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arthritis and some alternative therapies

AUTHOR: Marc Mitnick DPM

REVIEWED BY: Podiatric Medical Review Board

--> arthritis

Arthritic pain can be very crippling. The foot is no exception. Look at the pictures below. It is easy to see the difference in a normal foot x-ray (right) versus an x-ray of rheumatoid arthritis (left).

Historically joint pain relief has been achieved through anti-inflammatory medication (NSAID's). This class of medication can be very helpful but some people may pay a price for this type of pain relief. Over long term usage many people can experience stomach problems due to the irritation of the stomach lining from the medication. Less known side effects include kidney trouble and because many of these drugs retain sodium, they can elevate blood pressure in those with salt sensitivities,particularly the elderly.

This includes the over-the-counter brands as well. Click here for a warning issued by the FDA concerning this class of medication (December 2006).

Because of the potential problems with anti-inflammatory medication I tend to limit the duration that I allow my patients to take the medication. My opinion is that pain reduction through the use of this type of treatment is not a permanent solution and should be considered temporary at best.

For this reason anti-inflammatory medication can be very helpful for acute arthritic flare-ups. In acute attacks, along with medication, physical therapy can be very useful.

When necessary I will also give a cortisone injection.

In the foot and ankle, strapping and padding the affected area may also bring relief, which eventually may lead to the use of an orthotic which works by stabilizing the foot so there is less stress on the joints of the foot. Less stress on joints=less pain. An orthotic will also cushion the foot which will also lead to a reduction in arthritic pain. Take a look at the KLM orthotics to the right; they are an amazing orthotic at a very affordable price.

The problems with arthritis arise in the chronic form, or the progressive form where the problem just keeps getting worse. In these cases things like cortisone injections or physical therapy may reduce the discomfort but the pain will usually return at some point in time.


The type of arthritis most often seen in the feet is known as osteoarthritis, or the "wear and tear" type of arthritis. This condition is also known as degenerative joint disease. Basically, the joint just wears out over time. It is worth mentioning that the feet are not the only place where osteoarthritis occurs, if affects almost all joints in the body.

Some examples in the feet include bunions, hammertoes and midtarsal fault

Individuals with this type of arthritis will usually experience morning stiffness. You get out of bed and your joints seem stiff; they just do not move freely. However, as you move around, the joints loosen up and within a short period of time, you are moving freely. This is the early form of osteoarthritis.

In the latter stages not only will you experience morning stiffness, but the affected joints will actually worsen the more you move around. This is a sign that your problem has worsened. This is also the symptom that brings most people to the doctor's office.

Typically, the very earliest signs of osteoarthritis is a narrowing of the joint space between the two bones that form a joint, as seen on x-ray. To the casual observer, this is easily missed. What this tells us is that the cartilage has eroded and so the two bones are closer together which limits motion and causes at the very least, morning stiffness.

If you are just beginning to experience osteoarthritis or even if you have had if for a while but it is not too severe, there are things you might consider doing to slow down the process as it relates to pain in the foot or ankle.


Lose weight-If you are overweight, look to lose that weight. Realize that the heavier you are, the more pressure you put on your feet and ankles and so the quicker the joints will wear out. If you are presently suffering now you can pretty much assume it will only get worse with time.

Exercise-If you lead a sedentary life style consider exercise. The more you exercise the more you force the joints of the feet (and elsewhere) to move and so the less inclined they are to stiffen up. This may seem like a paradox because excessive movement of the joints is what initially caused the joints to wear out, but continued movement through exercise is what keeps them as limber as possible. When a joint is stiff and then is called upon to move, this limitation of motion is what causes pain.

Drink lots of water-There is a debate out there today as to whether or not clean water in large daily doses is healthy or not. As it relates to arthritis, drinking large amounts of water daily keeps the cartilage (which is the end of the bone that meets the end of the other bone to form a joint) well hydrated and the better hydrated it is the more function you will get out of the joint.

