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joint pain

  • Arthritis is a real pain in the joints — and nearly 30 million Americans have to deal with it.

    Twenty-seven million of us deal with pain and stiffness from the wear-and-tear of osteoarthritis, where the cartilage that covers and cushions the ends of your bones becomes thin or disappears, and your bones rub together and hurt.

    Another 2.5 million endure the red, hot, swollen and painful joints of rheumatoid arthritis, which is an autoimmune disease that causes your immune system to mistakenly identify your cartilage and bones as foreign invaders (like viruses)— and attack them.

    Arthritis isn’t an “equal opportunity annoyer.” It picks on seniors (65 percent of people over 65 have osteoarthritis) and on women (seven out of ten people with rheumatoid arthritis). With so many folks afflicted, you’d think modern medicine would offer some good, safe solutions for arthritis pain. Think again.

    The most common class of pain-relieving drugs—nonsteroidal anti-inflammatory drugs (NSAIDs)—hospitalizes more than 100,000 Americans a year from bleeding ulcers, and kills more than 16,500!

    Adding joint insult to digestive injury, NSAIDs don’t slow the progression of arthritis—and may even speed it up! The best advice? Take steps to optimize joint health, so you can minimize the chances of developing joint problems in the first place. And there are three easy ways to do just that.

    Joint-Optimizer #1: Feed Your Joints

    There are several nutrients and natural compounds that are uniquely effective for promoting healthy joints.

    Glucosamine Sulfate: Feeding Your Cartilage
    Glucosamine is a component of cartilage. When you take a glucosamine-containing supplement, the compound is incorporated into your cartilage molecules, which helps repair joints and reduce the pain that can result from overuse. I recommend the sulfate form (not glucosamine hydrochloride), because sulfate also promotes healthy joint function. The standard dose is 750 milligrams, two times daily, taken with or without food. After six months, you may find that you don’t need to take the supplement daily; at that point, you may choose to take it only when your joints feel like they need help.

    Chondroitin Sulfate: More Cartilage Support
    This compound also helps create, maintain and repair cartilage. One downside is that only 10 percent is absorbed. To improve absorption, use the “low molecular weight” form of chondroitin. (Look for those words on the label.) The standard dose is 400 mg three times daily, or 1,200 in a single dose.

    MSM: Sulfur, a Surprisingly Important Nutrient
    MSM is an abbreviation for methylsulfonylmethane, a sulfurcontaining compound that gives your proteins a key building block needed for tissue repair. Research show that MSM, chondroitin and glucosamine work well together. It is reasonable to take all three of these daily for the first six to twelve weeks after you begin the regimen. This will lay a solid nutritional foundation The best advice? Take steps to optimize joint health, so you can minimize the chances of developing joint problems in the first place from which you can begin to maintain healthy joint function. After that, you can scale back to a lower dose.

    For Nutritional Insurance, Take a Good General-Purpose Supplement
    Dozens of other nutrients are also helpful to promoting healthy joint function—like B vitamins, vitamin C, vitamin E, boron and zinc.)

    Joint-Optimizer #2: Balance Immune Function

    Curcumin and boswellia are two herbs that are particularly good at promoting a healthy and balanced immune system.

    These can be found in a number of good herbal mixes. Both curcumin and boswellia are provided in the supplement Healthy Knees and Joints. Another excellent product that contains a highly absorbable form of curcumin is Curamin. Yet another herbal formula, End Pain, contains boswellia and willow bark (the herbal granddaddy of aspirin). The End Pain can be taken along with either the Curamin or Healthy Knees and Joints. Allow six weeks to see the full effect. You’ll be glad you did!

    Another powerful immune regulator is fish oil. You can eat fatty fish like salmon, sardines, trout or mackerel a few times a week, or take a fish oil supplement.

    Joint-Optimizer #3: Use Them or Lose Them

    If you want to maintain flexible, healthy joints, you need to use them the way nature intended. Namely, you need to MOVE them! I suggest exercising at least 20 minutes daily. Go for a walk outdoors (also great for boosting levels of vitamin D, which supports healthy muscles and joints). Swim or exercise in a heated pool (the buoyancy and warmth make this an ideal exercise for joints that need a helping hand). Yoga, tai chi or any other form of stretching are also good.

    Important: Pain is your body’s way of saying, “Don’t do that!” So if you feel unusual pain while exercising, STOP and DON’T try to push through it.

    Heat and Stretch
    A great way to improve flexibility: use a heating pad or any other kind of moist heat for five to fifteen minutes on an affected joint, then slowly and gently move the bothered joint, gradually reclaiming your full range of motion.

    For joints in your hands, try the herbal-filled “bean bags” you can heat up in the microwave, putting them on your hands. After five to fifteen minutes, gently stretch your fingers.

  • In the past couple of years, oral forms of hyaluronic acid have become available. Oral HA is a nonprescription product that’s sold as a dietary supplement. The benefits of an oral formulation compared to injections are obvious: lower cost, no pain, lower risk, and improved convenience. The positive results for patients have vaulted this product into the limelight.

