Ethnomedicine for arthritis

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Ethnomedicine for arthritis. (Medical Anthropology).

Townsend Letter for Doctors and Patients, May, 2002, by Tim Batchelder

http://www.findarticles.com/cf_0/m0ISW/2002_May/85131551/p1/article.jhtml?term=

 

Arthritis is a disease that has plagued humans for millennia. Yet, because

it leaves very clear marks on the skeletal system, anthro-pologists have

been able to trace its occurrence to fundamental shifts in lifestyle that

began thousands of years ago with the invention of agriculture. In this

review I'll discuss some of the anthropological roots of arthritis as well

as conservative therapies from a variety of traditional cultures.

 

Diet and Evolution

 

A shift in diet has occurred over the course of evolution from a primarily

plant-based one to a diet rich in animal foods. Nutritional research has

suggested that animal food-rich diets increase levels of uric acid in the

body, which may be linked to arthritis. This acid is found mainly in meats

and increases the body's levels of prostaglandins. Highly allergenic foods,

which are often genetically altered super-foods such as grains, potatoes,

tomatoes, and peppers, are also implicated in arthritis. As discussed in

previous columns, our food supply has been increasingly altered genetically

from original wild varieties of certain cultivars which has resulted in our

body's inability to recognize and assimilate these foods, causing allergies

and inflammatory responses leading to arthritis. Studies support this

evolutionary hypothesis showing that vegetarian diets reduce symptoms of

rheumatoid arthritis. Other studies show that enzymes, when taken as a

dietary supplement, are highly effective in reducing the pain of arthritis.

From an evolutionary standpoint, early humans would have obtained much

higher levels of plant enzymes in foods since they were often uncooked and

minimally processed. This would be expected to have further reduced their

risk of arthritis before the food technologies of the agricultural revolution.

 

Evolutionary Kinesiology

 

According to archaeological evidence of human bone remains, wear and tear

of osteoarthritis increased dramatically in the human record with the

agricultural revolution (ten thousand years ago, roughly) throughout the

world. This was due to the increased repetitive motions of a specialized

economy: people began to take on specialized jobs that required they

perform the same motions throughout the day. In addition, diets shifted to

less nutritional mono-cultures such as grains which reduced access to

important nutrients needed for a healthy musculoskeletal system. Before the

agricultural revolution, people lived as hunter-gatherers or small scale

agriculturalists and performed a wide range of activities each day that

ensured a healthy musculoskeletal system. In general, the lowest incidence

of osteoarthritis can be expected in pre-agricultural societies who lead an

active and kinesiologically diverse lifestyle. In addition, the consumption

of wild plant foods, including medicinally active herbs, as found in the se

groups can be expected to have a preventive effect. Archaeological evidence

supports this hypothesis and shows an increase in arthritis with

agriculture in a wide selection of people.

 

Acupuncture

 

Acupuncture has become a widely accepted treatment for chronic pain and

inflammation including that of arthritis. Stimulation of specific points

along meridians in the body can correct the flow of qi to restore or

optimize health, or to block pain, according to Traditional Chinese

Medicine. The acupuncture points can also be stimulated with heated herbs

(called moxibustion), magnets, mild electrical current

(electroacupuncture), manual pressure (acupressure), low-frequency lasers,

or even bee stings. Some points correspond to areas called trigger points,

that are known to be rich in nerve endings, and studies show stimulating

them can prompt a cascade of chemicals in the muscles, spinal cord and

brain that releases the body's natural pain-killing endorphins and can also

improve circulation. Acupuncture relieves osteoarthritis symptoms so well

that in one Scandinavian study 25% of patients previously scheduled for

knee surgery canceled their plans. That same study showed booster

treatments once a month sustain ed the pain relief. Numerous NIH-funded

studies are underway looking at acupuncture and osteoarthritis. While

treatments can become expensive since they are outside of insurance

coverage, people can be taught to self-administer acupressure massage.

 

Electromagnetic Fields

 

Over the course of human evolution the electromagnetic field which we have

lived in has changed dramatically. With the construction of cities and

communications technology the background field has become even more

deranged than that found in natural environments. We still don't understand

the implications of exposure to artificial electromagnetic fields. However,

one signal that they may be implicated in arthritis, is the widespread use

of magnet therapies for this condition. In fact, in Japan an interesting

syndrome is recognized in which people are considered insufficiently

exposed to earth's natural electromagnetic field and are removed from urban

locations for therapeutic purposes. The way magnet therapy works is still

largely a mystery but it appears in part to affect calcium binding to

molecules in cells and speed up the release of certain enzymes.

