Offbeat Treatment for Arthritis

USELESS, WASTEFUL & HARMFUL

by Irwin M. Siegel, M.D.

Henry VII’s physician applied baked ox dung wrapped in cabbage leaves to his swollen joints, and even today many Americans suffering from arthritis are prime targets for questionable treatments and so-called arthritis cures. The Arthritis Foundation estimates that $950 million is wasted each year on worthless crack remedies. This amounts to $25 spent on unproved treatments for each $1 going toward bona fide research on rheumatic diseases. Such bogus cures take many forms, from copper bracelets to pyramid and aromatherapy. Not only are these treatments useless, but in addition to wasting your money some of them can be downright harmful. All of them delay effective therapy. If in doubt, contact your local Arthritis Foundation office and save yourself a lot of grief. You can reach the National Arthritis Foundation at 1-800-283-7800, or you can visit its World Wide Web site at http://www.arthritis.org, which provides a listing of local chapters as well as general information about arthritis.

Q: What are some of the unusual arthritic syndromes?

A: There are many. One is Reiter’s syndrome, which is arthritis associated with urethritis (inflammation of the urethra), cervicitis (inflammation of the cervix), conjunctivitis (inflammation of the eyes), and mucocutaneous lesions (small, painless, superficial ulcers commonly seen in the mouth).

A German doctor, Hans Conrad Reiter, first described the syndrome in 1916. Because of his involvement in Nazi medical atrocities, the Spondylitis Association of America, a patient advocacy group representing patients with Reiter’s syndrome, recently voted to rename this syndrome “reactive arthritis.” Christopher Columbus may have suffered from a form of arthritis accompanied by a low fever and painful eye inflammation during his third crossing (1498–1500) of the Atlantic. It was reported that in 1500, after a period of severe anxiety, all of his joints became swollen, and he had to be tied to the mast in bad weather to prevent his falling overboard. He died in 1506. The diagnosis of reactive arthritis has been suggested.

Another unusual type of arthritis is psoriatic arthritis, a rheumatoid-like arthritis associated with psoriasis of the skin or nails and a negative test for rheumatoid factor.

Yet another rare arthritic condition is Sjögren’s syndrome.  This is a chronic systemic inflammatory disorder of unknown etiology. It is characterized by dryness of the eyes, mouth, and other mucous membranes, and often is associated with rheumatic disorders showing certain autoimmune features.

Q: Is rheumatic fever a form of arthritis?

A: No. Rheumatic fever is an acute inflammatory complication of group A streptococcal infections. It is characterized mainly by arthritis, chorea (involuntary rapid, highly complex, jerky movements), or carditis (inflammation of the heart), appearing alone or in combination.  Residual heart disease is a possible sequela of the carditis. Skin lesions may be found.

Q: What is hemorrhagic joint disease?

A: Hemorrhagic joint disease is found in hemophiliacs.  Minor trauma can cause bleeding into a joint with subsequent damage because the blood does not clot.  Arthritic changes can occur with repeated episodes.

Q: Can infections cause arthritis?

A: By all means. Both bacterial joint infections and tuberculosis can lead to joint damage and subsequent arthritis.  This is also true of fungus infections, gonorrhea, and even syphilis.

Q: What is pseudogout?

A: Pseudogout is a joint disease with protean (many) manifestations. These may include intermittent episodes of acute arthritis as well as a degenerative arthropathy (joint pathology) that is often severe but can be asymptomatic (without symptoms). There is X-ray evidence of calcification of the articular cartilage (chondrocalcinosis) in characteristic sites. This is due to the deposition of a mineral crystal called calcium pyrophosphate dihydrate.  The cause is not known.

Q: Are there distinctive diseases that include arthritis as a finding?

A: Lyme disease (tick-borne), Salmonella food poisoning, scleroderma, and lupus are a few of the many diseases that can involve the joints and include arthritis as a symptom or finding. In the case of Salmonella food poisoning, the immune system, whose job is to destroy infectious agents, does this by attacking a protein in the Salmonella organism., But that protein resembles one found in normal cells, so a confused immune system attacks that too, causing the painful joint inflammation of arthritis.

Q: Can the temporomandibular (jaw) joint be involved with arthritis?

A: Most forms of arthritis can involve the temporomandibular joint, including osteo-, infectious, traumatic, and rheumatoid arthritis. Any of these conditions can cause ankylosis (fusion) of this joint. The temporomandibular joint also can suffer congenital and developmental anomalies.  More common is a myofascial pain and/or dysfunction syndrome of the joint. This condition is psychophysiologic, usually resulting from tension-relieving, jawclenching, or tooth-grinding habits.

Q: What is pigmented villonodular synovitis?

A: Pigmented villonodular synovitis is a condition in which the synovial tissue of joints, bursae, and tendon sheaths becomes thickened and covered with long, tangled, rubbery nodules. It typically is a disease of adults, and although its etiology is unclear, an inflammation of unknown origin is the most commonly accepted cause.

The knee is the customary site of involvement. Pressure indentation and sometimes actual destruction of bone can occur late in the disease. The predominant symptom

is a chronic swelling of the joint associated with mild aching. Bleeding into the joint may occur. The condition is benign, and the treatment is complete synovectomy (removal of the synovia). If all involved synovia has been removed, the joint is cured and a new, healthy synovia will grow back in short order.

From All About Joints by Irwun M. Siegel, M.D. Copyright © 2002 by Demos Medical Publishing, Inc. Excerpted by arrangement by Demos Medical Publishing, Inc. $19.95. Available in local bookstores or call 800-532-8663 or click here.