osteopath Dr. David Charlaff, cautions: “Bursitis usually involves a number of different tissues and other elements around the pain site, and not simply the fluid filled sac between muscles, muscles and tendons, and tendons and bones, called the bursa.”

He suggests first trying local and distal acupuncture particularly effective with electro stimulation. Secondly, if the pain is bilateral (on both sides), it could have a spinal cause, which osteopathy could deal with effectively. To reduce inflammation, he suggests homoeopathy initially using remedies such as Arnica, Ruta grav and Rhus tox in 6th or 30th potencies, depending on the indication. If they don’t work, he would then use herbal medicine.

There is good research to show the efficacy of herbal preparations in cases of bursitis. There are, for instance, hundreds of papers on the applications of bromelain in cases of inflammation due to arthritis, sports injury or trauma (J Ethnopharmacol, 1988; 22: 191-203). Bromelain has been shown to stimulate the production of anti inflammatory prostaglandin E1 (Med Hypoth, 1980; 6: 99-104) and may inhibit the synthesis of pro inflammatory prostaglandin E2 (Arzneim Forsch, 1986; 36: 110-12).

Curcumin, the pigment and active component of turmeric (Curcuma longa), has long been used in Ayurvedic medicine, locally and internally, for sprains and inflammation. The recommended dose is 400 to 600 mg three times daily (Agents Actions, 1989; 28: 298-303).

Feverfew may also be effective in reducing the synthesis of prostaglandin E2 and the formation of leukotrienes and thromboxane, all of which are involved in the inflammatory and pain process (Lancet, 1985; i: 1071-4). Feverfew’s efficacy is dependent on the level of parthenolide in the preparation used. Most clinical trials have a parthenolide content of 0.4-0.66 per cent.

David Charlaff also recommends remedial exercise, such as simple yoga or the Pilates method. A recent review shows that gentle stretching exercises, combined with nutritional supplements, may be the best way of keeping joints in good shape (Townsend Letter for Docs and Patients, April 1998). Be aware that it can take up to 18 months for pain to disappear completely. If the pain lasts longer, you may need to have further analysis, such as ultrasound, to determine the cause. However, Charlaff acknowledges that there is a certain amount of trial and error in whatever method one uses. Although removing your amalgam fillings was probably a good first step, detoxification can take some time particularly if you had many fillings in your mouth for a long period of time.

Finally, you may want to reconsider your use of blue green algae, also known as AFA (Aphanizommenon flosaquae). Recent reports are that some algae products, particularly those harvested from the Klamath Lake region of Oregon in the US have produced undesirable side effects such as nausea, vomiting chills and malaise symptoms usually associated with the presence of toxins (Proof!, 1998, 2: 20), causing or exacerbating chronic pain.

A-Bursitis is a painful inflammation of one or more bursae the little sacs that contain synovial fluid and help to smooth the gliding of your muscles, tendons and skin over your bones. If your problem is chronic, it is usually caused by trauma, which causes pressure to one or more joints. The most common cause of bursitis is overuse of the joint, particularly if you are out of shape. Because it usually affects joints, bursitis is often mistaken for arthritis.

But even if your doctor knows what he’s treating, he still will throw the same types of drugs at your bursitis that he would to a patient with arthritis.

Besides analgesics and oral steroids, doctors like to use ultrasound with these types of sports injuries, which is supposed to calm the inflamed area. They also commonly inject either an anaesthetic or a steroid into the area to reduce inflammation.

While all three regimes will help to reduce your inflammation, steroids have a well known list of side effects from bone loss to Cushing’s syndrome as do anaesthetic drugs. The side effects of using sound waves at close range to human cells and tissues is largely unknown, although we do know, from lab studies of ultrasound, that it causes heat and cavitation (bubbling) to unknown long term effects.

Happily, you may not need to resort to drugs. A number of supplements will help to reduce immediate inflammation every bit as effectively as drugs, according to WDDTY panel member Dr Melvyn Werbach, who has researched numerous supplements in depth.

One of the most important supplements to consider is injections of vitamin B12.

One study examined 40 patients given daily injections of 1000 mcg of B12 intramuscularly for 7 to 10 days, followed by three times weekly for two to three weeks, and once or twice weekly for another two to three weeks. All but three of the patients improved, reporting rapid relief of pain often within a few hours. Many had a complete resolution of symptoms within a few days (Indust Med Surg, 1957; 26: 20-2). In this instance, many of the patients had bursitis with calcium deposition and x-rays showed that the deposits had been completely disbursed.

Perhaps less dramatically, vitamin C with bioflavonoids also can help to reduce swelling. In one case report, a 38 year old with bursitis of the knee given vitamin C plus 200 mg of citrus bioflavonoids three times per day showed reduced swelling within a day and almost complete resolution of the lesion in three days (Am J Digest Dis, 1955; 22: 41-5).

Other bioflavonoids like quercetin have also been shown to set in motion a process which produces anti inflammatory prostaglandins (Prostaglandins, 1980; 20: 627-37).

Two months before you begin playing tennis, you may wish to start taking supplements of omega-3 fatty acids (4 g per day in divided doses), which also help to change the body’s balance of prostaglandins and leukotrienes, and so to markedly reduce inflammation (Wien Klin Wochen-schr, 1986; 98: 104-6). In a tiny study of seven subjects, supplementing with fish oils produced a 48 per cent reduction in the inflammatory products of the pathway which releases arachidonic acid (N Engl J Med, 1985; 312: 1217-23). You need to start taking these supplements two months before you begin playing tennis because it takes that length of time for the supplements to have their effect on body chemistry. Whenever you are taking omega-3 supplements, be sure to take vitamin E as well, which can prevent cellular damage through increased cell membrane peroxidation (Clin Res, 1987; 35: A565).

Besides fish oils, omega-6 fatty acids, which are rich in gamma linoleic acid, also can help reduce inflammation (Am J Clin Nutr, 1992; 55: 39-45).

You may also wish to take proteolytic enzymes such as chymotrypsin and trypsin, which break down amino acids, and have been shown to speed up healing in sports injuries. In one double blind study of football players who were randomly given either a concentrated proteolytic enzyme mixture or placebo, the group given the enzymes had fewer injuries taking them out of the game and were able to return to playing sooner than controls. The controls also had more minor injuries than those taking the enzymes (Am Chiropract, October 1981: 32).

