Posted on Natural Practitioner Magazine on March 2018
How practitioners can help their patients manage bone, joint and muscle issues using natural solutions.
Bone, muscle and joint pains are a fact of life for many people, regardless of age or activity level. The etiology of this type of pain can stem from systemic problems, overuse or injuries. Arthritis, for example, affects more than 54 million adults, according to 2015 data from the Centers for Disease Control and Prevention (CDC). The CDC also reported that there was an increase in people who battle severe joint pain, from 10.5 million in 2002, jumping to 14.6 million by 2014. Recent statistics predicted that this number could rise to 78 million people by the year 2040.
Even younger, active people are becoming more aware of preventive measures to keep themselves from experiencing pain later in life.
Musculoskeletal pain deriving from nerves, tendons, ligaments, etc., can limit activities, which is why most sufferers are anxious to alleviate these issues promptly and without side effects.
Over-the-counter and prescription medications to manage these issues are commonly used, though more and more people are looking to natural solutions to ease pain in the joints, bones and muscles; natural practitioners can help guide their patients on the path toward better musculoskeletal health.
The Etiology of Common Bone, Muscle & Joint Issues
Amy McKelvey, integrative herbalist and CEO of the manufacturer her vital way in California, said that the etiology of bone, muscle and joint problems derives from a complex interplay of various factors, including inflammatory diet, aging body, inactivity, gut issues, sleep disturbances and hormone imbalances.
Age, however, is often implicated in these types of issues. The Baby Boomer generation is getting older, and with age often comes achy muscles and joints due to wear and tear, stress and strain.
Evan DeMarco, chief marketing officer with California-based Omax Health, explained that those over 50 lose approximately 1 to 2 percent of muscle mass each year. “This age-related muscle protein breakdown is most commonly referred to as sarcopenia, which involves both neural- and muscle-dependent mechanisms,” he said. “Continuous age-related decrease in the number of motor neurons leads to chronic breakdown of communication between the nerves and muscle tissue. Combined with multiple other factors, such as decreased resistance training, diet, inflammatory mediators and chronic disease, we are seeing increased rates of sarcopenia.”
On the flip side, being young does not automatically exclude one from musculoskeletal problems, as a small but significant percentage of people under the age of 18 have reported issues of this type, noted Patrick Montgomery, DC, MS, FASA, based in Missouri.
But it’s not just age that contributes to this issue. “Americans are heavier than they have traditionally been in the past, which is hard on bones and joints,” said Brandon Price, president of the manufacturer, Medicine Springs Inc. in Montana. He added that mineral deficiencies due to the general population’s tendency to eat mass-produced food is another factor contributing to joint issues.
The three most common musculoskeletal conditions that send patients to seek medical treatment are trauma, back pain and arthritis, reported Dr. Montgomery. “The rate of musculoskeletal diseases far outstrips that of circulatory diseases and respiratory diseases, which affect about one in three persons, with the majority reporting relatively easily treatable conditions, such as chronic hypertension or hay fever and bronchitis. The cost of treating major musculoskeletal diseases, which often includes long-term pain and disability, is also greater than the cost of treating many other common health conditions,” said Dr. Montgomery.
He added that of joint disorders, osteoarthritis (OA) is the most common, likely due to the aging of the general population, as well as the obesity epidemic. “The rapid increase in the prevalence of this already common disease suggests that OA will have a growing impact on health care and public health systems in the future,” he added.
But the main causes of bone, joint and muscle problems, he said, are due to fractures, strains, sprains, degeneration due to abuse or nutritional imbalances, acute and chronic inflammation, as well as muscle movement imbalances.
Consequently, joint damage presents itself in many forms, such as rheumatoid arthritis or osteoarthritis, impact or repetitive stress trauma common amongst athletes, gout and simple injuries like sprains.
A Natural Approach
Traditional treatments for musculoskeletal disorders have included over-the-counter prescription medications, massage and chiropractic, physical therapy modalities, such as ultrasound and electrical muscle stimulation, as well as exercise programs.
While one or a combination of the above may provide relief, these medications have fallen out of favor with some because problems reported with overuse of NSAIDs, regularly used by millions of people, for example.
“While anti-inflammatory drugs like ibuprofen are effective at reducing inflammation and relieving pain, they function by inhibiting the production of prostaglandins. Inhibiting prostaglandins has the side effect of inhibiting the body’s ability to produce collagen, which is necessary to maintain healthy cartilage,” said Ross Pelton, RPh, PhD, CCN, scientific director at the manufacturing company Essential Formulas, based in Texas.
Another problem with NSAIDs, said Dr. Montgomery, is the potential for complications of the liver, kidneys and intestines, as well as the potential for addiction when taking prescription painkillers. There are a variety of natural approaches in managing the treatment of bone, joint and muscle pain that practitioners can utilize in a patient treatment program; many, like McKelvey, agree that taking a holistic, proactive approach will yield the best outcome. “Bone loss and the deterioration of joint and muscle health happens gradually, and so it makes sense to address it every day so that the integrity of these systems can be safeguarded,” she said.