Avoid all types of carbonated soft drinks-The phosphoric acid in soda creates an acidic environment in the body and the way the body tries to neurtralize it is to pull calcium out of your bones aggravating osteoporosis. (it also pulls calcium out of your teeth). The same problem arises in people who eat too much red meat.

Surgery?-In spite of all this there are individuals who suffer so much that eventually they must entertain surgical intervention. In an otherwise healthy individual I will recommend surgery if all conservative care has failed to bring adequate relief. It is all based on the quality of life a person wants to live. I have operated on people in their 80's because their foot pain was keeping them from doing the things they wanted to do. Of course in the elderly population the criteria for surgery is much more restricted and there is a limitation on the procedures that can be performed.


In this day and age many people are looking for alternative forms of treatment to alleviate arthritis and musculo-skeletal pain. One popular alternative is the use of Glucosamine sulfate. This nutritional supplement has anti-inflammatory properties similar to the anti-inflammatory medication on the market with less likelihood of stomach upset. Most of the original studies with glucosamine were done in Europe and involved primarily knee pain.

My experience has been that it can be effective in some individuals. For those who experience success with the supplement it is a wonderful alternative. However, like any other “pain reliever” it will only work on a certain percent of those who try it. I generally recommend one gram in the morning (two 500mg tablets) and 500mg at night. I suggest to my patients that they try it for at least three months and then decide if it is helping.

I usually only recommend glucosamine sulfate and not glucsomine with chondroitin. Chondroitin is supposed to regenerate cartilage but I think the jury is still out on that.

The only contraindication to glucosamine is for people who are allergic to shell fish since glucosamine is made from shell fish.

So, is there a natural pain relief for arthritis? Below are some other little known remedies that you can try. They are safe and inexpensive. I would not recommend trying multiple combinations at the same time.

DRINK TEA- research has shown that green tea is rich in polyphenols; a compound that suppresses a key gene involved in arthritis inflammation. Drink one or two cups of hot or cold tea each day.

EVENING PRIMROSE- BLACK CURRANT AND BORAGE OILS-contain the essential fatty acid gamma linolenic acid (GLA), which reduces joint inflammation. Adding good oils like these to your body -- and eliminating your intake of bad ones such as saturated oils -- can help you feel better overall. Take up to 2.8 g of GLA daily.

GINGER- is a popular choice for inflammation and pain relief. Pour boiling water over the grated root to make a tea, or add fresh ginger to your meals. If you want a stronger remedy, take 1 g to 2 g of the dried powder in capsule form two or three times daily, or use 1 ml to 2 ml of the tincture three times daily.

MSM (Methylsulfonylmethane) - organic sulfur -- has natural anti-inflammatory benefits because sulfur is an integral component of cartilage. Take 2,000 mg to 8,000 mg daily. Reduce dosage if diarrhea occurs. It is also available in combination with Glucosamine.

SAM-e (S-adenosylmethionine) - is an excellent supplement to reduce the symptoms of arthritis. A naturally occurring substance in the cells of the body that activates chemical reactions. In regard to the joints, SAM-e's methylation helps prevent the loss of water in cartilage, which keeps the joint more flexible. Take 600 mg to 1,200 mg daily for two months, followed by 400 mg to 800 mg daily as a maintenance dosage.

BOOST YOUR INTAKE OF VITAMIN C AND D- vitamin C is believed to slow the loss of cartilage due to osteoarthritis, while a diet low in vitamin D has been shown to speed the progression of osteoarthritis. Daily recommendations for vitamin C is 500-1000mg. For vitamin D, take 400 IU’s daily.

WILLOW BARK AND BOSWELLIA- willow bark is where aspirin comes from, while boswellia has been used for centuries to reduce inflammation and maintain healthy joints. Take 240mg of willow bark and 1000mg of boswellia per day.

EAT GRAPES- grapes contain resveratrol, which is a natural compound known to act as a COX-2 inhibitor. Eat one cup of white or red grapes daily. Additionally, grape juice, unsweetened, and wine contain resveratrol as well.