    The number one cause of disability in America isn’t heart disease or diabetes—it’s arthritis. According to statistics from the federal Centers for Disease Control (CDC), one in three adults is now affected by an arthritis-related condition.

    Arthritis is a general term for a group of conditions that cause pain, stiffness, and swelling in the joints. The most common form of arthritis is osteoarthritis, sometimes called “wear and tear” arthritis. Most people with arthritis have osteoarthritis— in fact, some 21 million American adults suffer from it.

    People with arthritis often face serious reductions in their quality of life. The pain, stiffness, and inflammation make it hard to stay active, but inactivity can lead to a downward spiral of worsening health. When activity levels drop, depression, obesity, diabetes, heart disease, and problems with work and relationships often develop. And inactivity actually makes sore joints even worse, which just accelerates the downward spiral. For most people, life just isn’t as enjoyable with arthritis.

    New Treatment Options
    The good news is the high prevalence of arthritis has led to increased awareness and increased research efforts. The most exciting part about the new treatment options that are now becoming available is they don’t just relieve pain. They actually improve function while also being very safe. Unlike anti-inflammatories such as naproxen (Aleve), for example, treatments such as glucosamine and hyaluronic acid don’t cause gastric bleeding or ulcers, and they don’t raise your risk of a heart attack, stroke, or kidney disease.

    In the 1990s, hyaluronic acid (HA) became available as a treatment for knee osteoarthritis. For people with severe knee arthritis, injecting HA into the joint often provides relief. Injectable HA is a prescription product that has to be administered by a physician. Most patients need a series of three to five weekly injections. Injectable hyaluronic acid is well-established as a safe therapy for osteoarthritis. In fact, it’s part of the American College of Rheumatology guidelines for treating osteoarthritis of the knee. Injectable HA works reasonably well. After receiving the series of injections, over half of all patients have improvements in pain and function that can last for up to a year. Because injectable HA provides long-lasting relief, osteoarthritis patients can often avoid the dangers associated with over-the-counter or prescription anti-inflammatory drugs.

    Injectable HA has some significant drawbacks, however. Receiving an injection directly into the joint isn’t something to take lightly. It’s an invasive procedure that involves pain and a small chance of introducing an infection in the joint. It’s expensive—the series of injections can run to $1,500 and may not be covered by health insurance. It’s also inconvenient to keep going to the doctor for several weeks in a row to receive the full series of injection—or repeat injections, if necessary.

    In the past couple of years, oral forms of hyaluronic acid have become available. Oral HA is a nonprescription product that’s sold as a dietary supplement. The benefits of an oral formulation compared to injections are obvious: lower cost, no pain, lower risk, and improved convenience. The positive results for patients have vaulted this product into the limelight.

    Understanding HA
    To appreciate what a breakthrough oral HA is, it helps to understand the crucial role of HA in joint health. In your body, HA is a naturally occurring family of extremely large molecules that are contained in many tissues, not just the joints. HA is one of the components that give our tissues flexibility. Your eyeballs, for instance, are “squishy” mainly because of their high HA content. The same goes for the cartilage in your joints.

    Joint cartilage (what doctors call articular cartilage) is a glistening, smooth, translucent, whitish-colored living tissue found on the ends of your bones. Joint cartilage caps the ends of the bones in the 230 different joints found in the human body. When it’s healthy, cartilage is extremely smooth. It provides a low-friction environment for easy movement and also acts as a shock absorber to protect your bones and keep them from fracturing with activity.

    Hyaluronic acid is essential for healthy cartilage. It’s the chemical backbone that holds together the molecules, such as chondroitin sulfate, that make up the cartilage and give joint cartilage its special properties. HA is what makes joint cartilage the smoothest and most friction-free substance in nature. Nothing man-made can approach the performance of this remarkable tissue.

    In any joint, the whole structure of bone, cartilage, ligaments, and tendons is surrounded, held together, and protected by a watertight, fibrous joint capsule. Specialized cells called synoviocytes line the interior portion of the joint capsule. They produce the synovial fluid—a thick, clear substance that looks and feels like raw egg white. Synovial fluid fills the space within the joint. It lubricates the articular cartilage, much as grease lubricates the ball joints of your car. Synovial fluid also increases the effectiveness of shock absorption in the joint, much as hydraulic shock absorbers smooth out the ride of your car. Because joints don’t have a blood supply of their own, the synovial fluid also carries nutrients into the joint and carries waste products out.

    Osteoarthritis and HA
    Where does HA fit into joint health? It’s the principal functional component of synovial fluid. HA is what makes synovial fluid thick and viscous—and it’s these properties that are vital to normal joint function. But when osteoarthritis strikes, the hyaluronic acid in the joint is affected. Here’s how it happens: The joint cartilage on the ends of the bones slowly erodes, the bone underlying the cartilage changes (leading to bone spurs and pain), and the synovial fluid in the joint changes in character. Specifically, the amount of HA in the joint drops. In severe osteoarthritis, the level of hyaluronic acid in the joint fluid may decrease by 75 percent or more. Because HA serves as a shock absorber and lubricator, it’s no wonder that a big decrease in such an important molecule results in adverse consequences. When HA levels in the knee drop, for instance, the result is a creaking or grinding sensation, pain, and often a condition called “movie-goers knee.” It may sound funny, but movie-goers knee is no joke. It’s a real medical condition that occurs after someone with knee osteoarthritis sits with the knee bent at a sharp angle for a prolonged period of time—such as sitting through a feature movie or driving a car for a couple of hours. Upon arising, a sudden, sharp, stabbing pain occurs in the knee. The pain usually goes away after walking a few steps, as the remaining fluid in the knee coats the surfaces of the cartilage and cuts down on the friction.