In lab studies, oral doses of chymotrypsin have been shown to increase blood levels of the enzyme (J Clin Pharmacol Ther, 1964; 5: 712-15).

Perhaps the best remedy of all may be taking a combination of supplements. In one lab study, proteolytic enzymes, bioflavonoids and vitamin C given together proved to have a broader action than NSAIDs in reducing inflammation (Arzneim Forsch, 1977; 27: 1144-9). Bear in mind, though, that this particular study used rats, and the results of animal studies do not necessarily apply to humans.

Besides vitamins and supplements, a number of botanicals also contain the same substances that help to reduce inflammation. Chief among these is bromelain, a mixture of proteolytic enzymes from the pineapple plant. Numerous reports have shown that bromelain can reduce swelling after sports injury or trauma (J Ethnopharmacol, 1988; 22: 181-203).

Bromelain is mainly thought to work by stimulating the production of the antiinflammatory prostaglandin E1 (Med Hypoth, 1980; 6: 99-104). It’s also been tested in reducing pain and inflammation of surgery.

In one double blind trial of 160 women who’d received a mediolateral episiotomy (a painful version of the perineum incision to ease birth that is rarely used these days) the women given the bromelein suffered less swelling and pain than controls (Obstet Gynecol, 1967; 29: 275-8). Dr Werbach recommends that you take 125-450 mg three times a day on an empty stomach.

Extract of bilberry (Vaccinium myrtillus), which is often used for varicose veins and macular degeneration, can also reduce inflammation. The active ingredient is anthocyanoside; it’s important to get hold of an extract which has been standardised with an anthocyanidin content of 25 per cent. Dr Werbach suggests a dosage between 160 mg and 480 mg per day.

Curcumin, the yellow pigment of the spice turmeric, also makes for a good antiinflammatory at a dosage of 400 to 600 mg three times per day. In one study, it was shown to have an antiinflammatory response similar to that of the NSAID phenylbutazone, but worked better in reducing oedema and tenderness in patients immediately after surgery (Int J Clin Pharmacol Ther Tox, 1986; 24: 651-4).

You could also try using feverfew (Tanacetum parthenium), which also appears to inhibit the synthesis of prostaglandins and other factors involved in inflammation and pain, and has an action not unlike aspirin. Just make sure the type you purchase has a content of 0.40-0.66 per cent of its active ingredient parthenolide.

Finally, liquorice root (Glycyrrhiza glabra) also inhibits prostaglandin synthesis not unlike the mechanism of cortisone. Indeed, one study showed that the effects of prednisolone were heightened through the use of 200 mg of liquorice root (Endocrinol Japan, 1990; 37: 331-41). Dr Werbach warns that you must not take more than 3 g a day of liquorice root for more than six weeks or it may cause water and sodium retention, hypertension and suppression of certain hormones (N Engl J Med, 1991; 325: 1223-7; BMJ, 1977; 1: 488-90). In fact, one patient who consumed liquorice actually suffered cardiac arrest (BMJ, 1977; 2: 738-9).

If you plan to use liquorice as a therapy, it may be prudent to have regular monitoring of blood pressure and electolytes, and to also increase your potassium intake (N Engl J Med, 1991: 325: 1223-7).

To avoid future bouts of bursitis, it is first of all important for you not to just exercise in the summer. Most sports injuries occur because the patient is in poor physical condition, has bad posture, or moves one or more limbs in an awkward position. If you can manage to engage in some moderate exercise all year long, you won’t have this annual trial of fire when launching your summer tennis programme.

Another area to look at is your posture. Poor posture can result in bursitis. You may wish to investigate Alexander Technique or a good osteopath or chiropractor, who can check that you are in alignment.

Make sure to eat plenty of cold water fish, such as salmon, herring, mackerel, tuna and bluefish, which contain plenty of omega-3 fatty acids.

You should also have your mineral levels checked. Inadequate levels of zinc and copper can cause reduced superoxide dismutase enzyme activity, leading to accumulation of the superoxide radical, which can contribute to the development of inflammatory diseases (Prog Med Chem, 1989; vol 26).

Repetitive Strain Injury (RSI) has become an epidemic. The National Institute of Occupational Safety and Health in the US estimates that the problem has increased from 18 per cent to 56 per cent of all workplace maladies in less than 10 years. RSI now accounts for over half of all worker compensation claims.

This increase is pretty much down to the use of the computer. “Without stepped up keys to reach, paper to change or a carriage to push, computer typists get no breaks from activity that is drastically confined to the wrist and forearms,” explains Dr Alan Hedge, director of ergonomic research at Cornell University, New York.

Despite its prevalence, there still remains a hard core of GPs who refuse to recognise RSI as anything more than yet another psychosomatic disorder, mainly because there is little supportive epidemiological or pathological evidence.

They can also be a bit sniffy about the language. RSI is not a medical definition; it is a layman’s term for a range of symptoms affecting the muscles, nerves and tendons of the upper limbs which is collectively known by your doctor as carpal tunnel syndrome (CTS), bursitis or tendonitis, to name but three.

Your other problem is political. Doctors and, it’s rumoured, UK government health agencies are reticent to recognise and diagnose a condition that can lead to expensive, and sometimes disputed, claims against employers.

Assuming you overcome all this and can find yourself a sympathetic doctor, there is a limited amount he can offer. Depending on the severity of the condition, he might prescribe an anti inflammatory, a diuretic or steroids.

Of the three, steroids seem to be the most effective, according to one double blind placebo study (Neurology, 1998; 51: 390-3).

In another study, the steroid prednisone offered rapid and effective relief for the first eight weeks only (Neurology, 1995; 45: 1923-5). This finding was also observed in another study involving 32 carpal-tunnel-syndrome patients, which found that the benefits of steroids were “transient” (J Neurol, 1993; 240: 187-90).

Your GP might also tell you to stop whatever’s causing the RSI. Good advice, in fact, and by far the best thing to do is to stop it before it really starts. Once it takes hold, full recovery is uncertain and may go on for a very long time, irrespective of the treatment, conventional or alternative.

If you’re getting early warning signals, such as numbness or tingling around the thumb or fingers, you must find a way to curb the activity. Even if you can’t take time off work, learn to break up the day and walk away from the keyboards once an hour or so, or vary the workload so that you are not constantly keying in.