FISH OIL CAPSULES- fish oil among its many benefits will "lubricate" arthritic joints. Take them for a few months and you should start to experience less discomfort in your achy joints.


In the United States vitamins and nutritional supplements are not under the jurisdiction of the the FDA. Because of this there are a lot of "snake oil salesman" out there. Particularly on the internet you will find outrageous claims made by people looking to make a quick buck.

Secondly, if you buy low grade quality vitamins they either will be manufactured from very cheap sources or many times you will not get the actual dose listed on the bottle. Your 500mg. of vitamin C may actually only contain 400mg.(as an example).

I am a big believer in the value of nutritional supplements but believe you also have to rely on natural food sources as well as vitamins to get a balanced mix for a healthy diet. Never use vitamins and supplements as a quick fix for poor eating habits.

If you do take supplements you should be taking "pharmaceutical grade" vitamins. The company you buy from should adhere to the "Good Manufacturing Practices" protocol.

Otherwise, you have no guarantee of getting the benefit you hope to derive from taking supplements. You are just wasting your time and money.


Mayo Clinic

Arthritis Foundation

Medline Plus

Want more information? CLICK HERE

For more information on this subject, check out the links below.

Alternative treatments- from

Arthritis - provides helpful information

One of the best resources on alternative medicine, visit:
Life Extension

ORTHOTICS for multiple types of foot pain
best buy in a pre-made orthotic
click link below


ORTHOTICS for heel and arch pain for those who must wear dress shoes
click link below


I've been doing some aggressive research lately (it's how I found your incredible website) and realize now that my symptoms are not consistant with the diagnosis. Jennifer

Hunterville, NC
….after reviewing your amazing site (great for the avg. jill). So thank you very much!!!


I am really, really impressed with your plain-speak explanations for the various conditions.


This was an extremely helpful site. I have an appointment on the 18th and your info. Was right on target…..


A well organized site containing much information written in a manner that the average reader can comprehend.


Ontario, Canada
I found your website and articles most interesting.


Thank you for a quick response. I think your site is the best information site on foot pain and I have viewed many.


(location unknown)
I came to your website, via www.foot-pain explained .com which I think is also your website? I thought explanations for different types of problems were well addressed and thoughtfully stated for the patient in mind.


New York
You have an amazing and extremely informative site. I enjoyed looking through all of the data and stats.


Memphis, TN
Thanks again so much for the information in the article. Very interesting.


Great article. I have had plantar fasciitis since I was in high school……..

J. Simmons

(location unknown)
Dear Dr. Mitnick, The orthotics arrived four days ago and I slipped them into my shoes immediately. I was skeptical as to the usefulness of the item, they really didn't look very exotic. I have to say though, after using them for just four days, I have experienced grand relief from my foot pain. Even the very first day, I was able to do a lot of work while on my feet with at least a 75% reduction of pain. It has only gotten better every day, and I go nowhere without my shoes with the orthotics. I had been experiencing extreme heel and sole pain for about six months and had to take extended breaks off my feet many times a day as well as regular doses of Ibuprofen. Since getting the orthotics, my life has returned to normal and I feel good again. Just wanted to say thanks for the recommendation for a very effective item, I had no idea what a change this item could affect.

Yours truly,

J.C. Forbes

Thanks for the Response, you hit it on the head.


Redondo Beach, CA
Thank you for your time and expertise in answering my question…..


(location unknown)
First, thanks for putting together this website. Its the most informative site I have found dealing with foot problems. Last June I started having pain and swelling at …….


(location unknown)
First of all, thank you for having all this useful information available in one place. I've been through most of your website and based on my research, pain and evaluations I think I've narrowed things down quite a bit.

Pete M.

(location unknown)
Thank you for the best site I have found when researching foot pain.

Glenda B.

Madison, Alabama
Thanks for replying so quickly. I was a bit concerned. I think your website is great, and chock full of info.....