    The prevailing theory of how HA works is that the molecules attach to binding sites on cells within the joints. Once the attachment is made, it triggers a complex cascade of events within the cells. One of the things that seems to happen is the HA molecules inhibit some of the enzymes that help break down the cartilage matrix in the joint. HA also seems to inhibit some of the natural chemicals, such as interleukin-1b and prostaglandin E2, that create inflammation in an arthritic joint. The anti-inflammatory mechanism of HA isn’t fully understood, but we do know it’s quite different from that of anti-inflammatory drugs. HA molecules also appear to disrupt some of the nerve impulses that transmit pain signals from the joint to the brain. Importantly, HA molecules can stimulate the cells that line the joint capsule and trigger them to manufacture even more hyaluronic acid—something highly desirable in osteoarthritic joints.

    When there’s not enough HA in a joint, all the things it does to maintain pain-free normal function don’t happen as well— that’s where supplemental HA comes in.

    Choosing the Best HA Supplement
    As researchers learn more about the HA pathways in the joints, they continue to discover new ways in which HA helps relieve pain and improve function in patients with osteoarthritis. One of the things they’ve learned is oral HA supplements can be very effective—but only if they’re a high-quality product that closely mimics the body’s own HA.

    Today the oral forms of hyaluronic acid sold as dietary supplements come from three general categories: low-purity animal extractions mixed with large quantities of (relatively inactive) collagen; fermentation from bacteria; or concentrated extraction from avian cartilage. The original pharmaceutical forms of injected hyaluronic acid were all derived from the avian cartilage, so it makes sense this is also the optimal form for dietary supplements. Low-purity animal extractions mixed with collagen are undesirable because of two reasons. To get an adequate quantity of hyaluronic acid from these supplements, you’d have to take them in very large amounts. Also, it’s questionable whether the biologic activity of this source of hyaluronic acid compares with the others.

    Hyaluronic acid derived from bacterial fermentation may also be less functional and it doesn’t have some of the natural active components found in the concentrated extractions from avian cartilage. Perhaps this helps explain the results of an internal study comparing the effectiveness of fermented HA to a concentrated extract from avian cartilage. When a culture of living synovial cells was exposed to the avian extract, the cells were stimulated to produce twice as much HA as when they were exposed to the bacterial HA—even though the concentrations of each product was the same (200 mcg/ml ).

    It’s also important to note that concentrated avian extracts have been used in most of the important worldwide research that has been done on HA. The concentrated extractions have been utilized extensively in the clinic and in large human studies (some of long duration) sponsored by the pharmaceutical industry.

    Hyal-Joint® Oral Hyaluronic Acid Supplements
    Hyal-Joint oral hyaluronic acid supplements appear to be the best available product. This product is a concentrated HA extraction from avian cartilage and also contains other naturally active components such as vital glycosaminoglycans. Hyal-Joint has been studied in a number of laboratory experiments, animal studies, and in a human clinical study. Even more research is underway. The studies suggest that Hyal-Joint raises HA levels in the joints and, just as important, also stimulates the body to produce more of its own natural HA. In the first human study, the participants took only 80 mg of Hyal-Joint a day, an amount that fits into a small capsule or tablet. This daily dosage delivers approximately 48 to 54 mg HA, 4 to 12 mg other glycosaminoglycans, and 16 to 24 mg collagen. A clinical trial is underway now using a smaller dose of just 40 mg, and some supplement manufacturers are considering adding 20 mg of Hyal-Joint to existing joint health formulations containing other active components such as glucosamine and chondroitin sulfate.

  • Back in the news is MSM (short for methylsulfonyl-methane, also known as dimethyl sulfone). MSM has generated broad anecdotal support for its benefits in cases of allergies, arthritis and joint pain. However, the list of conditions that are said to respond to MSM is much longer. Broadly speaking, MSM has been tested with clinical results in inflammation, joint and tissue pain, muscle spasms, hair and nail growth, even snoring! So just what is this compound and how does it work? Is it really a panacea?

    Nature’s Sulfur Cycle
    MSM’s initial popularity was due, in part, to the success of the booklet, “The MSM Miracle: Enhance Your Health with Organic Sulfur,” by Earl L. Mindell, R.PH., Ph.D. which was followed in 1999 by the definitive The Miracle of MSM (by Jacob, Lawrence and Zucker). However, the story of MSM dates back at least to the early 1960s. Unfortunately, these first suggestions of the nutritional and therapeutic potential of MSM were not immediately followed up. Yet another decade lapsed before real clinical studies began. The catalyst for renewed interest was a report presented at a meeting of the New York Academy of Sciences in the early 1980s. Since that time, thousands of patients have been given MSM under medical supervision to determine its benefits and side effects when given either by mouth or intravenously, with much of that work performed at the Oregon Health Sciences University. Hundreds of thousands more individuals have purchased MSM from health food store shelves.