You also need to get advice about posture and the positioning of the keyboard and screen. The desk should be at an appropriate height without a sharp leading edge, and the keyboard should be spaced 8 to 10 cm away from the desk’s leading edge.

Finally, try and use an ergonomically designed chair that makes your back do more of the work and prevents slouching. A good source is Back in Action (3 Quoiting Square, Oxford Road, Marlow, Bucks SL7 2NH; tel: 01628 477177).

There might also be a method of early detection, even before the tingling begins. Dr Bruce Lynn of University College Hospital in London and physiotherapist Jane Greening have used a machine called a vibrametre, produced by Somedic in Stockholm, Sweden, which detects a change in the nerve vibrations among typists who may go on to suffer RSI (Int Arch Occup Environ Health, 1998; 71: 29-34).

If your problem is more advanced, your doctor may well refer you to a specialist. As the average wait in Britain on the NHS to see a consultant is around seven months, and if you are wedded to the idea of staying with conventional medicine, you could book in to see an orthopaedic surgeon or a physiotherapist in the meantime.

The consultant more than likely is going to recommend surgery, particularly if your RSI, or CTS, is particularly chronic.

The UK support group RSI Association urges anyone to think twice before accepting surgery. “We are not aware of any surgery that has been completely successful. Ask the consultant for details of any patients whose surgery has been 100 per cent successful. He never can,” says association chairperson Wendy Lawrence, an RSI sufferer for more than 10 years.

Her view is supported by the medical trials. In one study, incisions for carpal tunnel release, the standard procedure, on 47 patients resulted in pain and scar sensitivity (J Hand Surg, 1997; 22: 317-21). In another, involving 57 neuritis patients, surgery was no better than steroids (Int J Lepr Other Mycobact Dis, 1996; 64: 282-6).

Keyhole surgery is becoming a popular technique, but recovery with this form of surgery does not seem any better than with conventional surgery. In one study of 29 CTS patients, those who had the keyhole surgery suffered numbness in the ring finger (J Hand Surg, 1996; 21: 202-4).

Another new technique, involving the use of a glass tube with a groove which is inserted into the hand, is also of questionable value. In a trial using 10 hands from patients who had recently died, the cotton tip came off inside the incision of one hand, and the glass tube broke in another (J Hand Surg, 1995; 20: 465-9).

Other approaches your consultant might suggest include ultrasound or electrical therapy. A mixed bag of electro therapies has been developed in the last few years, possibly born out of the indifferent success of other conventional treatments.

The jury’s out on ultrasound treatment. In one study, it was no more effective than placebo (Arch Phys Med Rehabil, 1998; 79: 1540-4), whereas another trial found that ultrasound did offer short term relief (BMJ, 1998; 316: 731-5). A better result was had with high voltage pulsed current (HVPC), which was passed through a wrist splint. Those who had the treatment were able to carry out repetitive tasks afterwards (AAOHN J, 1998; 46: 233-6).

Low level laser has been used with some success for long term management. The laser rapidly stopped the pain and tingling in the arms, hands and fingers of 35 CTS patients in one study, and the researchers believe it could be used together with physical supports, such as cervical collars (Int J Clin Pharmacol Ther, 1995; 33: 208-11).

According to research, CTS sufferers tend to be low in vitamin B6 (pyridoxine). A double blind trial using either placebo or vitamins found that the condition of those given the supplement improved to such an extent that surgery was not necessary (Proc Natl Acad Sci USA, 1982; 79: 7494-8). Wendy Lawrence at the RSI Association says that nutrition is an entirely new area of treatment, and that building the immune system has helped to ease the condition. Interestingly, she’s noted that more than the expected number of RSI patients also suffer from either endometriosis or irritable bowel syndrome.

In view of the limited help that conventional medicine can offer, it’s little wonder that the favoured route for many RSI sufferers is alternative medicine. Wendy Lawrence says that her members report greater benefits and pain relief using one of the alternatives, and of these chiropractic, osteopathy and Alexander technique seem to be the most favoured, although osteopathy seems to be of little use in treating chronic cases.

The types of alternative treatments which can help, depending on the extent of your RSI and your own inclination, fall into several groupings, as listed by RSI sufferer and author David Ruegg. The physical treatments are chiropractic, osteopathy and dietary supplements; postural therapies include the Alexander technique or Feldenkrais; relaxation techniques encompass massage, biofeedback and flotation tanks; exercise involves walking, swimming and jogging; stretching comprises yoga and stretching exercises; energy medicine is made up of acupuncture and healing; and cognitive behavioural therapy embraces pain clinics and counselling.

Scientific evidence for any of these therapies is in limited supply. Yoga exercises were tested on 42 CTS sufferers who went through a regimen of 11 postures to strengthen, stretch and balance each joint for eight weeks. The yoga group reported significant improvements in grip strength, pain intensity and sleep disturbance (JAMA, 1998; 280: 1601-3).

Chiropractic was tested against the use of ibuprofen (a non steroidal anti inflammatory drug) on 96 CTS patients and was found to be as good as but no better than the drug therapy (J Manipul Physiol Ther, 1998; 21: 317-26).

Osteopathy came out better in one trial when it was tried on 20 CTS patients with mild to moderate symptoms (J Am Osteopath Assoc, 1994; 94: 647-63).

Biofeedback was tested against relaxation training in a group of patients with a range of chronic, upper body traumas. All patients had immediate relief from pain, but the relaxation group expressed greater short term benefits. However, within six months there were no differences between the groups (Pain, 1995; 63: 199-206).

Useful UK contacts: RSI Association, tel: 0800 018 5012; British School of Osteopathy, tel: 0171 930 9254; Society of Teachers in Alexander Technique, tel: 0171 351 0828.

A bursa is a pocket of connective tissue found adjacent to a joint. Lined
by a smooth inner surface, it facilitates the gliding movements of muscles
and tendons over bony prominences. Bursitis is inflammation of a bursa which
results in pain, tenderness, stiffness and in some cases, swelling and redness.
Any bursa can be affected by the inflammatory process, but bursitis involving
the shoulder, elbow, hip and knee are most common.

Although the cause of this condition is unknown, repetitive direct pressure
over a bursa can be a predisposing factor. In particular, certain activities
or occupations are associated with specific example because of the nature
of the physical stress placed on the bursa: e.g. housemaid’s knee (kneeling),
student’s elbow (leaning). Shoulder bursitis, the commonest type, is characterized
by an aching pain localized on the outside of the top of the shoulder. Pain
is intensified by lifting and backwardly rotating the arm. Typically, there
is stiffness in the morning which diminishes with heat and routine activities.