Denison, TX
Dr. Marc, Thank you so much for your reply which seemed to be right on. I have researched many sites but you put me on the right path to the possible answer. My foot pain may not rule the rest of my life after all! I believe I'll make a sign that reads, "THE END IS NEAR!" Thanks Very Much,


West lafayette, IN
Dear doubt you get positive comments re your site...May I please be added to the list of your admirers. In all of my years of web surfing I would say your site is right there with the very best. Thank you for taking the time to write the terrific info you provide and for putting things into laymen terms for us mere mortals. I pray you have much on going success and thank you again for a deed well done. As for me I did not find much help for my symptoms and will continue on my quest. Were you anywhere in the South I would make and appointment...Thanks again dear sir...m.e.

Michael E.

Tampa, Florida 33624
Hi. This is a great site! I'm a healthy middle aged woman who is in good health, but.....


Just a wee word of thanks for your wonderful website...It is a terrific service...Thank you for providing your knowledge and help...With highest regards, m ebeling

Michael D. Ebeling

Tampa, Florida 33624

Thanks for a most interesting website, which has helped a lot.



Dear Dr.Mitnick

I usually do my research on the Mayo clinic website. I think your website is the most informative site I have found when researching foot pain.

I thank you for putting together this incredible website.


Dragica W.


....I have been told that it is not hard enough to be cut off. Please help, I am not sure what to do now! THANKS FOR A WONDERFUL AND VERY HELPFUL SITE!


South Africa

You have an unusually clear, informative and well-written website for laypersons. Thank you for that.

Matthew W.

Mansfield Ctr, CT

First, I'd like to thank you for all the information that you provide on your website and the opportunity to write to you.


Placentia, California

First, I want to let you know that you have the best web site I've found related to foot issues. (The only thing I had difficulty finding was the "ask a question" page.)


Unknown location

I received the orthotics Monday afternoon and began wearing them Tuesday. After two days I would say that I have noticed a huge improvement in the discomfort I have been experiencing. My foot feels better than it has in months.

Ric J.

Unknown location

I greatly admire someone like you who would donate and dedicate so much time and effort to helping strangers with no compensation. Truly, it is uncommonly kind. And your site is so intelligently arranged.

Ron R.

Pacific Grove, CA

I used to work for a podiatrist (front desk) back during summers in college years ago, so I know the benefits of good care. Again, I want to thank you for an EXCELLENT website. It was so great to get to your site (top of google search) and actually find all the answers I needed EASILY and QUICKLY! Clearly you put a ton of work into it and I really appreciate it.

All the best,


Alameda, California

By the way, millions of websites could use yours as a guideline on how to organize information and make the site user-friendly. Kudos to you!


Thank you for your very interesting and informative site!


Hi. I come to your site often looking for information. It is really informative and I appreciate it very much. I have RA and have been having considerable amount of foot pain...... Dee RN

Thanks very much for the wonderful informative site.


New Zealand

Thank You for my answer! I have been schedule for a bone density scan, allingment, and I am in the process of getting orthotics made, and checking out the natural remedies. Thank again! What a great web site!



Yes I want both pair of orthotics. You don't have an option of ordering 2 at one time so I had to place the order twice. Thanks. My husband likes these and wants to put them in all of his shoes. (referring to Superstep orthotics)

Cindy H.

I searched the internet everywhere for a clear description and illustration of my symptoms/problem. was where I ended my search with answers. If I lived in Jersey (left 30 years ago) and didn't live in Florida I would definetly make an appointment with Dr. Mitnick.

Thanks, Kathy

1st of all THANKS A LOT for your great site......


Thank you so much for your response. I will let you know how I am doing if you would like. Your website is awesome!


South Carolina
Hello! I want to thank you for such an informative website! I found you based on my ankle pain search and am happy to realize that there may be a relatively simple cause and solution....


unknown location

...Thanks for your fantastic service.


Arlington, VA

Thank you so very much, that would be much appreciated. I love those insoles, by the way. (referring to Superstep orthotics)

Kelly W.