    MSM is a stable source of sulfur that can be derived mostly from plants grown either on land or in the sea. Marine sources include algae and phytoplakton. Indeed, MSM is an integral part of the “sulfur cycle” in the biosphere in which sulfur is taken up from the soil by plants, is released into the atmosphere as the highly volatile dimethyl sulfide, which in turn is oxidized in the upper atmosphere to dimethyl sulfoxide (DMSO), which then becomes the atmospheric source of MSM. DMSO and MSM return to the soil via the rain, and then the sulfur cycle repeats itself.

    Of our normal foods, milk is one example of a source of MSM, and so are onions, garlic, asparagus, cabbage, broccoli and Brussels sprouts as well as eggs and red peppers. However, there is a caveat. Plants in their fresh state thus contain a quantity of MSM when grown on sulfur-rich soils, yet most of the compound found in plant foods may be lost by improper handling and storage. Food preparation, especially excessive cooking and cooking in large volumes of water, also reduces the levels of MSM found in foods.

    Bioavailable Sulfur (MSM) Improves Joint Health and More
    MSM is a bioavailable source of sulfur, which is important for supplying the building blocks for the production and repair of the skin, hair, cartilage, ligaments and tendons. In the cases of arthritis and similar joint and ligament injuries, MSM may work through several different mechanisms. For instance, it was discovered in the 1930s that sufferers from arthritis often have below normal levels of cystine (a metabolite of cysteine) in their fingernails. This can lead to brittle or soft nails and can be an indication of either inadequate sulfur in the diet or a poor ability to manipulate dietary sulfur to match the body’s needs. Interestingly, when sulfur was given to one hundred arthritis patients intravenously in one trial, many found that the pain and other symptoms of their arthritis disappeared and that their fingernails returned to normal in the nail test for cystine.

    Sulfur is required for the repair of joint tissues and for the construction of connective tissues generally. This is one rationale often given for the use of glucosamine sulfate as the preferred form of glucosamine in the treatment of osteoarthritis. Likewise, the cartilage extracts that were employed so successfully in many of the European arthritis trials certainly contained some quantity of sulfur along with other compounds. This suggests that MSM might be used in conjunction with glucosamine to yield improved results. This was confirmed recently in a trial combining MSM with glucosamine. The researchers concluded that the “combination of MSM with Glu (glucosamine) provides better and more rapid improvement in patients with osteoarthritis.”

    Joint health to most of us means arthritis. However, this leaves out sports injuries, one of the areas in which MSM has been researched. Also, not just humans benefit from MSM. There even is research, for instance, on the effective use of MSM with racehorses.

    Pilot clinical trials suggest that a realistic time frame for response to MSM therapy is four to six weeks. For instance, in a small arthritis trial conducted at UCLA by R. M. Lawrence, pain scores exhibited a 60 percent improvement at four weeks and an 82 percent improvement at six weeks compared with placebo, which exhibited improvements of 20 and 18 percent respectively. Similarly, in a pilot trial on hair and nail health, 3 grams of MSM ingested daily led to significant improvements within six weeks.

    MSM–An Autoimmune Connection?
    One of the more curious findings with MSM is that some types of autoimmune responses are positively modulated. The reasons for this are not at all clear. One route of protection may be improvements in gastrointestinal health. Rheumatoid arthritis, which is an autoimmune disease, is strongly associated with the passage of toxins and certain proteins through the wall of the gut and into the blood stream. This is sometimes referred to as “leaky gut” syndrome. Interestingly, MSM is sometimes said to improve allergies, constipation, and even problems with parasites. Common to all of these are problems with the health of the intestinal wall.

    This observation actually takes us back to the role of the glucosamines in health. Glucosamines are forms of amino sugars. Amino sugars are essential components of all body tissues, being integral parts of cell membranes and their surface structures, and of interstitial tissue that holds cells together. About half of the interstitial tissue components are derived from amino sugars. An amino sugar is made up of a sugar (glucose or galactose) and an amino group (typically one nitrogen and one or more hydrogen atoms), forming glucosamine or galactosamine. While most sugars come from dietary sources and are burned for energy, amino sugars are mainly formed in the body and used in manufacturing tissue components. Normal wear and tear during body functions means that tissues are constantly broken down and rebuilt or restructured. The amino sugars are steadily and necessarily recycled. The loss sustained during such turnover must be made up by the bodily synthesis of new amino sugars from glucose inasmuch as dietary supplies of amino sugars are usually low. Of course, if amino sugars are to be used to efficiently construct connective tissue, there must be sulfur freely available to the body.

