In the first of this two-part series on using the mind-body healing tools of Ayurveda to treat osteoarthritis, Chopra Center medical staff member Sheila Patel, M.D. discusses how the practice of meditation and the use of Ayurvedic herbs can be used as an effective treatment for osteoarthritis. Part II of the series focuses on how those coping with osteoarthritis can use yoga to maintain flexibility and mobility and alleviate pain.
Dr. Patel’s integrative healing approach combines the best in conventional Western medicine with the wisdom of ancient healing traditions. As a board-certified family physician with experience in many areas of medicine, Dr. Patel offers medical mind-body consultations at the Chopra Center. She also teaches classes in mind-body health at the Center’s Perfect Health program.
Part I: Two Powerful Tools for Treating Osteoarthritis: Meditation and Ayurvedic Herbs
Osteoarthritis (OA) is a chronic condition of the joints in which the cartilage cushioning the ends of the bones gradually loses its elasticity and wears away. Without the protective cartilage, the bones begin to rub against each other, causing stiffness, inflammation, and loss of movement. It can occur in any of the body’s joints but most often develops in the hands and weight-bearing joints, including the knees, hips, and spine (usually in the neck or lower back).
Osteoarthritis is the most common form of arthritis worldwide, with symptoms ranging from minor discomfort to debilitation. For people coping with advanced osteoarthritis, the effects are not only physical but also emotional as pain and decreasing mobility can limit the ability to work, participate in daily activities with friends and family, and enjoy life.
Current conventional medical treatments focus on pain reduction and control of inflammation; however, these approaches have no effect on the natural course of the disease. The most common medications prescribed for osteoarthritis are, at best, moderately effective. In addition, side effects of these treatments can be quite significant, and at times life-threatening. Often times, the ultimate treatment for a disabling joint is joint replacement, with the inherent risks and cost that come with surgery. If current trends continue, it is estimated that 600,000 hip replacements and 1.4 million knee replacements will be carried out in the U.S. alone in 2015.
What Causes Osteoarthritis?
While science has no definite answers about what causes OA, researchers have identified several factors involved in the development and course of OA. Some of these factors include inflammation, biomechanical imbalances that put stress on the joints, and cellular disorders that lead to the abnormal breakdown of cartilage. It is important that the approach we use in treating OA address as many of these factors as possible.
Ayurvedic Approaches to Osteoarthritis
Given the only moderate effectiveness and potential side effects of conventional treatment, both patients and health care professionals are seeking out alternative therapies, including those offered by the ancient healing system known as Ayurveda. In this article we’ll look at two of the three main modalities Ayurveda uses to treat osteoarthritis and other disorders: herbal treatments and meditation.
Ayurvedic Herbal Treatments
Ayurveda offers many herbal treatments for the treatment of OA. These plants have documented anti-inflammatory properties without the side effects of commonly prescribed medications. For example, at a recent meeting of the American College of Rheumatology, a study was presented that showed an herbal Ayurvedic therapy to be as effective in treating knee osteoarthritis as a commonly prescribed medication (Celebrex) and glucosamine – and with fewer side effects. The ACR stated that Ayurveda offers “safe and effective treatment alternatives” for OA.
The herbs boswellia, turmeric, ashwagandha, ginger, triphala, guggulu, and shatavari have all been shown to decrease inflammation by interfering with the production of inflammatory chemicals in the body.
There is evidence that the Ayurvedic herb Boswellia serrata, also called Indian frankincense, helps alleviate joint pain and inflammation. Boswellia blocks an enzyme (5-lipoxygenase) that plays a major role in the formation of chemicals called leukotrienes, which stimulate and perpetuate inflammation. Researchers have found that people with osteoarthritis who took boswellia along with ashwagandha, turmeric, and zinc reported less joint pain and increased mobility and strength.
Turmeric is a spice commonly used in South and East Asian cooking. It is also used both orally and topically in traditional Ayurvedic medicine to treat a wide variety of ailments, many of which are related to inflammation. The active ingredient in turmeric, curcumin, has been shown to inhibit key inflammation-producing enzymes (lipo-oxygenase, cyclo-oxygenase, and phospholipase A2), thus disrupting the inflammatory cascade at three different stages. Interestingly, some data suggests that it may protect the stomach against non-steroidal anti-inflammatories (NSAIDs). Although current studies for its use in treating osteoarthritis are few, curcumin/turmeric is a promising option in the treatment of OA.
Another Ayurvedic herb, ashwagandha (Withania somnifera), has known anti-inflammatory effects. In a study published in 2007, the extract of this herb was found to suppress the production of pro-inflammatory molecules (TNF-alpha and two interleukin subtypes). In one study, the anti-inflammatory effect of ashwagandha was comparable to taking the steroid hydrocortisone.
The anti-inflammatory effects of ginger (Zinziber officinale) have also been documented. Ginger works as an anti-inflammatory by interfering with an enzyme (cyclooxygenase) that produces inflammatory chemicals in the body. There is some data showing that ginger has a moderate beneficial effect on OA of the knee. Further research is needed to determine the extent of ginger’s effectiveness in treating OA.
The Ayurvedic herb triphala has been used in India for thousands of years for treatment of osteoarthritis. Triphala is a formulary that consists of three herbs (amalaki, haritaki, and bibhitaki). Preliminary studies show that the herbs in triphala have anti-inflammatory effects.