Both tendinitis and tenosynovitis occur spontaneously or in association
with injury, work and sports activities, certain types of arthritis or infection.
As with bursitis, the shoulder is most commonly affected. The attachment
of the biceps tendon at the shoulder is especially vulnerable to this condition.
Bicipital tendinitis is manifested by aching along the biceps muscle that
radiates up to the shoulder and down to the forearm. The pain is worse with
movement. Among the other common locations for tendinitis are the elbow,
wrist, hand, knee, and ankle.

Actions indicated for the processes behind this disease:

Anti-Rheumatics often help, but the choice of appropriate
anti-rheumatic depends upon its other properties, in turn governed by the
interpretation of the patients needs.

Anti-Inflammatories will be important as the primary action for symptomatic
relief.

Anti-Spasmodics help in easing associated local muscular tension.

Circulatory Stimulants & Rubefacients contribute by increasing
local blood circulation.

Analgesics may help. However, the legal herbal analgesics do very
little in such cases. Pain relief is best achieved through the use of anti-inflammatories
and anti-spasmodics.

System Support

Connective tissue may benefit from using herbs that strengthen it. The practitioner
must attempt to identify broader contributing factors, such as general stress.

Specific Remedies

No true specifics are described in the herbal traditions of Europe and North
America.

One possible prescription:

Salix spp. 2 parts

Viburnum opulus 2 parts

Apium graveolens 2 parts

Zanthoxylum americanum 1 part to 5ml of tincture

taken 3 times a day

Anti-Spasmodic rub:

Lobelia inflata

Viburnum opulus equal parts of tincture rubbed into the painful muscles
as needed

In this combination we are combining anti-rheumatics that provide
these relevant actions:

• salicylate anti-inflammatory: Salix spp.

• general anti-inflammatory: Apium graveolens

• anti-spasmodics: Lobelia inflata, Viburnum opulus, Apium
  graveolens

• peripheral vaso-dilator: Zanthoxylum americanum
  

• Poor posture and/or unnatural sleeping positions. Sleeping on a soft mattress can give you a stiff neck the next morning.
  
• Tension and stress. When you feel tense, the muscles around your neck can go into spasms.
  
• Tendinitis, inflammation of a tendon, the cord-like tissue that connects muscles to bone. Left untreated, tendinitis can turn into “frozen shoulder”, a stiff, painful condition that may limit your ability to use your shoulder.
  
• Bursitis, an inflammation of the sac (bursa) that encases the shoulder joint. Bursitis can be caused by injury, infection, overuse, arthritis or gout.
  
• Osteoarthritis. Unlike rheumatoid arthritis, osteoarthritis develops from normal wear-and-tear of the joints as we age or from repeated injuries. Aging can cause the joints to wear out, producing bony spurs that can press on nerves and cause pain.
  
• Accidents and falls. Collarbones can break after falls or auto accidents.
  
• Motor vehicle accidents. You can develop a whiplash injury when your vehicle is hit from behind.
  
• Pinched nerve. Arthritis or an injury to your neck can pinch a nerve in your neck. Pain from a pinched nerve usually runs down the arm and one side only.
  

• Stretching and strengthening routines, especially before exercising, helps prevent tendinitis. So can using the right equipment and following the proper technique.
  
• Avoid injuries to the shoulder by wearing seat belts in cars and trucks and using protective gear during sporting events.
  
• Avoid vigorous exercise unless you are fit. If you are out of condition, start to strengthen your muscles gradually and slowly increase exercise intensity.
  
• Don’t sleep on your stomach. You are likely to twist your neck in this position.
  
• Sleep on a firm mattress. Use a feather, polyester or special neck (cervical) pillow. Use a thinner pillow or none at all if you have pain when you wake up.
  

• Stretch the back of your shoulder by reaching with one arm under your chin and across the opposite shoulder, gently push the arm toward your collarbone with the other hand. Hold for 15 seconds. Repeat five times, then switch sides.
  
• Raise one arm and bend it behind your head to touch the opposite shoulder. Use the other hand to gently pull the elbow toward the opposite shoulder. Hold for 15 seconds. Repeat five times, then switch sides.
  
• Holding light weights, lift your arms out horizontally and slightly forward. Keeping your thumbs toward the floor, slowly lower your arms halfway, then return to shoulder level. Repeat ten times.
  
• Sit straight in a chair. Flex your neck slowly forward and try to touch your chin to your chest. Hold for 10 seconds and go back to the starting position. Repeat five times.
  
• Sit straight in a chair. Look straight ahead. Slowly tilt your head to the right, trying to touch your right ear to your right shoulder. Do not raise your shoulder to meet your ear. Hold for 10 seconds and straighten your head. Repeat five times on this side and then on your left side.
  

Unfortunately, no matter how careful people are, injuries do occur. Injured tendons, muscles and ligaments in any part of the body can take a long time to heal. Longer, in fact, than a broken bone. Don’t ignore the aches and pains. Studies show that exercising before an injury has healed may not only worsen it, but may greatly increase the chance for re-injury.

Put the arm with the injured shoulder in a sling when you take the person to the doctor.

Treating Tendinitis – Taking over-the-counter pain relievers such as aspirin, ibuprofen or naproxen sodium eases the pain and reduces inflammation. Acetaminophen eases muscle soreness but does not help with inflammation. [Note: Do not give aspirin or any medication containing salicylates to anyone 19 years of age or younger, unless directed by a physician, due to its association with Reye’s Syndrome, a potentially fatal condition.]

R.I.C.E. – Rest, ice, compression and elevation, is the accepted treatment for tendinitis. While the pain could linger for weeks, with the proper and immediate treatment, it usually disappears in a few days.

R — Rest the injured shoulder. Rest prevents further inflammation, giving the tendon a chance to heal. Resume your activities only after the pain is completely gone.

I — Ice the injured area as soon as possible. Immediately putting ice on the injury helps to speed recovery because it not only relieves pain, but also slows blood flow, reducing internal bleeding and swelling.

• Put ice cubes or crushed ice in a heavy plastic bag with a little water. You can also use a bag of frozen vegetables. Wrap the ice pack in a towel before placing it on the injured areas.
  
