NOTE: www.drdavidwilliams.com makes a good case Glucosamine & Chondroitin are already obsolete with his "Joint Advantage." Williams is one of those people who has ransacked the world looking for "natural" cures. Anyone suffering from arthritic pain ought consider giving it a look. It is based primarily on herbs used by Australian Aborigines. When was the last time you saw an ancient Abo on TV bouncing around like a teeny-bopper? They all do, it seems to me.

SAM-e, mentiomed below, in my considered opinion has been superceeded by MSM. The only liquid form of MSM is available via www.jacoblab.com. My default alternate is www.kalahealth.com. Both use the purest raw stock available in the world.


I received the following info via e-mail recently in response to the Vioxx ruckus.

Consumer’s Guide To Pain Reduction, by Dr. Steven T. Sinatra (www.drsinatra.com)

Almost every day at least one patient comes in to see me and says, “Oh boy, am I stiff. I just dread getting out of bed in the morning.” Waking up with aching joints is one of the many signs of aging. At least 80 percent of people over age 50 experience some joint pain. That’s about 12 percent of the U.S. population.

I could be counted in that group since I have osteoarthritis from participating in high school and college sports. The difference is that I don’t suffer because I know what to take for maximum joint mobility and pain relief and when to take it.

Whether pain is short-term from a headache or long-term from chronic arthritis, it can make your life miserable. Many of my patients try acetaminophen (Tylenol) or one of the nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Advil), naproxen sodium (Aleve), or aspirin for relief. These drugs usually work for the short term, but they should never be relied on long-term and may cause intestinal bleeding and damage. These side effects may be increased if you do not use these products in accordance with label directions. On top of that, they don't get at the cause of pain, they only block pain signals.

As far as the selective cyclooxygenase-2 (COX-2) inhibitors are concerned, although they claim to manage pain and reduce inflammation without the side effects of NSAIDS, with the recent recall of Vioxx, I need to see more research on the others before I recommend them to my patients-or use them myself.


Natural Solutions

Many natural supplements can be as effective as NSAIDs at relieving pain—without the dangerous side effects. The best ones for you depend on the source of your pain.

SAM-e, short for S-adenosylmethionine and pronounced “sammy,” is my favorite pain reliever. SAM-e is a natural substance found in every living cell; but like many beneficial substances in our bodies, it becomes less abundant as we age. I like SAM-e because it delivers several benefits at once: pain reduction, cartilage support, homocysteine lowering, mood elevation, and liver protection. Supplemental SAM-e  has been used in Europe for more than 20 years. It is considered non-toxic at normal doses. Its biggest downside is its cost—it can run as much as $50 a week. Nature Made manufactures a good SAM-e.
Take SAM-e in the morning because if it’s taken too close to bedtime, it could keep you awake. Start with 400 mg daily and work up to a dose that works for you, to a maximum of 1,600 mg a day. Give SAM-e at least a month to provide relief, though you’ll probably notice mood changes sooner.

MSM (methylsulfonylmethane) is another good pain reliever. It packs a load of sulfur into your body. Scientists aren’t really sure how sulfur relieves pain, but we know that it’s an essential element for the growth of new cells, including cartilage in damaged joints. MSM also makes cell walls more elastic and permeable so nutrients can get in and waste products can get out.

Note: It’s possible to take too much MSM: One of my patients who was taking 8 grams per day noticed an unpleasant odor coming from his skin. He reduced his dose of MSM a bit, and the odor went away. I recommend 2 grams (2,000 mg) a day to start, working up to a total of 3 grams. You know you’ve gone too far if, like my patient, you start stinking. I like MSM by Natrol, Enzymatic Therapy, and Great Earth.

Glucosamine sulfate is a natural glucose substance in joints that that helps build cartilage and maintain joint fluid thickness and elasticity. It has helped many people. I recommend 500 mg of glucosamine twice a day with meals; if you have symptoms already, boost your intake to 500 mg three times a day. It can take four to six weeks of regular dosing to restore comfortable function. Enzymatic Therapy makes a good glucosamine.

Essential fatty acids (EFAs). You can get a one-two punch by taking glucosamine with EFAs. This powerful combination reduces joint inflammation and builds cartilage. I’ve been using this combination with some patients, and the results have been astounding. While it may take a few weeks for glucosamine to work, the EFAs will provide comfort within one to two weeks because of their anti-inflammatory properties.