In addition, the herb guggulu (Commiphora guggul) has been shown to be a potent inhibitor of the enzyme NFKB, which regulates the body’s inflammatory response. There are several studies that show decreased inflammation and joint swelling after administration of extracts of guggulu resin.
Shatavari (Asparagus racemosus) is an Ayurvedic herb that is considered to have a soothing, cooling, and lubricating influence on the body. Studies have found that it has an inhibitory effect on chemicals that create inflammation in the body, such as TNF-alpha, and IL-1B.
Meditation’s Healing Power
An important principle in Ayurveda is acknowledgment of the importance of the emotional and spiritual aspects of health and healing. Health is achieved by balancing not only the body, but mind and spirit as well. Meditation provides a way to achieve this balance. The practice of meditation also creates many physiological changes, including reduction of inflammation in the body.
Mind-body practices such as meditation have value as part of a treatment regimen for chronic pain caused by a variety of conditions. Although to date there are no studies specifically done on the effects of meditation on osteoarthritis, several studies have shown that mindfulness meditation can be useful in the treatment of pain syndromes. A landmark study conducted in 1982 showing the beneficial effect of meditation on pain reduction was carried out by Dr. Jon Kabat-Zinn with a group of patients suffering from chronic pain. After completing a 10-week program of mindfulness meditation, 65 percent of the participants showed a significant reduction in pain levels. Since then, many other studies have confirmed these findings.
A Tool to Diminish Feelings of Pain
Researchers have found that through the regular practice of meditation, we can actually change how our mind perceives pain. Meditation doesn’t take the sensation of pain away; it develops our capacity for detached observation, which helps us separate our experience of physical sensations from the painful stories and emotions we generate in reaction to those sensations.
Emotional reactions such as anxiety, fear, and depression intensify feelings of pain. As many studies have found, meditation is a powerful tool for training our minds to regulate our emotions, reduce anticipation of pain, and increase relaxation – thereby decreasing our perception of pain.
Meditation Enhances Conventional Treatment
Another notable study by Randolph in 1999 found that meditation in conjunction with conventional medical treatment medicine enhances the effectiveness of Western medical treatment alone. In this study, patients were taught hatha yoga and meditation in two-hour classes. A year later, patients undergoing the pain and stress management program in addition to the medical treatment reported that their feelings of pain decreased by 79 percent.
Meditation is an important healing tool that uses the mind-body connection to help people deal with pain conditions, such as OA. Meditation is fast becoming recognized as an effective way of reducing pain. The American Pain Foundation acknowledges the use of meditation and offers many resources for meditation. By using meditation as part of a comprehensive treatment regimen for OA, patients have the potential to experience less pain and suffering. By addressing pain in a holistic sense, instead of just as a physical problem, meditation offers the opportunity to use the mind to influence the experience of pain.
Releasing the Stress of Chronic Pain
In addition to the emotional regulation of pain, meditation can help deal with the stress associated with living with a chronic pain condition. Since the 1960s, numerous studies have been done on the physiologic effects of meditation. These studies show that meditation results in the opposite of the physiological changes that occur during the stress response. When we’re faced with stress, whether physical or emotional, our body reacts with the fight-or-flight response: our heart beats faster, our blood pressure rises, our breath becomes shallow, our adrenalin and cortisol production surge, our blood sugar rises, we produce lower levels of sex hormones, and our immune system weakens.
In contrast, during meditation, our body enters a state of restful awareness. When we have a regular meditation practice, the physical and emotional healing benefits include:
- Decreased blood pressure and hypertension
- Slower heart rate
- Lower cholesterol levels
- Reduced production of “stress hormones,” including cortisol and adrenaline
- More efficient oxygen use by the body
- Increased production of the anti-aging hormone DHEA
- Improved immune function and more restful sleep
Getting Started with Meditation
There is an enormous variety of meditation techniques available, and it’s important to find one that resonates with you. The Chopra Center offers instruction in an easy-to-learn practice called Primordial Sound Meditation. It is based on the ancient Vedic and yoga traditions and uses a mantra to help the mind experience deep levels of stillness and silence. Learn more about Primordial Sound Meditation here.
Many people have also benefited from using guided meditations and visualizations. The Chopra Center’s 21-Day Meditation Experience is a great way to add meditation into your daily life.
Expanding into Greater Wellbeing
Ayurveda has many beneficial therapies to offer in the treatment of OA. These include, but are not limited to, herbal therapies, yoga, and meditation. These therapies offer their benefits without the significant risks associated with standard treatments. By treating the underlying imbalance, or root cause of the disease, it is possible that the natural cause of the disorder can be altered. Perhaps most significantly, by addressing the integration of body, mind and spirit, these therapies can lead to a better connection to self, and a greater sense of health and happiness. Read Part II in the series on how yoga can help treat OA here.
Listen to Dr. Patel on Chopra Center Radio. On the most recent episode, she discusses the foundations of Ayurvedic medicine, including your mind-body constitution, known as your dosha, and how bringing it into balance is a vital key to health and wellbeing.
*The information in this article is intended for your educational use only and is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition and before undertaking any diet, fitness, or other health program.
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