resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
Correcting Rib Dysfunction: Improve Patients' Pain, Posture and Breathing
As chiropractors, we tend to focus on the spine, and rightly so. Many problems our patients face can be corrected by manipulating the correct spinal level.
The Acupuncture Channel System (Part 2)
The primary channels (main channels) are introduced in chapter 10 of the Ling Shu, these channels are referenced in many chapters throughout the Su Wen and the Ling Shu. The primary channels have become the main channel system used in TCM.
A Brief History of Acupuncture and Oriental Medicine Doctoral Programs
A doctorate in acupuncture and Oriental medicine has been a goal of the profession since its beginnings in the late 1970s. At that time, however, the maturity of the educational institutions and the regulatory environment made it a goal with only a distant completion date.
VF Works / DMX Works Epilogue: Almost Two Decades Later, the Lawsuits Continue
An article in the March 8, 1999 edition of Dynamic Chiropractic examined whether then-VF Works / Nu-Best Franchising was selling its franchises illegally to doctors of chiropractic.
Gather & Grow
I recently attended a faculty seminar held by one of the acupuncture schools. There was a facilitator who led us through some very interesting experiences. The attendees were a diverse group with varying opinions.
The Large Intestine Official
The large intestine (AKA colon) is the great eliminator, or as J.R. Worsley called it, "The Drainer of the Dregs." Dregs are defined as the remnants of liquid with its sediment left in a container, or the basest, least valuable portion of anything.
Near-Infrared Therapy for Diabetic Neuropathy
The pain experienced by people with diabetes is a symptom of diabetic neuropathy. The impact on quality of life is significant. Pain makes walking difficult, sleep troublesome, and eventually contributes to a decrease in social interaction.
Treating the Lower Pelvis (Pt. 2): Midline Structures and Fascia
My previous article [October 2016 issue] outlined evaluation and treatment of pelvic issues involving the sacrotuberous ligament and the pubic symphysis. Now let's discuss two case studies that illustrate how to address additional problematic areas of the pelvis.
Spiritual Initiation: Opening Your Higher Healing Abilities
People drawn to the field of acupuncture and Oriental Medicine tend to be those who march to the beat of a different drummer.
TCM & the Caregiving Population: Treatment Considerations & Our Vital Role
Informal caregiving is increasingly a reality for many Americans who find themselves providing unpaid care for a loved one or a family member with a long-term, terminal, or chronic illness.
Advancing the "Whole Organ" Spine Model
Historically, the human spine has been organized by body region utilizing specific anatomical landmarks and transition zones.
House Calls With Dad
My father was a chiropractor and he did house calls. On Wednesday nights, while my mother attended the weekly women's meeting at the Odd Fellows and Rebekahs hall in our small town, dad loaded up the portable adjusting table, fired up the Pontiac and drove off to treat a few patients in their homes. I went with him.
Latest Cassidy Study on Stroke Risk Published
The latest study to investigate whether a unique association between chiropractic manipulation and risk of cervical artery dissection / stroke exists has yielded similar encouraging findings, with the authors noting "no excess risk of carotid artery stroke after chiropractic care" and no significant risk difference between patients receiving care from a DC or a primary care medical provider.
ICA Goes on the Vaccine Offensive
Have you watched the vaccination documentary, "Vaxxed: From Cover-Up to Catastrophe," by Andrew Wakefield MD, director, and Del Bigtree, producer? This is the documentary Robert DeNiro was pressured to remove from his Tribeca Film Festival.
Paperwork Done Wrong, Done Right
I was visiting a doctor's office recently and a member of his staff brought a stack of forms to his private office and laid them on the doctor's desk. She informed him he needed to complete the forms for patients and a few third parties.
Waist Circumference: A Conversation Starter
New estimates suggest more than two-thirds of Americans are either overweight or obese. The medical significance of this statistic is astounding.
AOM Residency at NUNM
Imagine you're a recent acupuncture graduate, worried about making enough income as you forge your new career and seek more in-depth training in a particular treatment style.
