-IBIS-1.7.6-
tx
musculoskeletal system
osteoarthritis
Botanicals

primary herbs

Arctium lappa: nutritive, alterative
Boswellia serrata: anti-inflammatory action (Safayhi H, et al. Mol Pharmacol. 1995 Jun;47(6):1212-1216; Ammon HP, et al. J Ethnopharmacol. 1993 Mar;38(2-3):113-119; Safayhi H, et al. J Pharmacol Exp Ther. 1992 Jun;261(3):1143-6.)
Bryonia alba (toxic): muscular pains, pain on movement (Ellingwood, p. 91)
Capsicum frutescens: tired painful muscles, stiff joints; capsaicin as a topical application
(Felter and Lloyd, p. 436; McCarthy GM, McCarty DJ. J Rheumatol 1992 Apr;19(4):604-607.)
Chimaphila umbellata: anti-rheumatic via improved kidney function (Mitchell, p. 13)
Cimicifuga racemosa: muscular soreness, ache (Ellingwood, p. 145)
Gaultheria procumbens: locally use oil; internally use tincture; rheumatic conditions
Glycyrrhiza glabra: anti-inflammatory
Harpagophytum procumbens: (Mitchell, p. 13)
Juniperus communis: chronic arthritis (Weiss, p. 235)
Medicago sativa: nutritive
Populus tremuloides: (NCNM Botanicals)
Smilax sarsaparilla: chronic rheumatism (British Herbal Pharmacopoeia, p. 198)
Symphytum officinale (toxic) (leaf): rheumatic pain, arthritis (British Herbal Pharmacopoeia, p. 202)
Xanthoxylum americanum: stimulates circulation (McQuade, Hoffman, p. 11)
Zingiber officinale: warming


complementary herbs

Arctium lappa + Rhamnus purshiana + Zingiber officinale. instructions: 15-30 drops twice daily. (NCNM Botanicals)
Larrea mexicana (leaf) + Harpagophytum procumbens + Yucca spp. + Cimicifuga racemosa + Medicago sativa.


footnotes

Ammon HP, Safayhi H, Mack T, Sabieraj J. Mechanism of antiinflammatory actions of curcumine and boswellic acids. J Ethnopharmacol. 1993 Mar;38(2-3):113-119.
Abstract: Curcumine from Curcuma longa and the gum resin of Boswellia serrata, which were demonstrated to act as anti-inflammatories in in vivo animal models, were studied in a set of in vitro experiments in order to elucidate the mechanism of their beneficial effects. Curcumine inhibited the 5-lipoxygenase activity in rat peritoneal neutrophils as well as the 12-lipoxygenase and the cyclooxygenase activities in human platelets. In a cell free peroxidation system curcumine exerted strong antioxidative activity. Thus, its effects on the dioxygenases are probably due to its reducing capacity. Boswellic acids were isolated from the gum resin of Boswellia serrata and identified as the active principles. Boswellic acids inhibited the leukotriene synthesis via 5-lipoxygenase, but did not affect the 12-lipoxygenase and the cyclooxygenase activities. Additionally, boswellic acids did not impair the peroxidation of arachidonic acid by iron and ascorbate. The data suggest that boswellic acids are specific, non-redox inhibitors of leukotriene synthesis either interacting directly with 5-lipoxygenase or blocking its translocation.

British Herbal Medicine Association. British Herbal Pharmacopeia. West Yorks, England: BHMA, 1983.

Ellingwood F. American Materia Medica, Therapeutics and Pharmacognosy, 11th ed. Sandy, OR: Eclectic Medical Publications, 1919, 1998.

Felter HW, Lloyd JU. King’s American Dispensatory, 18th ed. Sandy, OR: Eclectic Medical Publications, 1898, 1983.

McCarthy GM, McCarty DJ. Effect of topical capsaicin in the therapy of painful osteoarthritis of the hands. J Rheumatol 1992 Apr;19(4):604-607.
Abstract: Topical capsaicin 0.075% was evaluated for the treatment of the painful joints of rheumatoid arthritis (RA) and osteoarthritis (OA) in a 4 week double blind, placebo controlled randomized trial. Twenty-one patients were selected, all of whom had either RA (n = 7) or OA (n = 14) with painful involvement of the hands. Assessments of pain (visual analog scale), functional capacity, morning stiffness, grip strength, joint swelling and tenderness (dolorimeter) were performed before randomization. Treatment was applied to each painful hand joint 4 times daily with reassessment at 1, 2 and 4 weeks after entry. One subject did not complete the study. Capsaicin reduced tenderness (p less than 0.02) and pain (p less than 0.02) associated with OA, but not RA as compared with placebo. A local burning sensation was the only adverse effect noted. These findings suggest that topical capsaicin is a safe and potentially useful drug for the treatment of painful OA of the hands.

