Natural Arthritis remedies: Boswellia

Boswellia, also known as Indian Frankincense, is a traditional ayurvedic medicine that has been used for all sorts of conditions from coughs and sores to snakebites and colic, and of course, it has also been used as treatment for arthritis pain, as well. But does it really work? And is there any basis for it working at all?

Generally speaking, these are the critical questions that you must always ask when you are considering taking supplements, like Boswellia, along with added questions of safety and interactions with any current medications/medical conditions that you may be taking, so it's important to always consult with your physician.

It appears that in the case of Boswellia, the answer seems to be that it may in fact, be helpful to some degree with alleviation arthritis pain, even though unlike most arthritis treatments (like NSAIDS for instance, Boswella is neither an anti-pyretic (helps reduce fever) or an analgesic (helps reduce pain topically like a mentholated cream).

Boswellic acid, which is the major constituent, seems to have an anti-inflammatory effect, inhibiting the production of several inflammatory cytokines such as NF-KB and TNF-alpha, which are powerful cytokines that can produce fever, cell death, and sepsis. Likewise, Boswella may help reduce the production of inflammatory molecules called eicosinoids by inhibiting enzyme called 5-lipoxygenase. This may help relieve the pain of osteoarthritis, (1) as eiconosoids modification can be helpful in lessening the pain from arthritis. This is what Omega-3 fatty acids are thought to do, that is they help modify the eiconsoids metabolism/milieu so it is more generally anti-inflammatory.

Still, some skepticism should be applied, if not liberally, as other studies have been less enthusiastic in proclaiming a pain relieving effect. (2) In this study, ASU's (which are derived from soybean and avocado oil) have been shown to be much more effective in the treatment of arthritis pain, which is what I typically recommend for most patients, along with several other supplements and dietary strategies, to help attempt to naturally relieve some of the symptoms of arthritis.

Is Boswella then right for you? Hard to say, really. Although it does not appear to be harmful, it may not be all that helpful compared to some of the other more well known and well-studied supplements available, such as chondroitin, MSM, and glucosamine.  That being said, it may be worthwhile to consider this supplement (under your doctor's supervision is always preferable) if these other more well known supplements fail to help relieve the pain you have.

References: 

Sengupta K, Alluri KV, Satish AR, et al. A double blind, randomized, placebo controlled study of the efficacy and safety of 5-Loxin(R) for treatment of osteoarthritis of the knee. Arthritis Res Ther. Jul 30 2008;10(4):R85.

Chrubasik JE, Roufogalis BD, Chrubasik S. Evidence of effectiveness of herbal antiinflammatory drugs in the treatment of painful osteoarthritis and chronic low back pain. Phytother Res. Jul 2007;21(7):675-683.

Django Reinhardt: A Gypsy Guitar Magician

When people think of great guitarists of the 20th century, often names like Les Paul, Jimi Hendrix, Jeff Beck, and Jimmy Page come to mind. Indeed, all of these men were are  great guitarists, but they were  also all masters of the modern electric guitar, which, in many ways,  is a completely different animal than an acoustic guitar. 

Having played the guitar on and off through my youth and adult life, I have learned that although both electric and acoustic guitars are difficult to play well, but in terms of the physical hand and finger strength necessary, I really believe that the acoustic guitar is, on the whole, much harder to play.

And this is just one of the things that makes a man like Django Reinhardt such an unusual on so many levels. Reinhardt is generally regarded as one of the greatest, if not the greatest guitar player of the 20th century, and he gained this fame by playing the acoustic guitar and not the electric guitar.

The acoustic guitar was not even the dominant instrument during the time he played (in the early 20s and 30s).  Much of reason of the acoustic guitar's lack of popularity had to do with the simple fact that an acoustic guitar was simply not very loud, certainly when compared to horns and drums. 

Once electric amplification came along, the guitar soon became the dominant instrument not only in jazz but in popular music as well.  In fact, the electric guitar became a cultural icon representing strength, power, glory and an almost transcendent element, heralding the age of the so-called 'Guitar God'. And certainly, when the future looks back to discuss 20th century music,  it seems undeniable that the electric guitar, in all of its various roles, will be a big part of that discussion. 

Furthermore, as you can see by the photograph above, Django playing hand was severely crippled as a result of  a burn sustained in a house fire. This makes everything that Django Reinhardt accomplished all the more amazing, especially from a hand surgeon's perspective, because I still can't figure out how on earth he created some of the sounds he did with such a severe contracture of his ring and small finger.

 Jazz in particular, relies on a much more complex chords and chord arrangements which usually require the ring and the small finger to produce. But Danjos ring and small finger were not only crooked, they didn't even move! It really defines logic and explanation on many levels, as does Reinhardt as a person himself.

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Born in 1910 in Brussels, Django was a gypsy from the Manouche tribe of gypsies known for their musical ability. In his native language, Roma, Django means hope, which I think is an appropriate name for this singularly talented virtuoso.

In his early twenties, as I've mentioned, Django was badly burned in a house fire, which resulted in the loss of his left ring and small fingers. Teaming up with violinist Stephane Grappelli to form the Hot Club Quintet of France, Danjo  made numerous memorable albums with Django that are now considered classic of Jazz.

Django Reinhardt was both a complicated and colorful man, outside his musical talent and gifts. For instance, He never learned to read or write, and loved to gamble, carrying a roll of cash with him wherever his went that was usually much fatter the night before! But money was never all that important to Django Reinhardt as he loved to paint, and like to play his music on his terms, sleeping in, and missing gigs frequently when it was his will.

And Danjo was a very fine painter indeed, and probably, a good lover too if you study his paintings as most of them are nude portraits of women!