Diet is one major factor that practitioners should consider when developing a holistic-based treatment plan for their patients. Based in part on the availability of processed foods and the increased intake in sugar, Americans are more overweight than ever before. However, today, there is a greater understanding of how gut health is tied into overall health. “We now understand that chronic inflammation is at the core of many long-term bone, joint and muscle issues,” said Dr. Montgomery.
DeMarco added that soda is one of the biggest catalysts to these issues, as the phosphoric acid found in many sodas, even diet, can leach calcium from bones, making them brittle and more susceptible to injury. “Sugar also has an impact on calcium absorption and can be very pro-inflammatory,” he said.
Reducing sugar, and its cousin, high fructose corn syrup, as well as the intake of wheat, gluten and dairy, has been shown to reduce chronic inflammation, while an increase in omega-3s, such as those found in cold-water fish, and leafy greens, have the same positive effects. In addition, McKelvey and Pelton added that increasing dietary fiber intake is important for bone health. “It is all about the health of the gut. Health comes from within, not from without. Good in, good out. Bad in, bad out,” said Dr. Montgomery.
Though exercise has been touted since time immemorial as an essential part of a healthy lifestyle and a means for reducing excess weight, it is another tool in the arsenal for keeping bones, muscles and joints in good shape. “The body was built to move, and if it’s not engaged in movement on a regular basis, movement of all kinds, the body will deteriorate, and musculoskeletal health and wellness in general will be hugely compromised,” said McKelvey. Further, regular resistance training is especially important, in addition to cardio; both DeMarco and Pelton agreed that regular resistance training could stave off aging muscles, while McKelvey also advocates for yoga and tai chi.
In addition to diet and exercise, natural practitioners often advise patients to go the natural supplementation route. Some of the common ingredients that are anti-inflammatory agents are bromelain, turmeric/curcumin and frankincense (boswellia), as well as omega-3s, all of which have been studied for its anti-inflammatory properties. For example, said Dr. Montgomery, an enriched extract of the herb Boswellia serrata has been shown to reduce the symptoms of osteoarthritis. Other well-known ingredients aimed at supporting bone, muscle and joint pain, said DeMarco, are glucosamine and chondroitin.
Pelton added that other common supplements in this category include bone-building supplements, such as calcium, magnesium, B-vitamins, as well as vitamins K and D3. “The minerals help to build strong, healthy bone matrix. The B-vitamins help metabolize homocysteine. Elevated homocysteine is a known risk factor for osteoporosis.”
Essential Formulas manufactures Dr. Ohhira’s Probiotics, targeted to support bone density. “The health of the microbiome and the health of an individual’s GI (gastrointestinal) tract is critical for bone health and the prevention of osteoporosis,” he said. “I believe this important health issue is underappreciated and/or not understood by most doctors and the general public.”
One of the most studied and well-known ingredients that target inflammation are omega-3s. Omax Health focuses on polyunsaturated fatty acids (PUFAs), like those found in omega-3s, and has launched four products, such as Omax3 UltraPure. “It is important to get an omega-3 supplement high in EPA with a high concentration above 90 percent to avoid the extra pro-inflammatory omega-6. Branched chain amino acids (BCAAs) are also a great addition to a healthy diet and lifestyle. BCAAs work synergistically with PUFAs to help with muscle protein synthesis,” DeMarco said. “Omega-3 supports a healthy inflammatory response while blocking inflammation pathways. In addition, these PUFAs help support muscle protein synthesis and decrease muscle protein breakdown.”
DeMarco added that his company is also launching Phyto-3, which combines omega-3s and phytocannabinoids. “Phytocannabinoids show incredible promise for treating joint pain. Omax Health has spent a great deal of time developing this concept for the practitioner market,” he said.
her vital way offers FlexFree for joint support and StrongSea-K for bone health, products geared toward women. The former combines glucosamine, a vegetarian source of chondroitin and MSM, and the latter is a combination of Aquamin calcium derived from seaweed as well as vitamins K2 and D3.
Medicine Springs addresses joint issues with minerals found in natural, healing springs; its products absorb through the skin and are intended to increase circulation while submerging the body in a mineral-rich environment. “By recreating famous healing hot springs, a person can add these necessary mineral supplements to their bath or hot tub water, allowing the body to absorb many of the minerals we are deficient in,” said Price. “By soaking in water, this also allows a person to remove the stress on the muscles, bones and joints while allowing these mineral supplements to work into the body.”
Price explained that magnesium is viewed as a natural anti-inflammatory, one that absorbs readily through the skin, but many people are magnesium-deficient.
Medicine Springs manufactures six products, including its Sports Formula, Joint Formula and Skin Formula, and each of these is sourced from different magnesium-rich natural springs found around the globe. For example, “The Sports Formula is made from hot springs spreading from Yellowstone down through Central and South America,” Price said. “We chose hot springs that were known as warrior pools to the Native Americans—Maya, Inca and Aztec. Among all the minerals present, these springs are noticeably higher in magnesium, potassium and bicarbonates. This helps to free up movement and bicarbonates help promote circulation; this all helps to promote recovery.”