    Normally, the mucosal cells lining the digestive tract have an especially high turnover rate such that the whole layer of surface cells may be renewed in three to four days. An inability to manufacture adequate glucosamine therefore will cause the intestinal wall to “thin” and allow toxins and not fully digested proteins into the blood stream. A lower than normal sulfur content in the gut wall is also associated with rheumatoid arthritis and may play a contributory role. Studies with MSM given to animals in their drinking water indicated that microorganisms in the gut lining may be responsible for incorporating sulfur from MSM into sulfur-bearing amino acids, with a positive benefit to this essential aspect of the metabolism. MSM may thus play a role in improving this aspect of gut health and likely works even better in this regard in conjunction with a glucosamine source, such as glucosamine sulfate, or N-acetyl-glucosamine (NAG).

    It may be the case that the autoimmune modulating effects of MSM are partially due to free radical scavenging actions. Unfortunately, although it is the object of numerous U.S. patents, MSM, has been the subject of only a handful of published studies in this particular area.

    MSM often is associated with the name of Stanley W. Jacob, M.D. in the Department of Surgery at Oregon Health Sciences University in Portland, Oregon. Dr. Jacob used MSM with more than 12,000 patients and therefore from clinical practice there is a foundation for suggesting an approximate intake of MSM for supplemental purposes. The minimum dosage is 750–1,000 mg and a common dosage level is two to three grams of MSM per day taken in divided doses; for instance, 1.5 grams ingested with the morning and evening meals. Increase the dosage slowly if a dosage higher than 1 gram per day is intended. Vitamin C and glucosamine are two nutrients often used in conjunction with MSM. A recent clinical trial for arthritis tested three grams MSM taken twice per day. Benefits usually become evident with three weeks or less, but as indicated above, there typically is further improvement in the period from four to six weeks. MSM is safe for chronic intake and is not associated with serious side effects even at dosages far above the two to three gram level.

    Selected Sources:

    1. Ameye LG, Chee WS. Osteoarthritis and Nutrition. From nutraceuticals to functional foods: a systematic review of the scientific evidence. Arthritis Res Ther. 2006;8(4):R127.
    2. Brien S, Prescott P, Bashir N, Lewith H, Lewith G. Systematic review of the nutritional supplements dimethyl sulfoxide (DMSO) and methylsulfonylmethane (MSM) in the treatment of osteoarthritis. Osteoarthritis Cartilage. 2008 Nov;16(11):1277–88.
    3. Childs SJ. Dimethyl sulfone (DMSO2) in the treatment of interstitial cystitis. Urol Clin North Am 1994;21(1):85–8.
    4. Jacobs SW, Lawrence RM, Zucker M. The Miracle of MSM. (New York: G.P. Putnam/ Berkeley Trade, 1999).
    5. Jacob, SW, Herschler, RJ. Introductory Remarks: Dimethylsulfoxide After Twenty Years. Annals of the New York Academy of Sciences, 1983.
    6. Kim LS, Axelrod LJ, Howard P, Buratovich N, Waters RF. Efficacy of methylsulfonylmethane (MSM) in osteoarthritis pain of the knee: a pilot clinical trial. Osteoarthritis Cartilage. 2006 Mar;14(3):286–94.
    7. Klandorf H, Chirra AR, DeGruccio A, Girman DJ. Dimethyl sulfoxide modulation of diabetes onset in NOD mice. Diabetes 1989;38(2):194–7.
    8. Lawrence, RM, Methylsulfonylmethane (MSM): A double-blind study of its use in degenerative arthritis. International Journal of Anti-Aging Medicine 1998 Summer;1(I);50.
    9. Mindell, Earl L. The MSM Miracle: Enhance your health with organic sulfur. (New Canaan, Connecticut: Keats Publishing, Inc., 1997).
    10. McCabe D, O’Dwyer P, Sickle-Santanello B, Woltering E, Abou-Issa H, James A. Polar solvents in the chemoprevention of dimethylbenzanthracene-induced rat mammary cancer. Archives of Surgery 1986;121(12):1455–9.
    11. O’Dwyer PJ, McCabe DP, Sickle-Santanello BJ, Woltering EA, Clausen K, Martin EW Jr. Use of polar solvents in chemoprevention of 1,2-dimethylhydrazine-induced colon cancer. Cancer 1988;62(5):944–8.
    12. Richmond VL. Incorporation of methylsulfonylmethane sulfur into guinea pig serum proteins. Life Sciences 1986;39(3):263–8.
    13. Usha PR, Naidu MU. Randomized, Double-Blind, Parallel, Placebo-Controlled Study of Oral Glucosamine, Methylsulfonylmethane and their Combination in Osteoarthritis. Clin Drug Investig. 2004;24(6):353–63.
  • Extreme weather changes can affect a person's pain levels1. The scientific name for the study of these occurrences is called biometeorology (or medical meteorology2). Medical literature provides us with insights from physicians that prolonged exposure to severe outdoor temperatures can worsen painful symptoms in patients. Especially for patients who already suffer from different types of chronic pain. While further study is needed, individuals can implement several strategies to alleviate pain brought on by scorching heat or freezing cold temperatures. Even though we cannot control the weather, It is important to add these tips to our daily routines as we navigate through seasonal shifts in order to avoid unwanted pain.

    extreme winter weather pain

    Icy Winter Days
    People who suffer from chronic conditions such as arthritis, rheumatic conditions, depression and/or anxiety are susceptible to increased pain during cold winter months. One theory3 suggests sudden changes in barometric pressure may be to blame. With colder temperatures steadily lowering outdoor air pressure, exposure to these atmospheric changes triggers inflammation in muscle and joint tissue, resulting in pain. We can make ourselves more comfortable during the colder months with some minor adjustments to our daily routines.