• Apply the ice pack to the injured shoulder for 10 to 20 minutes. Reapply it every two hours and for the next 48 hours during the times you are not sleeping.
  

E — Elevate the shoulder whenever possible to further reduce the swelling.

The swelling is usually eased within 48 hours. Once the swelling is gone, apply heat to speed up healing, help relieve pain, relax muscles and reduce joint stiffness.

• Use a heating pad set on low or medium or a heat lamp for dry heat. Or, use a hot-water bottle, heat pack or hot, damp towel wrapped around the injured area for moist heat. [Note: Damp heat should be no warmer than 105¡F.]
  
• Apply heat to the injured area for 20 to 30 minutes, two to three times a day.
  

Treating Bursitis – Prolonged use of a joint or arthritis can cause the pain and discomfort of bursitis. Fortunately, these flare-ups can be controlled by:

• Applying ice packs to the sore shoulders.
  
• Taking a hot shower, using a heat lamp, applying a hot compress or heating pad to the affected shoulder, or rubbing the area with a deep-heating liniment.
  

After first checking with your doctor, you can ease neck discomfort by:

• Resting as much as possible by lying on your back.
  
• Using cold and hot packs. See how to use them in the above section on treating tendinitis.
  
• Improving your posture. When sitting, select a chair with a straight back and push your buttocks into the chair’s back. When standing, pull in your chin and stomach.
  
• Using a cervical (neck) pillow or roll a hand towel and place it under your neck.
  
• Avoiding activities that may aggravate your injuries.
  
• Covering your neck with a scarf in cold weather.
  
• Practicing some of the stretching and strengthening exercises listed under the section on prevention on page 106.
  

Questions to Ask

Along with the shoulder and neck pain are you: Feeling pressure in your chest, especially on the left side? Short of breath or having trouble breathing? Nauseous and/or vomiting? Sweating? Anxious? Having irregular heartbeats?
Did you experience a serious injury that caused shoulder and/or neck pain that is not going away and/or is getting worse?
Do you have a stiff neck along with a severe headache, fever, nausea and vomiting?
Do you have any of the following? Severe or persistent pain, swelling, spasms or a deformity in your shoulder? A shoulder that is painful and stiff with reduced ability to move it? Stabbing pain, numbness or tingling? Pain, tenderness and limited motion in the shoulder?
Is the shoulder pain severe or interfering with your sleep? Is the shoulder stiff in the morning, swollen, tender or hard to move?

Healthy Self: The Guide to Self-Care and Wise Consumerism

© American Institute for Preventive Medicine

]]> 15163 https://healthy.net/2000/12/06/accessory-nutrients-a-few-others-2/?utm_source=rss&utm_medium=rss&utm_campaign=accessory-nutrients-a-few-others-2 Wed, 06 Dec 2000 13:28:02 +0000 https://healthy.net/2000/12/06/accessory-nutrients-a-few-others-2/

Chondroitin Sulfates—Mucopolysaccharides and Glycosaminoglycans

Organo-Germanium

Royal Jelly

Propolis

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Chondroitin Sulfates—

Mucopolysaccharides and Glycosaminoglycans

There are substances present in the cartilaginous tissue between joints and concentrated in the artery walls. They are not essential nutritionally in that our body makes them. The commercially available mucopolysaccharide products are high in silicon, a mineral important to tissue strength and health. Mussels and oysters contain these chondroitin sulfates. A supplement extracted from green-lipped mussels, Perna canaliculus, is high in mucopolysaccharides and is currently available. It is theorized that taking oral chondroitin sulfates or products containing other mucopolysaccharides will help alleviate joint problems or rebuild degenerating cartilage. They may further help in maintaining strength and elasticity of the artery walls and in reducing potential inflammation and blood clotting time—all of which may help reduce cardiovascular disease potential. Mucopolysaccharides and collagen help hold our tissues together. Chondroitin sulfates may be an antiaging nutrient as well as support or increase production of seminal fluid in men, and may have mild aphrodisiac effects. These chondroitin sulfate/mucopolysaccharide products have been used in the treatment of various conditions, including headaches, arthritis, bursitis, ulcers, respiratory diseases, angina, and allergies. There is no hard evidence to date that these claims, often commercial, are accurate or that there is great therapeutic success in using the oral supplements (they may break down in the digestive tract), although bovine cartilage injections have been helpful in the treatment of arthritis and psoriasis. More research is needed to verify the potential for these very interesting molecules that are used in our body tissue.

Organo-Germanium

Germanium is a trace mineral that has recently come to the attention of the health world through some incredible work and results at a clinic in Japan. Germanium occurs naturally in very small amounts in the soil and in certain foods and herbs, such as shiitake mushrooms, ginseng root, garlic, shelf fungus, and aloe vera. It has been used for its semiconductor properties in making computer chips. Its possible medical value was discovered in the 1950s by Kazuhiko Asai when he noticed that fairly high amounts of germanium were present in coal, peat, and some of the more powerful and useful Oriental healing herbs. In 1967, Dr. Asai and his associates isolated an organo-germanium compound soluble in water and labeled it Ge-132 (bis-carboxyethyl germanium sesquioxide, the 132nd form they had synthesized). In 1968, Dr. Asai founded the Asai Germanium Research Institute to study the clinical application of Ge-132 further. Over the next 15 years, Dr. Asai and coresearchers found that germanium was essentially nontoxic and had an incredible effect on many pathological conditions, particularly in suppressing tumor activity in tumor-bearing animals. In 1980, Dr. Asai published a book very optimistically called Miracle Cure: Organic Germanium.

Germanium is trace element number 32 in the periodic table. It is twice as heavy as oxygen (16) and seems in some way related to it, as it supports cellular and tissue oxygenation. Research in Japan also verified a number of effects of Ge-132 on the immune systems of animals and humans. (This is not the effects of the trace mineral but of this special organo-germanium; see the discussion in Chapter 6, Minerals.) Ge-Oxy 132, as it is sometimes called, has been shown to have both antitumor and antiviral effects. These may be a result of its varying immunological actions, such as stimulating interferon production, stimulating macrophage (“Pac-man” white cells) and NK (natural killer) lymphocyte activity, and enhancing cell-mediated immunity. There is some suggestion that Ge-132 helps in pain relief; particularly dramatic relief has occurred in some cases of severe cancer pain.

