Friday, June 02, 2006

The Wilder Shores of Arthritis - Fit the Fifth


In the face of this mainstream helplessness, alternative therapies have burgeoned. Some people swear by acupuncture, not just as a treatment but as a cure. Acupressure can also work, but for a while only; as soon as the pressure is released, back comes the pain.

People with rheumatoid have a list as long as your arm of food they should, and should not, eat. Studies show that fish oils, for example, have a beneficial effect, on both rheumatoid and osteo, so we all gulp cod-liver-oil until another set of studies casts doubt. Partly, of course, this is the fault of the modern media intrusion into areas of scientific interpretation they are just not competent to dabble in. For instance, I recall an excited news report a couple of years ago that some component of green tea had found to be useful in preventing/reversing the degeneration of osteo. So of course, I pricked up my ears. The truth is rather less dramatic. It is likely, that if you drank green tea every day for about forty years, you might slightly reduce or delay the damage to the joints. That's all. You might well also suffer some side-effects, such as hallucinations, from the green tea, which itself is mildly toxic in quantity, if you overdid it.

The media also never seem to be able to distinguish between osteo and rheumatoid; it never seems to occur to them that, if the causes and effects are quite distinct, the preventatives and treatments might be so as well.

Aromatherapy apparently traces its origins back to Ancient Egypt, specifically the use of spices and essential oils in embalming. Erm, yes, though I can't imagine an allopathic clinician would seek to win confidence for his ars longa by claiming skills and practices honed in the undertaking trade. Anyway, it is a branch of phytotherapy, or herbal medicine. I had not realised that it can be internal as well as external in application. It boasts an impressive list of essential oils that can be used externally for arthritis (which type? it doesn't distinguish), gout, and rheumatism, from Angelica, via Eucalyptus and Nutmeg, to Thyme. This means, of course, massage with rubbing alcohol or sweet oil; a treatment in itself. Internally, Garlic, Juniper, and Onion are among the oils recommended.

A recent report on osteopathy and chiropractic has concluded that the benefits they bestow, as far as these diseases are concerned, are no better than placebo, much to the predictable outrage of their professional associations. This seems to me to miss the point with admirable precision: if you have no effective treatment or cure, then placebo is what you use, allopath, homeopath or whatever. It may even help. I myself have got much benefit from reflexology, which the BMA doesn't even deign to recognise, much less assess; I am quite sure that the benefit is placebo-derived but what the hell? It relieves the pain for a while without giving me an ulcer, blood dyscrasia, or liver damage, and that, these days, is something to be thankful for.

Urtication, TNS and capsaicin therapy all work essentially on the counter-irritant principle. TNS is derived from the "gate theory" of pain transmission. The idea is that the spinal cord can transmit only so much sensory (pain) information; fill the fibres up with the impulses generated from the TNS machine, and there is no room for the signals from the complaining skeleton. It's a bit of a circular argument: TNS works because the gate theory is correct, and the gate theory is proved to be correct because TNS works. (It does, incidentally, but not for every kind of pain.)

Urtication (nettle-stings) and capsaicin (derived from capsicum peppers) are local skin irritants just like Ralgex. Probably it's the rubbing-in, the massage, which gives as much relief as anything. St John's Wort oil (Hypericum perforatum) is another rubifacient with a good reputation. They can all cause local skin allergic reactions.

In some people, for example the late actor Jack Warner, bee-sting therapy has worked dramatically; the poison seems to stimulate the innate antiinflammatory response just right, and the stiffened, aching joints are released and move freely. Nobody knows how exactly it works.

(Incidentally, it was hoped that a dermal plaster of paracetamol preparation would be just as effective an analgesic as an oral dose while avoiding the gastric irritant effects; sadly, longer trials have revealed that any but the briefest usage reduces the user's response to the drug to the point where pain relief is inoperative.)

Herbal remedies, of course, persist, many of them never having been updated since Hippocrates, either in their materials or in the theory behind them. A sentence such as "constipation is almost always a factor in rheumatic disease, causing toxic overload" and recommending purgatives and diaphoretics, would have commended itself to all those ancient practitioners who thought that disease was down to mysterious malignant entities who must be physically expelled - by any orifice available - before curing could take place. I am considerably pro herbalism, but only if it is conducted in a properly scientific manner, accompanied by at least some knowledge of anatomy, physiology and disease processes, not a regurgitation of a couple of millennia's worth of exploded theories born of nothing but ignorance.

The book I am quoting from - I won't be so cruel as to name it, because it's only typical - cheerfully conflates rheumatism, fibromyalgia, osteo-arthrosis and rheumatoid arthritis as if they were all one and the same, then states "in all forms of rheumatic disease there are two main causes: stress, tension, and personality problems....and a poor, inadequate diet." We-ell, up to a point, Lord Copper. Stress and tension and personality problems generally are certainly factors in autoimmune inflammatory conditions, in that they make them worse, but cause....? Diet, again, can exacerbate these conditions by inadvertently providing allergens or excluding needed nutrients, but cause....? Face it, nobody knows precisely what triggers off such conditions, least of all the authors of popular herbals.

Willow, of course, is recommended, so are nettles (taken internally, as tea); and soothing rubs of chamomile; so far, so traditional. Other remedies include cowslip, onion, lemons, celery (seed) and seaweeds; more exotic are Devil's Claw (Harpagophytum procumbens) from Africa, which has been clinically investigated, mainly in Germany, and Guiacum (Lignum vitae) from the West Indies. Devil's Claw needs to be treated with care; I don't know how effective it is in treating rheumatism or the arthritises, but it has a potent effect on insulin metabolism, so diabetics beware. Guiacum, curiously enough, has a long history as a specific for syphilis; there is a form of acute inflammatory arthritis which is secondary to untreated syphilis, so perhaps that is the connection: it doesn't cure that either.

2 Comments:

Blogger Gimpy Mumpy said...

Hi CD,
I thought you might like this gallery of old product labels:
http://wings.buffalo.edu/aru//preprohibition.htm

I think I was born in the wrong century! :P

2:49 pm  
Blogger backcare said...

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12:13 pm  

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