 

Key Ethnopharmaceuticals for Arthritis Cartilage

 

People all over the world have been consuming animal cartilage for

centuries. In some cultures bones and cartilage are added to soup (for

example in China); in other societies bones are chewed. Cartilage in the

diet may help to rebuild the cartilage of humans. The body naturally

produces glucosamine sulfate to repair joints, but people often don't make

enough so consuming adequate amounts in the diet is essential. Glucosamine

is highly absorbable because its molecules are small and simple and they

actually penetrate the cartilage, where they can help build the special

proteins that keep cartilage strong and healthy. Other cartilage products

that may help include glucosamine hydrochloride, N-acetyl glucosamine, and

chondroitin sulfate. However, the molecules in these products are much

larger, which may limit the body's absorption of them. For example,

chondroitin sulfate is 250 times larger than glucosamine sulfate, and has

an absorption rate of 13% according to some studies. Glucosamine may also

stimulate pro duction of synovial fluid, a lubricating and shock absorbing

fluid in joints. Collagen hydrolysate contains the amino acids that make up

human cartilage and triggers the growth of new joint tissue in animals. A

test on humans found it most effective on knee and finger joints.

 

Cayenne

 

Cayenne is an herb and spice obtained from the dried, ground fruit of

various domesticated red pepper species (especially Capsicum frutescens)

native to South America. Cayenne stimulates circulation, aids digestion,

and promotes sweating. Cayenne is also used topically for pain relief since

the active chemical, capsaicin, alters the action of the bodily compound

(substance P) that transfers pain messages to the brain, thus reducing pain

and inflammation. For example, when applied topically, capsaicin may

initially cause the skin to become red and inflamed and produce pain and

burning. Over time, this initial reaction lessens and underlying pain and

inflammation is reduced. Thus, capsaicin has become accepted as the active

ingredient in over-the-counter and prescription creams (such as Zostrix)

used topically to treat not only arthritis but the pain of shingles (herpes

zoster), post-operative surgery, cluster headaches, and psoriasis and other

skin conditions.

 

Cannabis

 

A compound found in cannabis called cannabidiol has been shown to stop the

pain caused by rheumatoid arthritis, a disease that affects more than 2

million Americans. The compound apparently works much like Enbrel and

Remicade, drugs for rheumatoid arthritis, but unlike them it can be taken

orally according to Dr. Marc Feldmann, a prominent arthritis researcher at

the Kennedy Institute of Rheumatology in London and author of a report on

the compound in the Proceedings of the National Academy of Sciences. In

researching this compound scientists gave laboratory mice injections of

collagen, a connective-tissue protein that sparked an abnormal immune

system attack on the mice's tissues and joints. Rheumatoid arthritis is

characterized by such mistaken attacks by the body's own defense system,

which leads to swelling, pain, inflammation and destruction of joints. The

cannabidiol, purified from hashish, was injected into some animals and

given orally to others, while control animals received a placebo.

Researchers e valuated the drug's effect by measuring swelling,

inflammation and joint stiffness in the animals. Some of the rodents' hind

feet were removed so they could be studied for physical damage by the

renegade immune system attack. Animals who got the drug had significantly

fewer symptoms, and more of them escaped damage to their feet. Only a very

specific dose was effective, the scientists reported.

 

Feldmann had previously shown that a particular immune system signaler,

tumor necrosis factor, or TNF, is a major culprit in rheumatoid arthritis.

Blocking TNF, he found, also squelched the activity of other molecules

involved in the immune system's mistaken attack on the body's own tissues.

This paved the way for drugs like Enbrel and Remicade, which are

TNF-blockers that entered wide use in the past year and a half. Feldmann

said he was interested in testing the cannabis compound because of findings

over many years by Dr. Raffi Mechoulem in Israel, who is well known for his

expertise on cannabinoid chemistry. Enbrel and Remicade have brought

dramatic relief to many rheumatoid arthritis sufferers but have to be

injected by the patient or someone else twice a week and are expensive,

with a year's treatment costing about $10,000. Cannabidiol is easier to use

and better tolerated.

 

Borage Oil

 

Borage oil, taken from the seeds of the plant Borago officinialis, is rich

in the essential fatty acid gamma-linolenic acid (GLA), which is also found

in hemp, black currant, and evening primrose oils. GLA can be produced in

human tissues by the action of enzymes on linoleic acid. However, people

with many chronic health conditions often don't produce enough of it in

their bodies. Low levels of linolenic acid are associated with immune

dysfunction and arthritis. GLA is converted by the body to a hormone-like

substance called prostaglandin E1, which may account for its ability to

reduce inflammation. A common dose is several grams of borage oil per day,

which provides more than 400 milligrams of GLA. Another essential fatty

acid, omega 3, found in some fish and vegetable oils reduces the production

of another chemical involved in inflammation, interleukin 1, which is

precisely the chemical targeted by corticosteroids.