Getting Unstuck: Healing From Trauma With TCM, Qigong & Movement
We all come into this world vulnerable, with seeds to grow into our strength. Some of us — through a combination of good fortune (i.e., family and culture we are born into, constitutional inheritance, or ability to learn) grow with minimal interruption from traumatic injuries and experiences.
Helping Patients With Parkinson's Disease
Parkinson's disease (PD), a long-term degenerative disorder of the central nervous system that mainly affects motor function, has a slow onset over time.
Chiropractic in Texas Is Under Attack
The profession of chiropractic faces an unprecedented challenge in Texas, an attack that is more aggressive, sustained and dangerous than anything previously seen. The medical lobby has launched a coordinated, multi-front assault.
4 Things Every DC Should Know About Levels of Care & Prevention
As health practitioners, we help people with their health problems and assist them with health promotion and disease prevention.
Reader Beware: Consider the Source
The aftermath of last year's presidential elections brought a running conversation on the role played by "fake news" that was largely presented via social media.
December, 2001, Vol. 01, Issue 12
Natural Anti-Inflammatory Supplements: Research Status and Clinical Applications
By James P. Meschino, DC, MS
Editor's note: Dr. James Meschino holds a masters degree in science with specialties in nutrition and biology. He is on the board of advisors of the Academy of Anti-Aging Research, and is the Clinical and Research Director for the RenaiSanté Institute of Integrative Medicine in Toronto.He is also an assistant professor in the division of Graduate Studies and Research at the Canadian Memorial Chiropractic College (CMCC,) and a postgraduate faculty member of the American Council on Exercise (ACE). In recent years, scientific studies have demonstrated that many forms of arthritis and joint inflammatory conditions can be managed effectively through specific dietary and supplementation practices, in addition to joint mobilization; manipulation; muscle therapy; acupuncture; and exercise.1
Beyond the use of glucosamine sulfate as an effective intervention to halt joint cartilage destruction and help regenerate new cartilage in osteoarthritis cases, substantial clinical and experimental evidence supports the use of other natural health products, which demonstrate proven abilities to block inflammation, and reduce the signs and symptoms of arthritis and other joint inflammatory conditions. Studies indicate that many of these natural agents provide similar efficacy as conventional anti-inflammatory drugs, and are safer to use with respect to reported adverse side-effects.
Most medical practitioners have failed to embrace these alternative anti-inflammatory agents, and tend to rely primarily on synthetic anti-inflammatory drugs as their principal approach to managing these problems.2 It is well documented that these nonsteroidal anti-inflammatory drugs (NSAIDs) produce intestinal tract ulcers (with potential internal bleeding) in 10-30 percent of long-term users, and erosions of the stomach lining and intestinal tract in 30-50 percent of cases.3 As a result of these side effects, NSAID use is associated with 10,000 - 20,000 deaths per year in the U.S.4 Even the new COX-2 inhibitor drugs have only been reported to reduce intestinal tract damage by 50 percent, and their toxicity to the liver and kidneys is still under review.5
Anti-inflammatory drugs have been shown to accelerate damage and erosion of joint cartilage, advancing the osteoarthritic process. Conventional NSAIDs are also known to cause liver and kidney damage with long-term use.6 These and other statistics have lead certain esteemed investigators to conclude: "The epidemiological data highlight the importance of implementing acetylsalicylic acid (ASA)/NSAID therapy only when strictly necessary."7
Reducing Inflammation Naturally
The discovery that certain natural agents produce marked anti-inflammatory effects presents an opportunity for chiropractors and other natural health practitioners to add an important and effective adjunct to the management of these cases.