    Generate Warmth
    Regulating your body heat is a simple, but effective way to alleviate pain. Take the time to properly protect yourself during especially low temperatures by wearing extra layers of clothing. Opt for insulated gloves, outerwear and thermal undergarments. Wool is an excellent fabric for preserving body heat-but if it irritates your skin, alternatives such as cashmere and alpaca wool offer warmer, lighter, and softer protection that is gentle on the skin and more effective at retaining heat than synthetic materials. When at home, warm showers and baths can not only help keep you warm, but lower blood pressure and increase blood circulation. Also utilize heating pads or electric blankets, which are an excellent way to stay warm during freezing nights.

    Exercise Daily
    Routine daily exercise and maintaining a healthy weight will put less stress on your joints, especially those in the back, hips, and knees. While frigid outdoor weather can significantly restrict access to outdoor exercise, studies show staying active and exercising regularly can help reduce pain4. Start small with exercises that are gentle on your joints, like yoga, tai chi or swimming in a heated, indoor pool. Before bracing the chilly weather, remember to stretch and loosen muscles and joints, your body will thank you later.

    Spice It Up
    Hot Tea for pain Joseph Pergolizzi Different foods and drinks can give you warmth as well. Hot tea is not only soothing, but can warm up your hands if you hold your teacup tight. Coffee is scientifically proven to increase body temperature due to the high amounts of caffeine that stimulate the metabolism, encouraging the body to burn fuel. The most effective way to drink coffee is black. Adding cream and sugar will just break down instantly and produce a sugar crash. Besides drinks, certain foods can also keep you warm like ginger, which improves blood circulation, helping to warm your extremities and keep away the chills. For those who like their food a bit more bold, any spicy pepper, like jalapenos or habaneros, will help you heat up. Capsaicin5 is the active component that is found in all peppers, the chemical produces a burning sensation to any tissues it comes into contact with, keeping you nice and toasty.

    Sweltering Summer Days
    Heat waves and humidity can have an effect on anyone, however, for people in pain, especially those dealing with chronic pain like arthritis and other conditions, heat can intensify the pain and make it worse6. Studies show hot weather alone can cause dizziness, lightheadedness, fatigue, and muscle cramps7, even in people who do not normally experience muscle pain - so stay cool by using these tips:

    Choose Water
    When you feel thirsty, it is your body telling you that you are already mildly dehydrated. Our muscles require water, without enough fluid, our muscles can become extremely sensitive and spasm. Make sure to hydrate with water from morning to evening and pick beverages wisely. Drinks such as alcohol and/or highly caffeinated beverages (like soda, coffee or some teas), can cause dehydration. The best choices can also pertain to certain foods, some summer snacks are higher in water, which make them ideal choices for staying cool. According to studies from Australia, about one-fifth of our water consumption comes from foods8 - primarily fruits and veggies. Summer favorites with high amounts of water include: watermelon, cucumbers, cantaloupe, tomatoes, strawberries, iceberg lettuce and pineapple.

    Favor Shade Over Sun
    The hot temperatures and humidity can exhaust us, but the harmful rays of the sun can also make pain even worse. When venturing outside try to wear a hat, sunglasses and sit or walk in the shade whenever possible. By spending time in the shade, your skin can repair itself and it is a good way to avoid sunburn, which can intensify any existing aches and pains. Put away the denim and sweaters, and choose breathable, light-weight clothes made from polyester or cotton to help protect your skin, and regulate body temperature. For those who already struggle with headaches, or migraines, avoid bright sunlight as much as possible. While just being out in the heat stresses your body, direct sun can cause sunburn and intensify pain, picking shade over sun can help you stay cool.

    Pain Cream vs. Pain Pills
    Extreme heat can cause painful muscle spasms or soreness, which can occur even if you have never had them before, and especially if the body gets too warm and can't cool itself fast enough. These spasms are referred to as 'heat cramps9', and are usually experienced by pro-athletes, but in extreme weather can happen to anyone. In this instance, effective pain relief creams can work quicker than oral pain medications. Oral medications and supplements take time to absorb in the body via ingestion, some even require a waiting period of 6 to 8 hours between doses. Pain creams, on the other hand, can better target pain by applying cream directly to affected joints or muscles, providing instant relief. Another advantage to pain relief creams is that you can apply it more frequently than you can take an oral pain relief medication.

    topical pain relief Joseph Pegolizzi

    Topical pain relief creams have proven effective for my patients in both weather extremes, especially pain creams that contain hyper-oxygenated oil10. These oils have been praised as a valuable remedy throughout history, from the days of ancient Rome. The Spartans would rub oil onto their bodies before going into battle. In those days, the oil was made from local flowering plants and then left to ferment in the sun for up to 20 years, infusing the oil with oxygen. When massaged in, the action of the rubbing in the soothing oil helps accelerate blood flow deep in the superficial vascular network. Pain creams that utilize oxygenated oil usually have lower doses of menthol, and have been proven to be more effective than menthol-only creams.