Essential fatty acids also improve circulation by speeding the removal of inflammatory byproducts and bringing nutrients to the site more readily. EFAs can be taken in supplement form or through diet (fish, nuts, seeds, flax oil), but it’s difficult to get adequate levels from diet alone. That’s why I recommend that everyone take EFA supplements. Look for a fish oil supplement that delivers at least 200 mg of DHA (docosahexaenoic acid) and 300 mg of EPA (eicosapentaenoic acid) daily. For a vegetarian source of DHA, try DHA by Neuromins, which is made from algae.

Chondroitin sulfate works with glucosamine to lubricate joints and make tendons and ligaments more elastic. A 1998 investigation of 42 people suffering from osteoarthritis of the knee reported reduced pain and increased mobility with 800 mg of this compound daily. The placebo group experienced no relief of symptoms.
Begin with 100 mg daily. You can increase that to half the amount of glucosamine. (For example, take up to 500 mg of chondroitin if you’re taking 1,000 mg of glucosamine daily.)

Shark cartilage (100 mg daily) is a good source of chondroitin, and sea cucumber extract (at least 75 mg per day) is another source of chondroitin. For brands of the extract combined with glucosamine and other nutrients, I recommend Joint GS from Solaray or CMG from Natrol.

Uña de gato, also known as cat’s claw, contains more than 40 compounds, several of which act to reduce inflammation. Start with about 200 mg; you can take up to 3 grams daily safely. Caution: Cat’s claw activates your immune system, so if you’ve had an organ or tissue transplant you should not use this herb. Great Earth makes a good  product.

White willow bark is a natural cousin to aspirin, but without the unpleasant gastrointestinal bleeding that can be a side effect. Take 60–120 mg daily. I like white willow bark by Great Earth and Nature’s Way.

Bromelain, an enzyme from pineapple, breaks down prostaglandins, hormones active in the pain cycle. Take 100–500 mg daily. Enzymatic Therapy and Source Naturals are reputable brands.

Boswellia is an extract from a tree that grows in the dry, hilly areas of India. Studies have shown that boswellic acids have anti-inflammatory action, much like NSAIDs, and I have seen improvement in my asthma after taking boswellia. Take 900 mg daily to reduce inflammation and swelling. I like Great Earth, Solgar, and Source Naturals.

Turmeric, the fragrant yellow spice found in curry, has many of the same effects as aspirin without its blood-thinning properties. It is terrific at squelching free radicals. This is important because any type of inflammation is a firestorm of free-radical activity. In fact, turmeric is eight times more powerful than vitamin E in this capacity. You could take a quarter teaspoon of this spice each day—if your taste buds can stand it. If not, Source Naturals makes a quality capsule supplement. Start with 250 mg per day.

Feverfew reduces the frequency and severity of migraine headaches, according to a double-blind study in the British Medical Journal. Take 50–100 mg per day for prevention. Great Earth, Solgar, and Source Naturals are good brands.

Yucca is an herb traditionally used by South­ western Indians. It contains saponins, compounds that interfere with prostaglandins. Begin with 100 mg per day. I like yucca from Great Earth and Nature’s Way.
Supplements Can’t Do It All

Avoiding pain in the first place is far better than treating it once you get it. Any health program should include:

A high-quality multivitamin/mineral supplement.
Gentle exercise to get blood flowing to arthritic joints. Yoga, T’ai Chi, Qigong, and swimming are all excellent, safe activities for people who want to relieve arthritis symptoms.

A diet full of healthy oils and antioxidants. Olive, flax, and walnut oils are some of the best bets.

Magnets are another therapy to consider. I wasn’t a big believer in them until a recent winter when I spent the day shoveling snow and then skiing. Like anyone who overdoes it, I hurt myself—in this case, my back. I tried taking just about everything I recommend in terms of supplements, but nothing helped. I went to a chiropractor, but the adjustments actually made my back worse. So, willing to try just about anything, I got some high-quality magnets and slept on them. After just one night, I was a new man! I couldn’t believe it. And while the magnets helped my situation, the moral of this story is not to ski and shovel snow in the same day!

Try a Nonchemical Tranquilizer

Therapeutic touch has been used for centuries to reduce tension and promote good health. Touch is crucial to growth, healing, and well-being. Research suggests that premature babies who are massaged daily gain more weight and have shorter hospital stays than infants who are not massaged.

Another study showed that massage therapy produced relaxation in 18 elderly people by lowering their blood pressure and heart rate while increasing their skin temperature. Animal studies also show interesting results. For example, baby rats deprived of tactile stimulation exhibit decreases in growth hormone, metabolic rate, and protein synthesis.

Massage can be compared to a nonchemical tranquilizer without side effects. Many studies have documented its benefits for treating acute and chronic pain, muscle spasms, anxiety, depression, and psycho-emotional stress. It improves circulation, and affects the immune system positively.