Most of these effects are noted more in people who are immune suppressed than in normal individuals. Research on the topic has begun at the University of Texas. In an article published in the November 1984 issue of the Journal of Interferon Research, Fugio Suzulu and Richard B. Pollard commented, “Ge-132 belongs to a group of compounds capable of modulating immune response in hosts that have an alteration of immune homeostasis. Although there are a few reports describing enhancement of Ge-132 on natural killer cell activity in healthy subjects, studies in immune suppressed animals and patients with malignancies or rheumatoid arthritis suggest that Ge-132 restores the normal function of T-cell lymphocytes, B lymphocytes, antibody-dependent cellular cytotoxicity, natural killer cell activity, and numbers of antibody-forming cells, but does not enhance them above normal limits.”

Interestingly, in both sick and normal animals and humans, Ge-132 is virtually nontoxic. Suzulu and Pollard’s article continues, “Preliminary toxicological and pharmacological studies of this compound (Ge-132) indicate that it has several unique physiological activities without any significant toxic effects.” Ge-132 really could be classified as a “highly safe drug” even though it is a trace mineral compound. It has practically no toxicity or influence on reproductive or other functions.

More research is needed on Ge-132. Organic germanium from Japan, as Ge-Oxy 132, has become available only recently in the United States as a pure white powder that can be made into tablets, capsules, or dissolved in water. It is still fairly expensive and will continue to be until it is produced in this country. Now, many companies are marketing germanium products; make sure that it is in this organo-germanium sesquioxide form. Amounts in supplements range from 25–150 mg. or are available as pure powder. Suggested dosages for treatment range from 50–100 mg. daily (probably the minimum needed for an effect), up to 3–6 grams daily (the doses used in Japan for cancer therapy). The level of germanium sesquioxide needed to induce interferon synthesis in humans is a daily intake of 50–75 mg./kg. body weight.

Ge-132 looks very promising, and I am quite excited about it. Its use in the treatment of viral disorders, especially Epstein-Barr, and other problems of immunological suppression appears helpful. Gastrointestinal diseases, such as diverticulitis, circulatory problems, mental symptoms, or really any problem that might be aided by improved oxygenation could be helped by organo-germanium (Ge-132) supplementation. In my clinical experience, I have found that allergies have also been reduced by the use of this nutrient, particularly those allergies that arise to foods based on weakening of the intestinal mucosa. Germanium’s effect on cancer is probably due to its immunostimulating effects rather than a direct effect on cancer cells. Its current use by cancer patients may move it into the political arena soon, which will prompt the FDA and the medical establishment to set controls on its use.

Germanium is currently considered a food supplement. Since it is found in the soil and in many healing herbs, some levels of mineral germanium will always be available to us. More research into this fascinating, semiconductor trace element may help us to better understand the mysterious powers of some of our great, ancient healing plants.

Royal Jelly

Royal jelly is another panacea for health and longevity seekers. Worker bees make this exotic substance their queen bee. And all of us want to be queen or king bees, of course. Royal jelly is definitely an energizer. It is high in certain unique fatty acids, simple carbohydrates, and pantothenic acid, which is supportive of the adrenals. It also contains the other B vitamins, all of the essential amino acids, and many minerals, such as iron, calcium, silicon, sulfur, and potassium. Royal jelly has been used to support weight loss, as it is a rich and energizing nutrient yet low in calories (20 calories per teaspoon), and to treat problems such as fatigue, insomnia, digestive disorders, ulcers, and cardiovascular ailments. Whether this mysterious substance really is a great rejuvenator and supporter of youth and longevity will need to be studied. But many people, especially women, experience an uplifting feeling when they take either liquid or encapsulated royal jelly.

Propolis

Propolis is a resin obtained from the buds of some trees and flowers. This sap is rich in such nutrients as minerals and the B vitamins. Bees collect it along with pollen. Propolis is thought to contain a natural antibiotic, called galangin, and is used in a variety of remedies to treat or prevent low-grade infections, especially in people who do not want to take antibiotics. Many people have described to me positive results from using propolis products. Bees spread the propolis around their hives to protect them from bacteria and viruses. (The name “propolis” comes from Greek words meaning “defenses before a town.”) Other theories suggest that propolis improves energy and endurance and helps immunity by stimulating thymus activity. All of these claims must be helpful in potentizing the placebo effect, but more research needs to be done before propolis is readily adopted by the scientific community.

]]> 21948 https://healthy.net/2000/12/06/vitamin-b12-cobalamin-2/?utm_source=rss&utm_medium=rss&utm_campaign=vitamin-b12-cobalamin-2 Wed, 06 Dec 2000 13:28:02 +0000 https://healthy.net/2000/12/06/vitamin-b12-cobalamin-2/

Vitamin B12 (Cobalamin) is named the “red vitamin,” as it is a red crystalline compound.
B12 is unique in that it is the only vitamin that contains an essential mineral–namely, cobalt. Cobalt is thereby needed to make B12 and so is essential for health. B12 is unique also in that it is required in much tinier amounts than the other B vitamins. Only 3-4 mcg. (micrograms, or thousandths of a milligram) are needed at minimum; however, higher levels, up to 1 mg., are often used therapeutically.

Vitamin B12 is a very complex molecule. Besides cobalt, it also contains carbon, oxygen, phosphorus, and nitrogen. Cobalamin is stable to heat, though sensitive in heated acid or alkali solution, slightly sensitive to light, and destroyed by oxidizing and reducing agents and by some heavy metals.

Vitamin B12 was isolated in 1926 as the factor that treated a feared disease, pernicious anemia–termed “pernicious” because it could be fatal, most often from neurologic degeneration. But the substance cobalamin, when given orally (actually liver was used as the cure; it contains high amounts of B12), did not cure all of the people with the disease, and some people still developed pernicious anemia. It was later found that a mucoprotein enzyme produced by the stomach (by the parietal cells that also make hydrochloric acid) was also needed for vitamin B12 to be absorbed into the body from the intestines. This enzyme has been termed the “intrinsic factor,” while vitamin B12 is the “extrinsic factor.” Aging, stress, and problems with the stomach or stomach surgery weaken the body’s ability to produce the “intrinsic factor”; also, some people appear to have a genetic predisposition that makes them more prone to pernicious anemia. Hydrochloric acid helps the absorption of B12; if acid production is weak, the absorption is lessened. Calcium and thyroid hormone assist as well. Pregnancy, absorb this important vitamin. Aging more
likely lessens some of the many factors needed for ideal absorption of B12, so deficiency symptoms are more common in older people.

