Tuesday, April 2, 2013

Offbeat Treatments for Osteoarthritis of the Knee

Osteoarthritis of the knee is one of the most common arthritis problems seen by rheumatologists.

The treatment varies according to the severity of disease. Conventional approaches include topical and/oral anti-inflammatory drugs, analgesics (pain relievers), glucocorticoid injections ("cortisone"), viscosupplements (lubricants), bracers, exercises, physical therapy, weight loss, and the list goes on.

Proponents of alternative therapies also tout the benefits of glucosamine and chondroitin- the so-called nutriceuticals as well as omega oils, herbal remedies such as garlic, ginger, turmeric, frankincense, stinging nettle, boswellia, and bromolein.

The purpose of this article is to introduce some not so well known but potentially effective remedies that aren't so well known.

The first are leeches. Leeches have been used for centuries for a variety of medical problems. However, one little known area of research is their use to treat osteoarthritis of the knee. In two separate studies, one at Beth Israel Hospital in New York, and the other in Germany, leech therapy, termed hirudo medicinalis, was studied. Leeches were applied in a four quadrant distribution to a patient's knee. Leech saliva apparently contains a variety of substances including hirudin, hyaluronidase, vasodilators, collagenase, and other chemicals that block inflammation.

Bee venom is another type of treatment that has been touted as effective for arthritis. The term for bee venom treatment is apitherapy. Apitherapy has been studied for both its acupuncture like effect as well as for chemical compounds present in bee venom. Its use is particularly common in Korea. Bioactive compounds found in bee venom apparently have profound anti-inflammatory effects.

Another not so weird but intriguing one is the use of pulsed electrical fields to treat arthritis pain. A company called Bionicare makes a device that fits around your knee. Electrical impulses using special wave forms are then delivered to the cuff. Clinical trials have demonstrated improvement in pain that is statistically better than placebo. How it works is still not clear.

Another "weird" treatment is dimethyl sulfoxide (DMSO). DMSO is an industrial solvent found in paint thinner. It was popular in the 1950's as a topical cure for many ailments. Studies showed deleterious changes in the lens of test animals and the FDA eventually approved DMSO only for treatment of a rare bladder condition, interstitial cystitis. Since it comes in both industrial as well as medicinal strengths, it's a substance that should be used very cautiously. DMSO has remained popular among veterinarians who use DMSO to treat racehorses affected with joint inflammation. Interestingly, DMSO has found a niche as the vehicle that drives diclofenac, an anti-inflammatory drug, through the skin by pushing the drug through the small lipids (fats) in the skin. This combination medicine is marketed as Pennsaid.

So in this brief article I've outlined a few weird but potentially effective remedies. Nonetheless, it's important to check with your doctor before considering any type of new treatment.

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