As such, a review of the physiological action and clinical studies, involving the use of proven natural anti-inflammatory herbal agents, enables practitioners to use these substances in a safe and responsible way, and thereby help patients eliminate or minimize their reliance upon more dangerous NSAIDs and other synthetic anti-inflammatory drugs. Experimental research reveals that the efficacy of many natural anti-inflammatory agents stems from their ability to modulate the activity of the enzymes, cyclooxygenase and/or 5-lipoxygenase.8 The pathophysiology of joint inflammatory conditions involves the conversion of arachidonic acid to prostaglandin series -2 (PG-2) by the cyclooxygenase enzyme. PG-2 synthesis is known to produce a pro-inflammatory effect, exacerbating joint inflammatory conditions. Accordingly, the conversion of arachidonic acid to leukotriene B4 (LTB-4), by the 5-lipoxygenase enzyme within white blood cells, is also known to contribute to inflammation. White blood cell count in normal synovial fluid is less than 100ml on average. However, cellular response rises to 800ml or more in osteoarthritis and much higher than this in rheumatoid diseases, implicating white blood cells in the T-cell-mediated inflammatory response in inflammatory joint conditions.9 As is the case with many synthetic anti-inflammatory drugs, the active constituents of anti-inflammatory herbs have been shown to block the activity of the cyclooxygenase and lipoxygenase enzymes, inhibiting the synthesis of pro-inflammatory eicosanaoids of the PG-2 and LTB-4 series. These natural substances have been shown to reduce inflammation and pain associated with various types of arthritis and traumatic joint injuries. Unlike their synthetic counterparts, they have not been shown to cause erosion injury to the intestinal tract, accelerate cartilage destruction or produce liver and kidney toxicity.8 For these reasons, the following herbal agents can be considered viable alternatives to conventional anti-inflammatory drugs in a large percentage of arthritic patients and those suffering from other joint inflammatory conditions.
Effective Anti-Inflammatory Herbs and Supplements
Curcumin is the active anti-inflammatory agent found in the spice turmeric. It has been shown to inhibit the activity of the 5-lipoxygenase and cyclooxygenase enzymes, blocking the synthesis of pro-inflammatory eicosanoids (PG-2, LTB-4). A large double-blind study demonstrated that curcumin was as effective as a powerful anti-inflammatory drug (phenylbutazone) in reducing pain, swelling and stiffness in rheumatoid arthritis patients. It has also been shown to be effective in the treatment of postsurgical inflammation. Other studies indicate that curcumin can lower histamine levels and is a potent antioxidant. These factors may also contribute to its anti-inflammatory capabilities.
For best results, practitioners should consider using a 95-percent standardized extract of curcumin derived from turmeric. As a singular agent, the daily dosage to consider is 400-600mg, taken one to three times per day. (Lower doses can be used as part of a combination formula containing other anti-inflammatory agents). Side effects are rare, but primarily include heartburn and esophageal reflux. As curcumin inhibits the cyclooxygenase enzyme system, it may reduce platelet aggregation and thus may potentiate the effects of anti-coagulant drugs. To date, no bleeding disorders have been reported with curcumin supplementation, but its concurrent use with warfarin or coumadin should be considered a contraindication.2,8,10,11,12,13,14
Boswellia -- In clinical studies, the gum resin of the boswellia tree (yielding 70 percent boswellic acids) has been shown to improve symptoms in patients with osteoarthritis, and rheumatoid arthritis.12,13 Research indicates that boswellic acids inhibit the 5-lipoxygenase enzyme in white blood cells. As a singular agent, the usual dosage is 150mg, one to three times per day. (Again, lower doses are effective when combined with other natural anti-inflammatory agents.) Boswellia appears to have no important side-effects or drug-nutrient interactions of concern.15,16
White Willow Bark Extract provides anti-inflammatory phenolic glycosides, such as salicin, which have been shown to be effective in the treatment of arthritis, back pain and other joint inflammatory conditions. These phenolic glycosides are known to inhibit cyclooxygenase, blocking the production of PG-2, and exert a mild analgesic effect.
Unlike ASA, naturally occurring salicin (salicylic acid) does not irreversibly inhibit platelet aggregation, reducing the potential for a bleeding disorder. White willow extract has been shown to be slower acting than ASA, but of longer duration in effectiveness. The usual dosage is 20-40mg of salicin, one to three times per day. (Note that 100mg of white willow extract at a 15 percent standardized extract of salicin content yields 15mg of salicin per dosage. A lower dosage can be used as part of a combination formula containing other anti-inflammatory agents.)