Basic Back Massage for Enhanced Lymph Flow. One pleasurable way to improve lymphatic flow is through a relatively simple massage technique known as Manual Lymphatic Drainage. Gentle stroking with light pressure is all that’s needed, but you must know how and where to apply your efforts—toward specific lymph nodes—if you want to promote drainage.

To be effective, Manual Lymphatic Drainage should be done at least three times a week. It’s best when done with a partner. (Any activity that enhances contact with a loved one provides “double bonus points” for your heart.) I’ll use the terms “giver” and “receiver/recipient” for those of you lucky enough to have a partner with whom you can swap roles.

Receiver: Just lie there (for some of you, this is the hardest part).
Giver: Place your hands just above the receiver’s waist, one hand on each side of his/her spine, with your fingers pointed toward his or her head. Your thumbs should be at right angles to the fingers.

Move recipient’s skin upward, then out, toward the sides. Maintain contact long enough to allow the receiver’s skin to pull your hands back to position. Work your way up the recipient’s back in this manner, toward the heart. This is very healing.
     
Work the top of the shoulders by moving the skin forward and then releasing it in a circular motion.

Receiver: Say “Ahhh, feels good to me.” Repeat several times.
Giver: Gentle strokes may also be extended to the back of the neck, scalp, and face, as well as to the limbs. The same technique may be used for the chest and abdomen.
 
Massage Has Other Benefits

In your immune system, the lymphatic system is responsible for moving the traffic flow along. Instead of 4- or 18-wheelers, the traffic consists of lymphatic fluid that flows throughout the  body, bathing  internal tissues. This fluid sifts out toxic waste products and chemicals, sending them back to the liver, where they’re detoxified and excreted through the kidneys.

Many people get preoccupied with their circulatory system but don’t think about what’s happening on the lymph’s massive interstate. After all, when we’re cut, we don’t “bleed” lymph, and it’s easy to ignore body components that we can’t see. Not Dr. Gerald M. Lemole, a cardiothoracic surgeon who has operated on thousands of patients.

He has studied the lymph nodes, which are located in various parts of the body, most notably the neck, armpits, and groin. These are lymphatic highway stops where impurities are filtered out. If you’ve ever experienced “swollen glands,” you know what these nodes feel like when impurities back up—pretty painful.

Not only does massage make lymph flow easily, it’s also an excellent stress reliever. Massage deepens your breathing, puts you in touch with your body and soul and increases your feelings of well-being. Massage may even improve relations with your partner, especially if you take turns. Not a bad return for a small investment of time!

I hope you’ll start incorporating deep breathing and massage into your weekly regimen. Promoting drainage from your lymphatic system will not only help stabilize your HDL and increase clearance of oxidized LDL, it will also clear toxins and other metabolic byproducts from your body. As your lymph flows more freely, you can feel good knowing that you’re helping to cleanse your body and shutting down specific processes that enhance inflammation.

Use Your Mind to Reduce Pain

From PMS and pregnancy to menopause and arthritis, many women come to my New England Heart and Longevity Center suffering terribly from pain. My pain reduction program has proved a godsend to these women in several ways. First they focus on the brain’s destructive “loops” of anxiety, stress, and worry, and learn how to rewire themselves so that the stress stops. This in itself is a huge step forward from pain medications that often cause terrible side effects and which, more fundamentally, can rob a person of any participation in their recovery.

Try This Next Time You’re Stressed!

Put your hand on your belly, take a deep breath through your nose, and feel your hand rise on your abdomen. Exhale through your mouth. Do this 15 to 20 times, lying down or sitting.

Note: If trying to relax in a lying or sitting position doesn’t work, try doing it while walking.
 
Most physicians are skeptical of women in pain and dismissive of their symptoms. Women who come to me have been shunted from doctor to doctor and arrive at the clinic doubting their own sanity. But I know that the pain is not just in the head. It is everywhere; it is real and ceaseless; and it must be taken seriously by a doctor or it will never be cured.

Today, physical diseases travel first class. Mental diseases travel coach. And any disease that is both travels steerage. Finally, this is beginning to change. Today we can say, “I’m under a lot of stress and my lower back is killing me,” but even a decade ago that would have sounded absurd! Today we have compelling evidence that belief and prayer heal, that science and spirituality overlap, that body and mind are a single information system of awesome complexity, and that touch and play, forgiveness and silence are all powerful healers.  

Discover the Healing Power of Play

Pets Are Good for You. Pets can be a source of tremendous richness in our lives. They remind us of the simple pleasures of walking, attending to nature, and just being still at times. And because of these benefits, pets can be an important aid to your health—whether you’re trying to maintain or regain it.

