The Whole is Better than the Parts: Arthritis Series, part 3
In the Arthritis Series so far, we looked the overview of arthritis (Part 1) and the Chinese medicine view of arthritis (Part 2). Today let’s compare Western (conventional) and Eastern (alternative) approaches.
The conventional approach to arthritis is to look at the symptoms independently and try and treat them individually. This is reductionism, to look only at the symptoms and not the why. The approach of treating individual symptoms is really just management of the pain or trying to turn off the symptoms without really addressing the underlying cause of the problem. In contrast, holism sees the sum being greater than the individual parts. By addressing the body as a whole and making it run as efficiently as possible, the individual symptoms improve on their own.
When the check engine light comes on in your car, you could just disconnect the wire and that would turn off the light (reductionism) or you could investigate the cause of the check engine light and fix that, which would then turn off the light (holism). By just cutting the wire, the problem remains, you are just not being told about it anymore. This is the same in the body. The symptom of joint pain is your body telling you something is wrong. By taking a pain killing medication your are not fixing the problem, you are just cutting the wire to the light. This is why the problem continues to persist, soon the medication doesn't work anymore, and you start to have more symptoms or other symptoms. The body continue to increase the intensity of symptoms, or present new symptoms, until you address the root of the problem. It is best to address the cause when the symptoms are only whispering, before they can take root and become more persistent.
Conventional Treatments -
Treat the symptoms
The conventional treatments for arthritis start with some lifestyle modifications such as avoiding repetitive or strenuous activities, trying to balance rest with activity. Regular physical activity is recommended as well as maintaining a healthy weight and using assistive devices if needed (ie: walking with a cane, walker, or a wheelchair). Physical therapy may be used to help strengthen muscles around affected joints. Hot or cold therapy may be used for pain management.
As the condition progresses, medications are used to lower inflammation and reduce pain. These can range from over the counter to prescription strength. Non-steroidal Anti-inflammatories (NSAIDs) often used include: Ibuprofen (Motrin, Advil), Aspirin, Celebrex, Diclofenac, Diflunisal, Etodolac, Fenoprofen, Flurbiprofen, etc. NSAIDs work by blocking prostaglandins (hormone-like substances) which are involved in pain and inflammation. Side effects range from stomach ulcers, increased risk of blood clots, heart attack, and stroke. Risk is increased with prolonged use and high dose (1).
Corticosteroid Injection, a powerful anti-inflammatory, are often used for joint pain. In my clinical experience I have seen mixed results from them. For some it doesn’t help the pain at all, for others it can give temporary relief from anywhere from days to 6 months. The best results I have seen from corticosteroid injections is when the patient uses them in conjunction with other therapies including acupuncture, chiropractic, physical therapy and exercise rehabilitation. Side effects from injections include joint infection, cartilage or nerve damage, tendon rupture, and for some and increase in pain. (2)
Prednisone is another common anti-inflammatory used in the treatment of arthritis, usually during and RA or gout flare. Prednisone, a corticosteroid, is a synthetic version of cortisol, a hormone produced by our adrenal glands. Side effects include nausea, vomiting, loss of appetite, trouble sleeping, increased sweating, or acne.(3) Patients often report feeling “crazy” or all “ ampted up” while on Prednisone to then only crash after coming off the medication with rebounds in pain and sometimes feelings of depression and meloncoly.
When medications and other therapies no longer work, the next step is surgery. Surgery can range from an arthroscopic, minimally invasive procedure to full joint replacement. The two most commonly replaced joints in the body are the knee and hip (arthritis.org). In a full replacement the articulating surfaces of the joint are replaced with an artificial joint made of metal, ceramic, and/or plastic. A less invasive hip surgery is joint resurfacing, where the surgeon uses tools to reshape the head of the femur and place a metal cap where it articulates with the pelvis. Arthroscopic surgery is used to “clean up” joint space of debris and repair small tears in the surrounding tendons and ligaments.
These conventional treatments can help relieve pain, but they don’t address root of the problem and or do much to stop the progression of the disease.
Alternative Treatments -
Treat the Whole Body
In Chinese medicine the treatment is always about bringing the body back to balance. A balanced body is an efficient body, and an efficient body is able to heal itself and be resistant to future assault. This is a holistic approach to addressing the problem and bringing about lasting change.
In Chinese medical theory the disease starts long before there are physical symptoms. It actually starts when there is a disruption in the smooth flow of qi throughout the body. The best time to treat disease is before it happens (preventatively), by maintaining proper qi circulation and generate adequate amounts of qi. Once the manifestations of disease (symptoms) have started it is considered a more advanced stage of disease, so you must both repair the damage done and also nourish the body so that it can stop the progression. Treatments are designed to minimize acute symptoms, while nourishing the underlying deficiency so that that body is more resilient in the future. The main steps to any holistic treatment approach will incorporate nutrition, rehabilitation physically with exercises and stretching, along with adequate amount of rest. Holistic treatments can be in the form of acupuncture, herbal or nutritional medicine, rest, and exercise or movement therapies.
To learn more about alternative or natural ways of treating your arthritis or joint pain check out my ebook: The Arthritis Answer: Your Step by Step Guide to Living Pain Free.