Mills SY, Jacoby RK, Chacksfield M, Willoughby M. Effect of a proprietary herbal medicine on the relief of chronic arthritic pain: A double-blind study. Br J Rheum 1996 Sep;35(9):874-888.
Abstract: Eighty-two subjects with chronic arthritic pain were randomly assigned for 2 months without cross-over to either Reumalex, a licenced over-the-counter (OTC) herbal medicine, or a placebo. Entry characteristics were determined by a previous survey of arthritic customers at pharmacy and healthfood shop outlets. The AIMS2 questionnaire was completed at monthly intervals throughout and for 2 months prior to the trial, and a modified Ritchie Index provided clinical scores. Subjects also completed diary recordings of their use of self-prescribed analgesics and events they considered significant. There was a small but statistically significant improvement in pain symptoms, less so in sufferers from osteoarthritis. There were no other significant changes in any other measures nor in the use of other self-prescribed analgesics. There were few side-effects noted. It is concluded that Reumalex has a mild analgesic effect in chronic arthritis at a level appropriate to self-medication.

Safayhi H, Mack T, Sabieraj J, Anazodo MI, Subramanian LR, Ammon HP. Boswellic acids: novel, specific, nonredox inhibitors of 5-lipoxygenase. J Pharmacol Exp Ther. 1992 Jun;261(3):1143-1146.
Abstract: Isomers (alpha- and beta-) of boswellic acids (BAs), 11-keto-beta-BA and their acetyl derivatives were isolated from the gum resin of Boswellia serrata. BA and derivatives concentration dependently decreased the formation of leukotriene B4 from endogenous arachidonic acid in rat peritoneal neutrophils. Among the BAs, acetyl-11-keto-beta-BA induced the most pronounced inhibition of 5-lipoxygenase (5-LO) product formation with an IC50 of 1.5 microM. In contrast to the redox type 5-LO inhibitor nordihydroguaiaretic acid, BA in concentrations up to 400 microM did not impair the cyclooxygenase and 12-lipoxygenase in isolated human platelets and the peroxidation of arachidonic acid by Fe-ascorbate. The data strongly suggest that BAs are specific, nonreducing-type inhibitors of the 5-LO product formation either interacting directly with the 5-LO or blocking its translocation.

Safayhi H, Sailer ER, Ammon HP. Mechanism of 5-lipoxygenase inhibition by acetyl-11-keto-beta-boswellic acid. Mol Pharmacol. 1995 Jun;47(6):1212-1216.
Abstract: The formation of 5-lipoxygenase (EC 1.13.11.34) products from endogenous substrate by intact rat neutrophilic granulocytes and from exogenous arachidonic acid by rat granulocyte 105,000 x g supernatants and affinity chromatography-purified human leukocyte 5-lipoxygenase was inhibited by acetyl-11-keto-beta-boswellic acid (IC50 values of 1.5 microM, 8 microM, and 16 microM, respectively). With other pentacyclic triterpenes lacking the 11-keto function and/or the carboxyl function on ring A (e.g., amyrin and ursolic acid), no 5-lipoxygenase inhibition was observed. The presence of the noninhibitory pentacyclic triterpenes both in intact cells and in the cell-free system caused a concentration-dependent reversal of the 5-lipoxygenase inhibition by acetyl-11-keto-beta-boswellic acid, whereas the inhibitory actions of 5-lipoxygenase inhibitors from different chemical classes (MK-886, L-739,010, ZM-230,487, and nordihydroguaiaretic acid) were not modified. The inhibition by acetyl-11-keto-beta-boswellic acid and the antagonism by noninhibitory pentacyclic triterpenes were not due to nonspecific lipophilic interactions, because lipophilic four-ring compounds (cholesterol, cortisone, and testosterone) neither inhibited the activity of the 5-lipoxygenase nor antagonized the inhibitory action of acetyl-11-keto-beta-boswellic acid. Therefore, we conclude that acetyl-11-keto-beta-boswellic acid acts directly on the 5-lipoxygenase enzyme at a selective site for pentacyclic triterpenes that is different from the arachidonate substrate binding site.

Weiss RF. Herbal Medicine. Gothenhburg, Sweden; Beaconsfield, England: Beaconsfield Publishers, Ltd., 1988.