My wife and I live with three dogs: two Chows and a Norwegian Elkhound. I often bring them to my office. They help keep me calm, focused, and attentive, and most of my patients find that having a pet in the room makes them feel more at home, and more communicative as well.

In fact, I have watched my elderly patients smile broadly, and even cry with joy, as their hearts are touched by the opportunity to pet an animal again. We’ll have a short conversation about their most cherished experiences with their pets. In this interaction, I learn more about them as individuals, and often pick up a clue that helps me plan my recommendations to them. I believe that the contact we make during these moments helps both of us promote their healing. If your situation allows you to bring your dog to work from time to time, I would encourage you to do so, and see how it changes your day.

Medical research has shown, for example, that survivors of heart attacks who come home to loving pets have a 400 percent increase in survival rate over those who come home to a judgmental spouse. Imagine a drug that could do that!
 
That’s why play is an important part of my pain reduction program. It is one of the most healing things you can do for your physical and emotional well-being. Yet one of the most dismaying things I’ve learned in my years of medical practice is that adults no longer know how to play. In fact, when I ask my patients how they play, they often look at me with blank expressions on their faces.

Many of them answer that they “play” golf or tennis. But these sports are not really play. There is a difference between sports and true play. Very seldom have I heard of anyone dying while playing with their children, their dog, or their grandchildren. But many of my patients have had heart attacks while “playing” golf, tennis, and the most feared sport for sudden death, racquetball.

Sports are enjoyable, but they involve performance, usually with competition and the need to win. Play is different. True play is spontaneous, with no set agenda, no rules or regulations, and no desired outcome. When we play, we are totally free. That is, we do things solely for joy and pleasure and can become totally absorbed in what we are doing. When this happens we are taken out of our heads and into our bodies. Time stops for us.

True Play Takes You Away

Think of how absorbed five- or six-year-olds become when they are painting a picture. Within minutes, nothing else matters to them but the colors, the feel of the brush on the paper, the way the paint drips and blobs and runs, the way the colors mix, and how closely they can match the picture with the image in their minds. Being carried away by their imagination and getting their inspirations down on paper is, for a short time, the single most important thing in the world to them. Everything else falls away—worries, fears, pains, wants, needs, hunger—and is replaced by a sense of total satisfaction and gratification.

Playing this way can cut you free from stress and worry, and help heal your mind and body. Because of the nearly miraculous benefit of play, I try to teach my patients to play like children. If, like most adults, they’ve forgotten how, I ask them to observe children at play.

When you play like a child, you can experience a new sense of freedom. Have you ever seen a child just laugh and giggle, seemingly for no reason or over something silly? Sometimes this is contagious, and you find yourself laughing at something silly. Honest, uninhibited laughter is powerful medicine. When you laugh fully, your breathing increases and it frees up the rigidity in your chest. Remember, laughing is one way to experience strong feelings, just as crying is.

You Can Learn How to Play Again

Since most of us have spent all our adult lives stifling the impulse to play freely, the hard question is how can we learn to be childlike and play?

Playing with children is one way. If you do play with a child, remember to play on his terms, not yours. Let him take over and set the tone, because if you take over and become the adult, you’ll lose all the spontaneity that goes with playing with a child. Try swinging on a swing or playing catch, if you can. If not, blow bubbles, fingerpaint, or make up stories together. Children love these things; and if you let yourself become absorbed, you’ll find that you’ll love them too.

You can also play with your pet. One excellent way to play and be childish is to get on the floor and roll around with your dog. If you have a cat, try rolling a ball, stalking the cat, or tantalizing him with a piece of string. If you allow yourself to get carried away with such play, you will make contact with your pet and also with the joy inside you. This joy is your inner, healing force.

Remember, play has no outcome, no goal. You need to play for play’s sake alone, and when you play, try to bring out the little child inside you. Once you connect with your inner child (we all have one), it will bring you to another level of healing.

In Conclusion

I know I’ve just given you a lot of `option`s. And while I wholeheartedly endorse all of the supplements I’ve told you about, you must decide which work best for you. As I said earlier, supplements can’t do it all. You also need to exercise regularly, eat a healthy diet with lots of fresh fish to get those omega-3 fatty acids, and try to maintain a positive attitude.

If you’ve exhausted these `option`s or if constant pain makes your quality of life completely unsatisfactory, then and only then would I consider conventional medical treatments. Talk to your doctor—you may need to draw from the best of both worlds to ease your suffering and enhance your quality of life.