    Different therapies can offer a variety of solutions for all types of pain, but not all options are suitable for everyone or for all types of pain. Consult your doctor about the right treatment option for your pain. While it may not seem like you are doing a lot, taking simple small precautions during periods of extreme weather, and adjusting your routine accordingly, can have an effective impact on managing pain in any type of weather.


    1. Weather Patterns Associated with Pain in Chronic-Pain Sufferers - American Meteorological Society
    2. The Meteorology of the Human Body - National Library of Medicine
    3. How Cold Weather Impacts Joint Pain - Harvard Pilgrim Health Care
    4. Exercise and Chronic Pain - Utah State University
    5. Capsaicin - Wikipedia
    6. The Dangerous Combination of Chronic Pain and Hot Weather - Pain Medicine News
    7. Temperature-related Death and Illness - National Institute of Environmental Health Science
    8. Drinking Water and Your Health -
    9. Heat Cramps - University of Connecticut
    10. Ozonated oil in wound healing: what has already been proven? - National Library of Medicine

  • MSM is a naturally-occurring nutrient, a sulfur compound, found in normal human diets and the diets of all other vertebrates. Sulfur is an element present in all living organisms. It belongs in the same chemical family which includes oxygen. For organisms living in environments where there is no oxygen, sulfur often replaces oxygen as the source of chemical energy that drives life. It is not a pharmaceutical drug but a dietary supplement.

    Sulfur, the eighth most abundant element in the human body, has a long history as a healing agent. For centuries mankind has soaked in sulfur-rich, mineral hot springs to help heal a variety of ailments. While sulfur’s natural anti-inflammatory properties have shown benefits for a range of health problems, including arthritis, muscle and joint pain, much is still unknown about precisely how it works in the body.

    Without sulfur, life as we know it would not exist. Some of the essential functions that make sulfur possible for us to live include maintaining the structure of the proteins of the body, helping in the formation of keratin, which is essential for hair and nail growth, aiding in the production of immunoglobulin, which maintains the normal immune system, catalyzing the chemical reactions which change food into energy and neutralizing or eliminating toxins from the body. (Sulfur is needed to create/hold the molecular structure, particularly the sulfur amino acids: methionine, cysteine, taurine.)

    MSM and its related compounds provide the source of 85 percent of the sulfur found in all living organisms. The cycle of these naturally-occurring sulfur compounds begins in the ocean where microscopic plants called plankton release sulfur compounds. These salts are transformed in the ocean water into the very volatile compound dimethyl sulfide (DMS), which escapes from the ocean water as a gas. It then rises into the upper atmosphere where in the presence of ozone and high energy ultraviolet light, the DMS is converted into its cousins DMSO and MSM. Unlike the DMS, both DMSO (dimethyl sulfoxide) and MSM are soluble in water and when they return to the surface of the earth it is as rain. Plants take MSM rapidly into their root systems and concentrate it a hundredfold. MSM, and the sulfur it contains, is incorporated into the plant’s structure. Through plant metabolism the MSM, along with other sulfur compounds that it has spawned, is ultimately mineralized and transported back to the sea. Then the sulfur cycle beings again.

    Almost everyone in our modern society is deficient in MSM but with age the deficiency grows even more pronounced. What’s happening in our lives today is that we’re processing too many foods. The highest concentration of MSM is found in milk. MSM is a natural component of many fresh fruits, vegetables, seafood and meat. However, heat and processing reduce the MSM in foods. Onions, garlic, asparagus, cabbage, broccoli and Brussels sprouts are sulfur-rich foods, but not as rich as eggs and red peppers. Food preparation, like washing and steaming, also reduces the levels of MSM.

    The most efficient way to assure sufficient levels of MSM in the body, or to benefit from the therapeutic benefits, is to include it as a staple of one’s daily nutritional supplement program. MSM is available in capsules that can be taken with meals or in crystal form for mixing with drinks. It can also be purchased as a cream, lotion or gel and applied directly to the skin for additional relief from pain and inflammation.

    Although MSM is commonly characterized as a breakthrough remedy for people with osteoarthritis, its benefits extend beyond the treatment of chronic illnesses. In fact, in recent years athletes and fitness enthusiasts have begun to rely on MSM to reduce the pain, soreness and inflammation associated with injuries, strained or cramped muscles and over-extended joints. Many use MSM in ointment form to alleviate the pain of sprained ankles, elbows and shoulders, strained muscles and ligaments and tendon injuries.

    Experience shows that MSM is often so effective for pain relief that doctors are able to lower the dosage of medication they prescribe for patients. The end result is relief with fewer or no side effects that are frequently caused by prescription pain medications. It is also important to understand in that MSM is a naturally-occurring sulfur compound found in the body, it is not similar to inorganic sulfides, sulfites and sulfates to which many individuals are allergic.