Side-effects are rare, but primarily include nausea, headache and digestive upset. Contraindications may include conditions where ASA is contraindicated, including gout; diabetes; hemophilia; kidney disease; active peptic ulcer; glucose-6-phosphate dehydrogenase deficiency; and possibly asthma. However, the salicin content in a single dosage of white willow extract is very low compared to the content of ASA (e.g., 15mg vs. 320mg ); thus, these conditions may not be absolute contraindications for the use of white willow bark extract. It is important to realize that besides salicin, white willow extract contains other phenolic glycosides, which are also known to possess anti-inflammatory properties.8,17,18,19
Ginger Root Extract contains oleo-resins that have shown clinical benefit in the management of various arthritic and muscle inflammation problems, including rheumatoid arthritis, osteoarthritis, and myalgias. The active constituents in this regard are gingerols (oleo-resins), which inhibit the cyclooxygenase and lipoxygenase enzymes. The usual dosage is 500mg, one to three times daily, standardized to a five-percent gingerol content. (A lower dosage can be used as part of a combination formula containing other anti-inflammatory agents). Side-effects are rare, but include heartburn and digestive upset. It should not be given to patients with gallstones. It may also induce a mild anticoagulant effect (by inhibiting cyclooxygenase enzyme in platelets), therefore it should not be taken concurrently with warfarin of coumadin. However, there are no reports of bleeding disorders with ginger supplementation and no adverse drug - nutrient interactions have been reported in the scientific literature to date.2,8,14,20,21
Bromelain contains anti-inflammatory enzymes that have the proven ability to suppress the inflammation and pain of rheumatoid arthritis and osteoarthritis, sports injuries, and other joint inflammatory conditions. Bromelain has been shown to inhibit the cyclooxygenase enzyme, inhibiting the synthesis of PG-2. Bromelain also helps to break down fibrin (fibrinolytic), thereby minimizing local swelling. The usual dosage is 400mg, one to three times per day (a lower dosage can be used as part of a combination anti-inflammatory formulation). Bromelain may inhibit platelet clotting and is a known for its fibrinolytic properties. Therefore, it may potentiate the effects of anticoagulant drugs such as warfarin and coumadin, and should not be recommended in these cases.2,8,14,22,23,24
Quercetin is a bioflavonoid compound that blocks the release of histamine and other anti-inflammatory enzymes at supplemented doses (minimum 100-1500mg per day). Although human studies with arthritic patients are lacking at this time, anecdotal evidence is strong for this application, as is experimental research investigation. There are no well-known side effects or drug-nutrient interactions for quercetin. 14,25,26,27
Devil's Claw contains the anti-inflammatory agent harpogoside. Devil's claw has demonstrated efficacy in the management of low back pain and is used traditionally as an anti-inflammatory by numerous southern African tribes. The usual dosage is 100-400mg, one to three times per day (a lower dosage can be used if part of a combination anti-inflammatory formula). The only consistently reported side-effect is mild digestive upset on rare occasions. It is contraindicated in patients with active gastric ulcers (may increase gastric acid secretion) and in patients taking warfarin or coumadin (due to its anticoagulant effects).8,14,28,29
The body of evidence supports the use of natural anti-inflammatory agents as viable alternatives to synthetic drugs or as a means to help patients lower their requirements for conventional anti-inflammatory pharmaceutical agents. A number of quality-oriented companies manufacture single and combination natural anti-inflammatory supplement products that meet the above dosage and standardized grade criteria, along with dietary changes to lower arachidonic concentrations, support joint cartilage synthesis and promote the formation of anti-inflammatory eicosanoids (e.g., PG-1 and PG-3). Massage therapists may consider discussing the use of these herbal and accessory nutrients with clients suffering from arthritis and other inflammatory joint conditions.
Click here for previous articles by James P. Meschino, DC, MS.
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