When there is no time to soak in a bath or a hot tub, the company also makes a concentrated, magnesium-enhanced spray formula, which is spread on like a lotion. Price said that the skin as an absorption medium works very well in a bath or hot tub or also spraying the minerals on and rubbing them in like you would a lotion.
The California-based manufacturer Genexa has two different products to address bone, joint and muscle pain: Arnica Advantage, its USDA (U.S. Department of Agriculture)-certified organic and non-GMO (genetically modified organism) homeopathic medicine, and Pain Crush, a topical roll-on which will be available this spring. Company President Max Spielberg said that the latter is a conventional medicine but is certified USDA organic and non-GMO.
The active ingredient in Arnica Advantage is Arnica montana, which he said is an old-time remedy for muscle pain, soreness, swelling and stiffness. It is available in a chewable tablet.
“Our products are manufactured in the USA, in compliance with the FDA (U.S. Food and Drug Administration) finished pharmaceutical good manufacturing practices (GMPs) regulations for cleanliness, quality and testing. Additionally, all our manufacturing facilities are regularly inspected by the FDA to ensure safety. For a product to be certified organic by the USDA, the most stringent manufacturing standards are the norm,” said Spielberg, adding that his company has partnered with many practitioners and physicians to help supply patients with healthier alternatives to conventional, prescription medications.
“We’re proud to be working with practitioners who are highly esteemed in their respective fields and whom share our mission of providing people with healthier medicines,” Spielberg said.
Many manufacturers say that today’s market for natural products designed to ease bone and joint pain, and to relieve muscle aches is huge. Price said that the company’s products have generated positive feedback from athletes seeking to keep up their active lifestyle without aches and pains and to speed up their recovery times.
“The recent trend around the lack of minerals, especially magnesium, has pushed this category to the forefront. Magnesium is coming out in many forms including oral supplements and oils; however, Medicine Springs is the only company to offer it in hot spring form,” he said, adding that other mineral deficiencies besides magnesium are responsible for joint problems. “This category is only going to grow larger as the public begins to realize how important these minerals are and how much better they feel when their bodies are balanced.”
“Research collected by Genexa shows that a whopping 93 percent of customers would prefer to purchase a certified organic over-the-counter medicine,” added Spielberg, saying that nationwide data indicates that overwhelmingly, the younger generations are increasingly demanding, natural healthy products.
Other research, pointed to by Dr. Montgomery, shows that the global dietary supplements market is expected to reach $278.02 billion by 2024. “Rising consumption of clinical nutrition products as a prevention medium for reducing malnutrition is expected to have a substantial impact,” he said.
A positive upswing in the market will be attributed to the increasing use of omega-3 fatty acids. “A large aging population is the major driving force in this market. Lifestyle and diet choices over the last 30 years have led to the increase in joint issues, thus increasing a target market,” said DeMarco. “In addition, the acceptance of alternative methods of treatment through functional medical channels opens the demand for natural solutions to joint and muscle pain.”
Some companies, such as Medicine Springs, provide literature to help natural practitioners explain the healing benefits of their products. In addition, Essential Formulas offers trainings and power points, while Price advised that natural practitioners should offer a variety of products, as bone, joint and muscle health is one that is of top concern.
What is important is that practitioners should take a comprehensive approach to get to the root causes of musculoskeletal issues.
Prevention plays a big role in staving off bone, joint and muscle issues. No one can stop time, but a healthy lifestyle that includes a healthy diet and regular exercise is a piece of advice about which very few can disagree. But making sure that one has the appropriate amount of vitamins and minerals, whether found in food or in natural supplement form, is a potential means to stave off future problems as well as to relieve already-present aches and pains from bone, joint or muscle issues.
Whether a naturopath, herbalist or chiropractor, practitioners may recommend the use of dietary supplements. “People need someone to compel them into action – and practitioners are wonderful at that. They are part coach, advisor and even friend. This is how change happens. One caring, informed person at a time,” said McKelvey.
“Some practitioners will work with online companies who will stock all the items that the practitioner recommends. This helps the provider so that he or she doesn’t need to stock items that may go beyond their ‘fresh date,’” suggested Dr. Montgomery, noting that patients/clients can then receive the products in a short period of time by ordering this way.
For practitioners who recommend Genexa products, for example, the company offers a special practitioners’ portal on their website in which they can order products at special rates.
DeMarco agreed that practitioners might want to think about teaming up with a manufacturer for mutual support. “There is a real potential to create a groundswell of acceptance for supplements in health and wellness when the whole functional medical community aligns. That united front helps legitimize the use of supplements and alternative therapies in a holistic approach to treating an individual,” said DeMarco.
“The more practitioners learn and incorporate natural substances for use in their practices for the benefit of their patients, the less those patients will turn to potentially dangerous and addicting drugs,” Dr. Montgomery added. “The use and abuse of these drugs now poses a real threat to the health of the U.S. population.”
Healthy Take Aways
• According to 2015 data from the Centers for Disease Control and Prevention (CDC), arthritis affects more than 54 million adults.
• The three most common musculoskeletal conditions that send patients to seek medical treatment are trauma, back pain and arthritis.
• Arnica montana is beneficial for muscle pain, soreness, swelling and stiffness.