Imagine being unable to get out of bed in the morning or being unable to play sports, or even walk without pain. For some people with arthritis, this is a ­reality.

Many who live with arthritis find themselves reliant upon non-steroidal ­anti-inflammatory drugs (NSAIDs) or prescription drugs such as COX-2 inhibitors. While these drugs help to manage pain, they can also result in negative side effects that affect overall and long-term health.

Fortunately, a number of excellent remedies can help alleviate arthritic symptoms. In fact, unlike their pharmaceutical counterparts, many of them go beyond providing only symptomatic ­relief and can actually aid in healing damaged joints.

Understanding osteoarthritis
Osteoarthritis, or simply "arthritis" as it is referred to, is a chronic inflammatory, progressively degenerative joint condition characterized by pain (sometimes agonizing), swelling, joint stiffness, limited mobility and, in later stages, ­deformity. It is the most common of all joint disorders and affects up to 80 percent of people over the age of 50.

There are actually two types of ­osteoarthritis: primary and secondary. Primary arthritis, the most common form, ­results from joint wear and tear due to aging and excessive use. Secondary ­osteoarthritis is associated with underlying factors that can predispose the joint to degenerative changes, such as congenital or acquired joint misalignments, infection or structural trauma.

Other factors including diet, exercise and excess weight can also influence the development of both types of osteoarthritis. A comprehensive program for managing this condition would consider all of these factors.

Understanding joint degeneration
A normal, healthy joint consists of an articular surface made up of a thick layer of cartilage covering the surfaces. This cartilage prevents bone-on-bone contact. The joint capsule is lined with a synovial membrane-a very thin structure that produces synovial fluid. This fluid is a nutrient-rich substance that lubricates and cushions the joints.

Ligaments attach bones to one another, and tendons attach muscle to bone. Bursae are small structures that facilitate free movement of the skin and subcutaneous tissue over the joint. When the joints are no longer able to move properly, the muscles surrounding the joint become weaker, leading to greater instability and increasing pain.

When joints degenerate, joint structure begins to lose water; cartilage thickens and eventually softens due to loss of fluid; and small clefts begin to develop in the cartilage layer, eventually extending down to the bone. Proliferation of bone and cartilage may also occur, leading to bone spurs (osteophytes) that cause further joint deformity. Inflammation of the synovial membrane leads to loss of normal range of motion. With joint degeneration, associated ligaments, tendons and muscles also weaken.

Botanical support for arthritis
Three of the most time-honoured herbs for managing arthritis and inflammation include turmeric, devil's claw and yucca.

Turmeric: The spice we associate with the yellow colour of South Asian curries, turmeric is powerfully anti-­inflammatory. A November 2006 study in Arthritis & Rheumatism confirmed that turmeric effectively reduces joint inflammation. Curcumin, one of the thousands of constituents in turmeric, has been shown to inhibit the COX-2 activity associated with inflammation, as well as provide a host of other benefits, including liver support and preventing tumour metastasis.

Devil's claw: Native to Africa, ­devil's claw has a long tradition of use in the treatment of arthritic conditions. Though its name is derived from the ­appearance of its barbed, claw-shaped fruit, it is the ­underground tuber that is used ­medicinally. The tuber contains ­resin-like constituents called harpagosides that exhibit an anti-inflammatory effect. Devil's claw has proven to be as effective as NSAIDs. It is also an excellent digestive stimulant due to its bitter properties. This quality contributes to its overall therapeutic value, as many degenerative conditions are also associated with poor digestion.

Yucca: The root of the desert-loving yucca plant contains constituents collectively referred to as saponins, which resemble steroidal hormones such as cortisol-a natural anti-inflammatory hormone produced by our adrenal glands. It is theorized that, through their ability to bind to cortisol-receptor sites in the body, saponins can evoke a similar anti-inflammatory response.

The saponins of the yucca also limit the absorption of bacterial breakdown products in the intestine. These toxins are released from the cell walls of dying bacteria and have been shown to inhibit the repair of damaged joints by interfering with the synthesis of joint cartilage. Because intestinal health plays a significant role in many chronic conditions, it is important to ensure that your intestinal flora (bacterial population) is balanced and healthy.

Additional botanicals for the natural treatment of arthritis include ginger, boswellia, celery seed, barberry, black cohosh, willow and meadowsweet.

Important supplements for arthritis
Vitamin C: A very important supplement to consider for arthritis, and good health in general, is vitamin C. It is essential for production and repair of joint collagen and cartilage. During times of stress, including illness, our body's needs for this essential vitamin increase ­greatly. For more information on vitamin C ­options, as there are numerous forms, see page 6.

Essential fatty acids: Another essential supplement for overall good health and inflammation management are the omega-3 fatty acids EPA and DHA. These are derived from cold-water fish, including sardines, mackerel, anchovies and cod liver, and are also found in certain algae such as chlorella, spirulina and ­schizochytrium.

A usual recommended daily dosage for adults is 500 milligrams of EPA and DHA combined. With arthritis, ­consider increasing your daily intake until your condition improves. Consult with your health-care provider for appropriate dosages.

Ensure that your omega-3 fish oil supplement is both high quality and potency, molecularly-distilled (free of heavy metals, PCBs, dioxins and other environmental contaminants) and made up of 100 percent wild fish oil. (Manufacturers are legally allowed to label their products as "wild fish oil" even when it contains a certain percentage of farmed fish.) Sustainable harvesting is also an important factor. Avoid ethyl ester omega-3 oils, which are of less quality and effectiveness.

For vegetarians and vegans, algae-derived omega-3s from chlorella, spirulina and schizochytrium are an excellent alternative to fish oil. As these algae are commercially grown and harvested, verify that they are free of environmental contaminants and toxins. Chia seeds also contain omega-3s and can be either ground up or sprinkled whole on yogurt, cereals and salads.

I do not recommend flax seed oil as a source of plant-based omega-3 EFAs. There is research that the conversion of its primary omega-3 fatty acid, alpha-linolenic acid (ALA), to the biologically active metabolites EPA and DHA, is nominal-to-none in our body. Fresh ground flax seeds, however, contain other beneficial components and are an excellent source of lignans, which have anti-carcinogenic and cholesterol-supportive effects. Grind flax seeds just prior to consuming and enjoy them in salads, cereals, yogurt, pasta sauces and more.

Minerals: Like vitamin C, minerals are "essential," meaning the body cannot manufacture them so they must be obtained from the diet and/or from a quality supplement. Among their crucial roles in the body, minerals compose the very matrix of the bones, teeth, joints, ligaments and other tissues. Without them, we would literally fall apart. Choose a full-spectrum macro- and trace mineral complex.

Enzymes: Bromelain, the enzyme ­derived from the stem of pineapple, is a powerful anti-inflammatory and also enhances the absorption of ­curcumin (turmeric).  Serrapeptidase, from the ­micro-organism Serratia E15, is an ­enzyme that breaks down fibrin deposits and reduces inflammation and swelling.

If you are struggling with arthritis or inflammatory pain, consider supportive natural remedies and treatments that can assist in pain reduction and improved joint health.

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