 

Ashwagandha

 

Ashwagandha (Withania somnifera) is a small shrub in the nightshade

(Solanaceae) family which grows prolifically in the arid highlands of

Himalayan India as well as in parts of northern Africa and the Middle East.

The roots and leaves of this plant are used in Ayurvedic medicine

extensively to reduce the pain of arthritis without the sluggishness of

painkillers. The active compound for pain relief is a chemical called

withaferin A. Often sold in capsules, Ashwagandha is taken at a dosage of

one to two grams of whole herb standardized for two to seven mg of

" withanolides. " It can also be taken as a tea by boiling roots for 15

minutes and taking 3 cups (750 ml) daily. Tincture or fluid extracts of two

to four ml three times per day can also be used.

 

Stinging Nettle

 

Stinging nettle (Urtica dioica) is native to Eurasia but has spread to most

parts of the world, including North America. It is named for the fine

silica-rich hairs that cover its stems and leaves and break off when

touched, injecting irritating chemicals into the skin. The hairs are

destroyed by minimal processing and cooking. Stinging nettle is effective

when used in a manner similar to bee sting therapy as a topical treatment

for arthritis and rheumatism. Numerous chemicals in the plant may be

responsible for this action including formic acid, acetic acid, butyric

acid, acetyicholine, 5-hydroxytryptamine, serotonin, histamine,

leukotrienes, and a resin.

 

Wild Ants

 

The first medicine in the world made from wild ants to treat rheumatoid

arthritis has been licensed by China's State Drug Administration. The

medicine, developed by Wu Zhicheng, a doctor at the Jinling Geriatric

Hospital in Nanjing, capital of east China's Jiangsu Province, is now in

trial production at Nanjing's Zhongshan Pharmaceutical Factory. China has a

long history of using ants as medicine. Ben Cao Gang Mu or Compendium of

Materia Medica , the best-known and respected Chinese medical manual

written by Li Shizhen in the Ming Dynasty (1368-1644), includes a detailed

description of the medicinal properties of wild ants. Wu began his

pharmacological research on wild ants in the early 1980s. His studies show

that wild ants are rich in various types of protein, amino acids and

minerals, and are able to reduce inflammation and ease pain. More than 300

clinical tests conducted at six hospitals in Beijing, Shanghai and Nanjing

indicate that the new wild ant-based capsule has proven effective on 81.7%

of the tes t cases, a better result than that of other medicines.

 

Other Herbs

 

Numerous other ethnobotanicals are useful for arthritis but space prevents

their discussion. Guggulu (Commiphora mukul gum) is one of the most common

herbs used in Ayurvedic medicine for treatment of arthritis. A new extract

of ginger, called Zinaxin, works just like NSAIDs, but without the

toxicity, by interfering with the production of a hormone called

prostaglandin, which plays a major role in inflammation. Other

anti-inflammatory herbs worth mention include boswellia, turmeric, and

white willow.

 

Conclusion

 

Ethnomedicine holds both the key to understanding arthritis and solutions

for its treatment. With the widespread abuse of NSAIDs today and their

various severe side effects, the search for more conservative,

biologically-based treatments for this disorder becomes vital; and medical

anthropology is poised to provide the solutions.

 

About the Author

 

Tim Batchelder, BA, is a clinical anthropologist specializing in applying

ethnomedicine to modern health problems. For detailed reports on the latest

ethnomedical approaches to major health concerns please visit

www.anthrocode.com.

 

Selected References

 

Atal, C.K., and A.E. Schwarting, " Ashwagandha: An Ancient Indian drug, "

Economic Botany (1961), 16: 256-63.

 

Cappelletti et al.: External antirheumatic and antineuralgic herbal

remedies in the traditional medicine of north-eastern Italy. J

Ethnopharmacol 1982 Sep; 6(2):161-90

 

Duke JA. CRC Handbook of Medicinal Herbs. Boca Raton, FL: CRC Press, 1985,

514-15.

 

Iwu MM Anyanwu BN: Phytotherapoutic profile of Nigerian herbs.

Anti-inflammatory and anti-arthritic agents. J Ethnopharmacol 1982 Nay;

6(3):263-74

 

Grandhi, Anuradha, A.M. Mujumdar, and Bhushan Patwardhan. A comparative

pharmacological investigation of Ashwagandha and Ginseng. Journal of

Ethnopharmacology, 44(1994) pp. 131-135

 

Janick, J. et al. " Borae: A source of gamma linolenic acid. " In vol. 4 of

Herbs, Spices and Medicinal Plants: Recent Advances in Botany, Horticulture

and Pharmacology. ed. L.E. Craker and J.E. Simon, 145-86. Phoenix, Arizona:

Oryx Press, 1989

 

Trevathan, McKenna and Smith Evolutionary Medicine Oxford University Press 1999

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