Hi Sandra, I'm in my early 50s and have recently been diagnosed with mild osteoarthritis in the joints of my hand. I use my hands a lot in my work and I'm really worried about being unable to use them, as I'm still quite a way off retirement. Is there anything that can help? Thanks, Peter.

Hi Peter, thanks for your question.

Osteoarthritis (also referred to as degenerative joint disease or wear-and-tear arthritis) is caused by the breakdown of joint cartilage. Cartilage acts as a cushion between the bones that form a joint. Cartilage loss can cause bone to rub on bone in a joint - a condition that is very painful. Usually osteoarthritis begins in a single joint.

Conventional treatment usually involves non-steroidal anti-inflammatory drugs (NSAIDs). These may be necessary to bring down levels of pain or immobility that are unacceptable however over the long-term they can take a hefty toll on the liver and digestive system. As such, proven plant medicines should be considered as part of a wider arthritis management strategy.

Excellent evidence exists for Arnica (Arnica montana), used traditionally in rheumatic conditions for its pain-relieving and anti-inflammatory properties. Contemporary scientific evidence now supports traditional use, with a 2008 randomised double-blind placebo controlled study showing Arnica to be as effective as a popular NSAID in reducing pain and improving mobility in osteoarthritis of the hand.

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Other plants helpful for osteoarthritis include Willow bark (Salix spp), the well-known natural, side effect free source of the aspirin-like chemical salicin with mild analgesic, anti-inflammatory and anti-rheumatic properties. It has been used since the 1st century to reduce inflammation and pain in rheumatic conditions.

Comfrey (Symphytum officinale), another well-researched remedy, promotes the healing of joints and damage to the musculoskeletal system, in particular damage to the connective tissue. This can be particularly helpful for arthritic pain where degeneration of cartilage plays a role. Clinical trials support its use in osteoarthritis specifically.

A targeted application of these plants in a cream base is particularly useful for arthritis in small joints such as the hand. Apply a thin layer to the affected area 2-4 times daily or more frequently as required to support joint mobility and soothe discomfort.

For best results in osteoarthritis, I recommend plant medicine be taken internally to support healing from within. The medicinal plants Birch leaves (Betula pendula), Dandelion (Taraxacum officinale) and Nettle (Urtica dioica) are particularly beneficial in increasing the elimination of urates from the body via the kidneys due to their gentle diuretic action. Their mineral content makes them alkalising, which helps to balance out the excess acidity characteristic of arthritic conditions. These can be taken as an oral liquid or as a medicinal tea. Use 1-3 times daily as maintenance to prevent recurrence, or in acute attacks, increase to 4-5 times daily, to help manage the pain and inflammation and reduce reliance on NSAIDs.

Ginger is another traditional remedy that is clinically proven to ease pain in osteoarthritis. In a clinical trial, stadardised Ginger patches were applied topically to the small of the back of patients to stimulate blood circulation, and relieve muscular and joint pain and tension with statistically significant results in the reduction of synthetic pain medication, mobility and fatigue. Ginger patches are a medical technique where ginger is absorbed into the blood stream and distributed throughout the body, benefitting joint health without side effects.

Other supportive lifestyle measures for osteoarthritis include reducing pro-inflammatory foods such as refined foods and sugars. Include plenty of fresh vegetables, fruits and foods high in essential fatty acids such as oily fish, seeds and nuts, which are anti-inflammatory. A small percentage of people respond dramatically to a nightshade free diet - peppers, eggplant, tomatoes and white potatoes. A month-long trial is recommended.

I hope these measures will help in the management of your joint pain. If this condition worsens or does not improve, see your leading healthcare professional.

References
Ross, S. M. (2008). Osteoarthritis: a proprietary Arnica gel is found to be as effective as ibuprofen gel in osteoarthritis of the hands. Holistic Nursing Practice, 22(4), 237-239. doi: 10.1097/01.HNP.0000326007.03429.3e
Grube, B., Grunwald, J., Krug, L., & Staiger, C. (2007). Efficacy of a comfrey root (Symphyti offic. radix) extract ointment in the treatment of patients with painful osteoarthritis of the knee: results of a double-blind, randomised, bicenter, placebo-controlled trial. Phytomedicine, 14(1), 2-10. doi: 10.1016/j.phymed.2006.11.006