Features February 2003 Issue

Alternative Therapies: Help Or Hype?

If you can’t get relief with traditional treatments, it makes sense to try something else. But do your homework first.

When you suffer from arthritis, and conventional therapies provide only modest pain relief and little hope of a cure, it's not surprising if you want to seek alternative treatments. You’re not alone. One study indicates that nearly 94 percent of arthritis patients will try an alternative treatment at least once. More revealing, Americans spend nearly $27 million each year on “miracle cures” for arthritis.

But the largely unregulated world of alternative medicine is full of questionable products, practices and unsubstantiated claims. How do you sort through it all to find something that may help lessen your pain and improve your mobility?

“By being an open-minded skeptic,” says Susan Joy, M.D., staff physician in Sports Medicine at The Cleveland Clinic. “Before you try an alternative therapy, make sure you do your homework and talk it over with your physician. Just because something is ‘natural’ doesn't mean it's safe or without side effects.”

Natural Supplements
Knowing exactly what you're taking is key. Since supplements are neither approved nor regulated by the Food and Drug Administration, you need to read all labels carefully. Look for articles written about a particular supplement in magazines and newspapers. Then take the information with you when you visit your doctor. If he’s not comfortable talking about natural supplements, ask for a referral to someone who is.

The severity of osteoarthritis symptoms can vary. Pain and inflammation can change in intensity from day to day for no apparent reason even if you’re treating it, explains Dr. Joy. This makes it hard to know if improvement is due to an alternative treatment you're trying or to the natural variation in your symptoms. Resolving such questions is the purpose of clinical research, and several alternative therapies are now under study.

Glucosamine and Chondroitin
These two substances, taken together, are currently the most widely discussed and studied alternative therapy for osteoarthritis (see “The Glucosamine/Chondroitin Conundrum,” Dec. AA). Both compounds are found naturally in the body and are claimed to build and repair cartilage. Preliminary clinical studies have shown that taking synthetic versions of glucosamine and chondroitin may be as safe and effective in relieving pain as taking non-steroidal anti-inflammatory drugs (NSAIDs) like aspirin or ibuprofen. Though it is now well established that these substances can slow the progress of osteoarthritis, further studies are underway to determine if they have any effect on reversing the disease.

Capsaicin Creams
These creams, made from the active ingredient in hot peppers, have shown early evidence of providing local pain relief for osteoarthritis. Available over the counter, these salves seem to work best when applied to the skin close to the source of joint pain. Although why they may relieve pain is not fully understood, they may divert molecules in nearby nerves that would normally communicate joint pain. But they often cause a burning sensation on the skin that can be severe in sensitive people.

Vitamin Therapy
Vitamins C, E and beta-carotene have been shown to have anti-oxidant properties that may help the body defend itself against the harmful molecules (oxidating free radicals) linked to cancer.

Not enough evidence yet exists to know the effect that these vitamins may have on arthritis. However, it is known that megadoses of vitamins can be harmful. Taking too much vitamin E, for example, can have an anti-coagulant effect, promoting bleeding.

Herbal Supplements
This is a crowded category with dozens of products, but all lack convincing clinical evidence of effectiveness. Users need to proceed with caution. “Most herbal supplements contain active compounds that interact with your body as well as with other medications you may be taking,” says Dr. Joy. People on blood thinners or anti-coagulants need to be particularly aware of supplements that claim to be anti-inflammatory, since they may be similar to aspirin, which can add to the risk of bleeding. In other words, “herbal” does not mean harmless.

Although it has been used for more than 2,000 years in Chinese medicine, acupuncture—which is believed to relieve pain by releasing endorphins, the body's natural pain killers—has not been considered a first-line method of pain relief by practitioners of Western medicine. “It's difficult to draw conclusions from people who try it because it’s often used as a last resort and these people aren't necessarily a representative sample of the population as a whole,” says Dr. Joy. Clearly, the jury is still out on this practice,

Magnet Therapy
Magnet therapy involves placing magnetic discs on or near the body, with the goal of speeding up healing and reducing pain. By generating a strong and steady magnetic field, it is believed that magnets relieve pain by increasing circulation, suppressing inflammation, and changing the polarization of cells.

Although a number of studies have been conducted on magnet therapy, at this time there is no conclusive evidence that magnets actually relieve arthritis pain.

Copper Bracelets
The wearing of a copper bracelet is claimed to relieve arthritis pain through the absorption of copper into the skin. These bracelets, according to their makers, affect the body’s bioelectric balance, and when your body is balanced, bioenergy is generated, facilitating natural pain relief. There is no known risk of side effects from using these bracelets. However, a recent trial of more than 600 arthritis sufferers found that copper bracelets were no more effective in treating joint pain than a placebo bracelet.

Other Options
With the pain of arthritis so debilitating, it’s no wonder people search for relief in just about any form—from herbal teas to mineral waters to topical creams, vibrators, vinegar and honey. While these are harmless, others—such as bee and snake venom—can be downright dangerous because they can cause severe allergic reactions.

And there’s this: Some treatments may give you temporary relief because you believe they will. According to Dr. Earl J. Brewer, co-author of The Arthritis Sourcebook, when we focus on achieving a desired result, we may actually be able to gain relief, at least for a brief time. And arthritis is known for being up and down; you may feel good one day and miserable the next, and then go into remission for no apparent reason.

No alternative treatment will work for everyone, just as no medication will work for everyone. Consider alternative therapies not as alternatives to traditional medicine but as complementary treatments to be undertaken in addition to your current plan. Whatever alternative you may be considering, be sure to do your homework first, talk the plan over with your doctor, and proceed cautiously.