But above all, it was the guitar which ruled his passions and desires. Django would play incessantly, until his fingers bled, at all hours day or night. And even though he appears, by all accounts to be somewhat unruly and difficult to deal with, as artists of Django's caliber are wont to act, we are all blessed ultimately by the wonderful legacy of music he left behind for us to enjoy.

Sadly, Django died of a cerbral hemorrhage when in 1953 when he was just 43. His legacy, though, lives on through his music.

As a hand surgeon, I see devastating injuries of the hand frequently, and the emotional shock of the loss is often overwhelming, and can cause depression. However, if there is anything beyond music that Django Reinhardt's music and life can teach us is the resilience of the human spirit--how it is not easily quashed, and how music comes, not from the actual physical creation of notes, but from the soul itself, and it will inevitably find a way to express itself in spite of enormous obstacles.

3 keys to Addressing Carpal Tunnel syndrome before you ever see a Hand Surgeon

If you have (or think you have) carpal tunnel syndrome, before you actually make the commitment to visit a hand specialist for medical or surgical intervention, you might want to consider these three important points.

If you address these, it may not mean that you will cure yourself of your carpal tunnel syndrome, but it may mean that whatever treatments that are undertaken will work better because you have addressed some of the real underlying causes behind your hand pain.

1. Nutrition (Diet & Lifestyle): Above all, if you have carpal tunnel syndrome make sure that you are taking care of yourself in terms of nutritional and fitness perspective. This can mean that if you are overweight and suffering from pre-diabetes or metabolic syndrome, you should address these conditions before undergoing treatment for carpal tunnel syndrome. Carpal tunnel surgery has a much greater chance of not working for patient who has underlying health issues such as obesity related illnesses like diabetes than a person who is otherwise healthy and not suffering from these conditions. As many know, I write a lot about health and nutrition, as I think it is in many cases the best way to address obesity, diabetes, and other related diseases. In the case of carpal tunnel syndrome, your symptoms can lessen or even go away in some cases if you can lose weight and treat you diabetes. Likewise, you don't need to be 'sick' by any stretch of the imagination. If you are overworked, stressed, and not exercising, you may be 'healthy' but the reality is your healthy is declining and not improving. Take the steps necessary to improve your health, and in many cases you will find that all of the strange aches and pains, including the ones in your hands, will many times simply go away.

2. Specific Nutritional Deficiencies: Other nutritional deficiencies are equally important to consider. For instance, it is well known that B vitamin deficiency is associated with nerve dysfunction also known as neuropathy. This type of vitamin deficiency is not widespread in our society because many cereals and breads are fortified with B vitamins. That being said, there are certain conditions which can cause an otherwise healthy person not to absorb the vitamins correctly. And symptoms mimicking carpal tunnel syndrome may be also present. In this particular case, carpal tunnel surgery would provide little or no benefit compared to proper nutritional supplementation. Vitamin B12 deficiency is also becoming more and more common in our society, so it might be important to get your levels checked and perhaps even get an injection. I am one of the few hand surgeons that actually checks Vitamin B12 levels for patients I suspect have the deficiency, and give injections to help treat this condition.  Other nutritional deficiencies are equally important to consider. May people often benefit from added Coenzyme Q10 in their diet, either through supplementation or the intake of organ meats, as well as sulfur in the form of supplements like MSM, or sulfur rich foods like eggs. 

• Are there natural remedies for Carpal Tunnel syndrome? This a tricky question because it is important to note that I am suggesting that it is important to always be nutritionally optimized above all else, which is probably the most natural cure available, ie keep yourself healthy. You can not expect to take chondroitin, glucosamine, or anything else you can buy over the counter if you are not eating right, sleeping right, exercising,  sitting correctly at your workstation, wearing gloves, taking breaks, etc. Like I have said, if you have diabetes and you don’t take care of it, the best surgery will not provide the results you want or need.  Likewise, if you want the best result you can, and maybe even avoid surgery, then it is important to focus on your health and nutrition as the first, best, and only ‘natural’ remedy.

3. Treat your Diabetes!: If you are diabetic, specifically if you are suffering from type II diabetes or metabolic syndrome, it is important to discuss with your doctor how to treat these conditions first before surgical treatment of carpal tunnel syndrome is considered. High blood sugar levels affect the nerves by causing them to swell under the influence of high glucose levels in the blood. The nerves can either become damaged or pinched in places like the carpal tunnels because they are swollen, or what we call edematous.

The rates of Type II diabetes is skyrocketing in the US and around the world, and most of the type II diabetics in our society are both overweight and sedentary. In many cases, exercise along with dietary modification (which results in not only weight loss but the gaining of lean muscle mass) can go a long way in mitigating or even curing type II diabetes. This can also result in the lessening of carpal tunnel pain, and in some cases, carpal tunnel syndrome may even be cured.

Likewise, metabolic syndrome is a very similar condition which is characterized by such things as hypertension, hypercholesterolemia, poor lipid profile, obesity, and insulin resistance. I consider pre-diabetes, and so do many other doctors who treat the condition frequently. 

It can be treated effectively with an exercise regimen and dietary modification under the guidance of a skilled professional, especially one who is comfortable with the application of diets that are low in carbohydrates. 

I cannot stress enough the importance of proper nutrition and exercise in the treatment of carpal tunnel syndrome. In my view, it is an essential step which is often overlooked. Otherwise, the most fancy and expensive treatment, and the highest quality care is simply a very pretty (and expensive) band aid that does not address the critical physiology and anatomy that results in the disease process. 
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Dr. Ostric is a board certified plastic surgeon and hand specialist who practices in Chicago, IL. He has treated thousands of patients with carpal tunnel with excellent results. Call today for your evaluation. Many insurances are accepted, and Dr. Ostric offers competitive financing plans as well.