    Another major natural health property of MSM is that it is excellent for preventing allergies. I would say that it is probably the most important substance we have had for the prevention of allergies since the advent of the antihistaminic agents, and that was over four decades ago. People taking MSM orally, or sometimes supplementing that with nose drops, will not have the conventional burning of the eyes or the running nose or the hoarseness associated with allergies to pollens, dust and molds.

    MSM also has anti-parasitic properties. We have studied the two most common parasites in the gastrointestinal tract. The giardia is a parasitic infection of the small intestine which causes poor absorption of nutrition in humans. It is the most frequent cause of water-carried diarrhea in the U.S. MSM is quite effective when taken orally in controlling the symptoms and fighting the invading organism.

    Many women complain of yeast infections, which are caused by a parasite called trichomonas. The symptoms include increased itching and discharge which may be malodorous and discolored. Both the topical and oral supplements are effective therapy.

    MSM helps to control hyperacidity/heartburn naturally. Patients who have used antacids and products like Tagamet™ and Zantac™ make themselves worse by becoming dependent upon them. MSM is a nutritional supplement that has been shown to be more effective in stabilizing the digestive process and environment in doses of 3000 mg per day.

    Researchers at Oregon Health Sciences University studied a strain of mice that were prone to the spontaneous development of joint lesions similar to those in rheumatoid arthritis. They found that animals that were fed a diet that included a three percent solution of MSM as drinking water, from two months to five months of age, suffered no degeneration of articular cartilage. In a control group of mice receiving only tap water, 50 percent of the animals were found to have a focal degeneration of articular cartilage.

    Of the 16 patents granted to MSM, one is for relief from snoring. Research at Oregon Health Sciences University on 35 subjects suffering from chronic snoring has shown that MSM, as a 16 percent water solution administered to each nostril 15 minutes before sleep, provided significant reduction in 80 percent of the subjects after one to four days of use.

    As a control, in eight patients showing relief with MSM, saline solution was substituted for MSM without their knowledge. Seven of eight patients resumed loud snoring. The change occurred within 24 hours of the substitution. After the MSM treatment was restored, these eight again showed a significant reduction of snoring.

    Many years of clinical use at Oregon Health Sciences University has demonstrated that MSM provides the following pain relief and anti-inflammatory benefits without serious side effects:

    • Inhibition of pain impulses along nerve fibers (analgesia)
    • Lessening of inflammation
    • Increase in blood supply
    • Reduction of muscle spasm
    • Softening of scar tissue

    To date more than 12,000 patients have been treated at the university with Lignisul MSM at levels above two grams daily with no serious toxicity. About as toxic as water, even common table salt can be more toxic than MSM, which is a crystalline solid that is odorless, tasteless and readily dissolves in water.

    We completed a double-blind, placebo- controlled, pilot trial showing that 100 percent of the subjects on Lignisul MSM (methyl- sulfonyl-methane) increased hair growth, compared to the group on placebo1. Only one subject on placebo showed an increase in hair length. In addition, 30 percent of the subjects on Lignisul showed improvement in hair brilliance, while none of the subjects on placebo showed such an improvement.

    A second double-blind, placebo-controlled, pilot trial, conducted simultaneously, showed that 50 percent of the subjects on Lignisul MSM showed increased nail length and nail thickness growth compared to the group on placebo1. Approximately 10 percent of those on placebo showed increased nail length growth. None of the subjects on placebo showed an increase in nail thickness.

    Based on the results of the two trials, we concluded that oral supplementation with Lignisul MSM is a valuable addition to hair and nail growth. Hair and nail health was significantly improved in a short term of six weeks.

    The hair trial involved a total of 21 patients—16 women and 5 men. Data was collected by certified cosmetologists under my direction. The trial parameters included hair length, brilliance and diameter of the individual hair shafts using industry standard measurement scales.

    The nail trial involved a total of 11 subjects— 10 women and one man. Again data was collected by certified cosmetologists. Trial parameters included nail length, thickness, luster and general appearance using industry standard measurement scales.

    All subjects supplemented with Lignisul MSM were duly impressed with the changes in the health and appearance of their hair. The cosmetologists literally could differentiate which participants were on MSM by the appearance of the hair alone after six weeks.

    While researchers make no claim for cures, as a food supplement or dietary ingredient the following conditions seen in the clinic have responded to oral Lignisul MSM:
    • Allergies
    • Arthritis
    • Acne
    • Cancer: breast, colon
    • Hyperacidity/heartburn
    • Constipation
    • Burns (thermal)
    • Brittle/soft nails
    • Diabetes
    • Eye health
    • Hypersensitivity to drugs
    • Insect bites
    • Lung disease
    • Lupus
    • Mental acuity
    • Muscle soreness/pain
    • Oral/dental health
    • Parasites
    • Rheumatoid arthritis
    • Scar tissue
    • Snoring
    • Skin, hair and nails
    • Stress
    • Sunburn
    • Joint health—MSM combined
    • with glucosamine


    1. The Effectiveness of the Use of Oral Lignisul MSM (Methylsulfonylmethane) Supplementation on Hair and Nail Health

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