Cobalamin is absorbed primarily from the last part of the small intestine, the ileum. In the blood, it is bound to a protein globulin to be carried to the various tissues. The body actually stores vitamin B12, so any deficiencies may take several years to develop. The
highest concentrations of B12 are found in the liver, heart, kidney, pancreas, brain, testes, blood, and bone marrow–all active metabolic tissues. The “red vitamin” is very important to the blood.

Cobalamin is made in nature by microbial synthesis–produced by bacteria in the intestinal tracts of animals and stored in their tissues. Some B12 is made during fermentation of foods as well. Cobalamin is the naturally occurring vitamin B12. Cyanocobalamin, as B12 is often known, is actually the commercial variety of B12 and contains a cyanide molecule attached to the cobalt. B12 is not synthesized but, like penicillin, must be grown in bacteria or molds and then processed. Other forms of B12 include hydroxycobalamin (technically, vitamin B12a), aquacobalamin (vitamin B12b), and nitrocobalamin (vitamin B12c).

Sources: Vitamin B12 is found in significant amounts only in the animal protein foods.
B12 is also manufactured by bacteria in the human intestines, but it is not known how much we can naturally absorb and utilize from that source. In general, digestion and absorption must be good for adequate B12 to be obtained. Many laxatives and overuse of antacids can reduce absorption and deplete stores of B12.

Our primary food sources of vitamin B12 include meat, most fish, especially the oily ones (trout, herring, and mackerel), crabs and oysters, eggs (the yolk), and milk products, especially yogurt. Organ meats such as liver, heart, and kidney are particularly high. The vegan–that is, the strict vegetarian who consumes no animal-source foods–is not getting the necessary vitamin B12 from diet (although tempeh, a fermented soybean product, and some sprouts may contain some vitamin B12); thus, vegans will often need an additional supplement (which absorbs well) or periodic injections.

Functions: Although vitamin B12, cobalamin, apparently does not have as many functions
as some of the other B vitamins, it has some very important ones. It is essential for the metabolism of the nerve tissue and necessary for the health of the entire nervous system. It stimulates growth and increases appetite in children. Cobalamin, along with iron, folic acid, copper, protein, and vitamins C and B6, is needed for the formation of normal red blood cells.

Vitamin B12 is the “energy” vitamin, as it often increases the energy level, whether obtained from eating the B12 foods or from supplemental use. There may be several reasons for this. Cobalamin stimulates the utilization of proteins, fats, and carbohydrates. It also helps iron function better in humans and is important for the synthesis of DNA and RNA, as well as for production of choline, another B vitamin, and methionine, an amino acid.

Uses: Vitamin B12 is generally known as the longevity vitamin, possibly because it helps
the energy level and activity of the nervous system of the elderly. B12 injections (the main therapeutic use of this vitamin) have been a common practice of many doctors for the treatment of fatigue, and, in my experience, it works very often. However, it would only be a “cure” when the tiredness is a result of B12 deficiency. There are many reasons for fatigue. As we age, our digestion and absorption are not usually as finely tuned as when we were young, particularly when we eat and live the way most of us late twentieth-century beings do. And vitamin B12, even though it is needed in such small doses, is one of the most difficult vitamins to acquire through diet and to metabolize. The “red vitamin” is the main “antifatigue” vitamin; often given along with folic acid, it helps energy and prevents most anemia, provided there is good iron absorption and hydrochloric acid production.
Medically speaking, it is wise to check patients with fatigue for anemia and to measure vitamin B12 and folic acid levels before embarking on a treatment regimen.

B12, given intramuscularly, usually in doses of 500-1,000 mcg. (0.5-1.0 mg.), is used once, twice, or three times weekly for a period of time to both give energy and, in adults, help with appetite suppression in weight loss programs. These amounts also replenish the vitamin B12 stores. It has a mild diuretic effect as well and may be used premenstrually to diminish water retention symptoms.

In the treatment of pernicious anemia and the earlier symptoms of vitamin B12 deficiency, injections of cobalamin or its variants are usually necessary because most everyone with deficiency has poor absorption. It is difficult to become B12 deficient from diet alone, unless we are on a strict vegan diet for years. In any anemia, really, it is wise to supplement B12, because it helps the red blood cells develop to a point where protein, folic acid, iron, and vitamin C can then complete their maturation so that we can better carry oxygen and energy to all of our cells.

Vitamin B12 will stimulate growth in many malnourished children. In older people, it has helped with energy levels as well as psychological symptoms, including senile psychosis. B12 has also been used to help treat osteoarthritis and osteoporosis and for neuralgias, such as Bell’s palsy, trigeminal neuralgia, or diabetic neuropathy. It has likewise been used in the treatment of hepatitis, shingles, asthma, other allergies, allergic dermatitis, urticaria, eczema, and bursitis. Cobalamin has been used for many other symptoms besides fatigue, including nervousness and irritability, insomnia, memory problems, depression, and poor balance. Vitamin B12 is something to keep in mind when we are not “feeling our oats.”

Deficiency and toxicity: There have been no known toxic effects from megadoses of
vitamin B12. Thousands of times more than the RDA have been injected both intravenously and intramuscularly without any ill consequences. On the contrary, there is often some benefit.

Vitamin B12 deficiency usually results from a combination of factors. Restricted diets, as seen in vegetarians or poor nations, can be very limited in B12. Since the absorption into the body is so finely tuned, depletion and deficiency occur even more commonly from poor digestion and assimilation, or from deficient production of intrinsic factor. That is why it is so important to be aware of B12 and use some sort of supplementation once a deficiency has been diagnosed. Vitamin B12 blood levels, along with folic acid levels, are the most common vitamin tests performed by doctors. As we age, it is more likely that we may become B12 deficient. Also, alcoholics and people with malabsorption or dementia may have low B12 levels. Since the body stores vitamin B12, it may take several years to become deficient with dietary restriction or a decrease in intrinsic factor.

The strict vegetarian has more concern than the average meat- and dairy-eating person. B12 is not found in the vegetable kingdom other than in foods fermented by certain bacteria; thus most fermented foods have some vitamin B12. However, in vegetarians, there is usually a high folic acid intake, and since folic acid and B12 work similarly in the body, a B12 deficiency may be masked for a period of time, and then more pronounced symptoms may occur. If B12 is deficient in an animal eater, then we pretty much know there is a problem in absorption of the vitamin.

Most problems of B12 deficiency affect the blood, energy level, state of mind, and nervous system. Often, subtle symptoms may start with the nervous system. Vitamin B12 nourishes the myelin sheathes over the nerves, which help maintain the normal electrical conductivity through the nerves. Soreness or weakness of the arms or legs, decreased sensory perceptions, difficulty in walking or speaking, neuritis, a diminished reflex response, or limb jerking may result from B12 deficiency. Psychological symptoms may include mood changes with mental slowness may be one of the first symptoms.

With B12 deficiency, the body forms large, immature red blood cells, resulting in a “megaloblastic” anemia. Pernicious anemia refers to the deficiency in blood cells as well as the myriad of psychological and nerve symptoms. The anemia usually generates more fatigue and weakness. Menstrual problems, even amenorrhea (lack of menstrual flow), may also occur in B12-deficient women.

The problems related to the nervous system caused by vitamin B12 deficiency can lead to permanent damage, not correctable by B12 supplementation. This irreversible nerve damage may occur when the B12 deficiency effect on the red blood cells is masked by adequate levels of folic acid, as I mentioned. More severe pernicious anemia can cause a red, sensitive tongue, referred to as “strawberry tongue,” which may even ulcerate, and nerve or brain and spinal cord degeneration, which can cause weakness, numbness, tingling, shooting pains, and sensory hallucinations. Paranoid symptoms may even occur. In the early part of this century, pernicious anemia was often a fatal disease.

Requirements: Vitamin B12 is essential but required only in minute amounts; 3-4 mcg. is
needed in most adults to prevent deficiency, and at least that amount is required by pregnant or lactating women, as well as infants and growing children. From 10-20 mcg. daily is a good insurance level, although certain people may need increased amounts with higher protein intake. Vitamin B12 is often taken in higher doses, 500-1000 mcgs. per day, to relieve fatigue. Injections of B12 in these amounts are used to treat a variety of low-energy and mental symptoms previously described as well as during some weight loss programs. When there is fatigue or anemia, it is a good idea to get the blood level of B12 checked by a doctor. It may lead to a very simple and successful treatment.

]]> 22186 https://healthy.net/2000/12/06/anti-rheumatics/?utm_source=rss&utm_medium=rss&utm_campaign=anti-rheumatics Wed, 06 Dec 2000 13:28:02 +0000 https://healthy.net/2000/12/06/anti-rheumatics/ These are remedies that have been observed improving the patients experience of rheumatic problems. That is not to say that they have a specific effect upon the disease or even necessarily upon the musculo/skeletal tissue itself. It is a description of outcome rather than process, and as such is very limited in its applicability, unless the processes at play for each herb are understood.

Achillea millefolium Yarrow

Angelica archangelica Angelica

Apium graveolens Celery Seed

Arctium lappa Burdock

Arctostaphylos uva-ursi Bearberry

Armoracia lapathifolia Horseradish

Arnica montana Arnica

Artemisia absinthium Wormwood

Artemisia vulgaris Mugwort

Berberis aquifolium Mountain Grape

Betula spp. Birch

Brassica spp. Mustard

Capsicum minimum Cayenne

Caulophyllum thalictroides Blue Cohosh

Cimicifuga racemosa Black Cohosh

Dioscorea villosa Wild Yam

Eupatorium perfoliatum Boneset

Eupatorium purpureum Gravel Root

Filipendula ulmaria Meadowsweet

Fucus vesiculosus Kelp

Gaultheria procumbens Wintergreen

Guaiacum officinale Guaiacum

Harpagophytum procumbens Devil’s Claw

Iris versicolor Blue Flag

Juniperus communis Juniper

Menyanthes trifoliata Bogbean

Myrica cerifera Bayberry

Petroselinum sativum Parsley

Phytolacca decandra Poke

Populus tremuloides White Poplar

Rosemarinus officinalis Rosemary

Rumex crispus Yellow Dock

Salix spp. Willow bark

Smilax spp. Sarsaparilla

Tanacetum chrysanthemum Feverfew

Taraxacum officinalis Dandelion

Urtica dioica Nettles

Viburnum opulus Cramp Bark

Zanthoxylum americanum Prickly Ash

Zingiber officinale Ginger

The activity of these herbs as anti-rheumatics can be explained as an expression of a more broadly relevant action. This may be rationalized by the main action alone or a more holistic synergy of the plants actions. For example, the alteratives can work in a number of different ways, as can the anti-inflammatories (please refer to that section if this is unclear). Of course this cannot always be worked out. If you want predictable, reductionist cause & effect, become an accountant………………..

Anti-Inflammatories: Angelica archangelica, Apiumgraveolens, Betula spp., Dioscorea villosa, Filipendula ulmaria, Gaultheriaprocumbens, Guaiacum officinale, Harpagophytum procumbens, Menyanthes trifoliata, Populus tremuloides, Salix spp., Tanacetum chrysanthemum



Alteratives: Arctium lappa, Berberis aquifolium, Fucus vesiculosus, Guaiacum officinale, Harpagophytum procumbens, Iris versicolor, Menyanthestrifoliata, Phytolacca decandra, Rumex crispus, Smilax spp., Urtica dioica



Diuretics: Apium graveolens, Achillea millefolium, Arctostaphylosuva-ursi, Eupatorium perfoliatum, Eupatorium purpureum, Juniperus communis, Petroselinum sativum, Taraxacum officinalis



Circulatory Stimulants: Armoracia lapathifolia, Brassicaspp., Capsicum minimum, Myrica cerifera, Rosemarinus officinalis, Zanthoxylumamericanum, Zingiber officinale



Anti-Spasmodics: Cimicifuga racemosa, Viburnum opulus



Other action or basis unclear: Arnica montana, Artemisiaabsinthium, Artemisia vulgaris, Caulophyllum thalictroides

A number of useful books are available for both the practitioner and patient. Those that deal with exercises and non-drug pain relief will prove most valuable. An excellent example is:

Gach, Micheal Reed. Arthritis relief at your fingertips.Warner Books, New York, 1989

Very useful information is supplied by these organizations:



The National Arthritis and Musculoskeletal and Skin Diseases Information Clearinghouse

Box AMS

Bethesda, MD 20892



Arthritis Foundation

1314 Spring Street, NW,

Atlanta, GA 30309.

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