San Clemente, CA

Dr Marc is fantastic...He seems to know exactly what you are feeling with the problems you are having. I wish he was in my home town so I could go to him with my problems!!!!!!!!!!!!!


location unknown

Great insights! Thanks Doc, you're the best.


location unknown

I have been experiencing foot pain of various sorts and am working to figure out what it is. I found this site and can only say BRAVO!! What an excellent site! The time it must have taken to put all this together must've been a daunting task! I am sure it has helped so many people. Thank you so very much for doing this.


location unknown

Dr. Mitnick, Thank you so much for your reply. I did let my physician know and they took an x-ray - all is well! Also, thank you for providing this wonderful site, it is very helpful with lots of useful information! I appreciate your gift of time! God bless.


Dr. Mitnick, Thank you, you were 100% correct. The pain finally brought me to the ER. I spent 8 days in the hospital. The Doppler you spoke of was able to show that there was no pulse in that foot. This was an arterial clot that split and traveled throughout my leg. My leg was almost amputated. I am in rough shape but have all my parts intact!! You certainly know what you are talking about. Thank you for taking the time to answer. Yours Truly!


Staying at home after hallux surgery I spend quite a lot of time seaching info useful for avoiding problems which might come back. Today I found your site and I am .... delighted it happened. It's one of the best site I found last days.



Thanks for taking time to read and answer so many questions. It is truly a public service!


Seattle, WA

I just wanted to say that I am very greatful for this website!!


location unknown

Also, and importantly, just want to praise this web site. Thorough and thoughtfully presented, it certainly must be of considerable assistance to anyone with a foot problem. Terrific -- and very interesting.I trust the address comes up easily for those seeking information.


New Jersey

Thanks so much for answering my question. You've been more help to me than my own Dr. has been lately. Thanks again....I hope to be able to walk without pain someday.


location unknown

Wow, that is exactly the information needed!!! thank you thank you thank you!!! I appreciate this help so very much from Marc Mitnick DPM. Excellent information and help to improve One's life.


location unknown

Thanks so much for this website Dr. Marc! It is so nice that you have this ask the doctor feature..I'm sure I'ts been helpful for alot of people. I will try what you suggested and see if it helps...thanks again!


Evansville, IA

Dear Marc

I just want to say thank you for the quick response and the good info. I find it amazing and a super nice thing that you do here by answering medical questions at no charge.

Russ W.

location unknown

Your website is full of a lot of helpful information, and I am very impressed with the time in which you responded to my post. Thank you again for your time and consideration in your response.


location unknown

Thank you very much for the information, I will consider it. Excellent web site.


San Diego, CA

Dr. Mitnick, Just want to say thank you so very much for your quick response and very informative reply! After reading what you had to say, I called the doctor's office and was able to get in and see him the same day as my injury. Toe was x-rayed and luckily, it is not broken or fractured. Very badly bruised and will probably lose the toe nail. And although my toe and toe nail are still very black and blue and very sore, they ARE both starting to feel a little better. So again, thank you! I am so very happy that I came across your website. The service you provide is outstanding and immeasurable!


Albany, NY

Thank you so much for all of your advice. In searching the web for people dealing with this same issue i can tell you that you are a Knight In shining Armor! If I lived in Jersey I would gladly be your Spokesperson. Hopefully next time you hear from me it will be good news. God Bless,

Jill S.

location unknown



Whichita, KS

thanks again, this site is very helpful.


Boston, MA

Like others have stated...This site is amazing and I am so thankful that it was created.

....Keep up what your doing. Your a life saver.



Thanks again for the information provided on your site. It's easy for non-medical folk to understand your writing, and helps provide better communication between patient and doctor.



Wonderful advice

by: Anonymous

This is the best site for foot problem info.

Thank you for this information. This description fits my pain and inflammation behind my 2nd toe perfectly.

by: Max

location unknown
Again, I really appreciate that you responded to my inquiry, and that your mention of Parkinson's helped me to find my way to a diagnosis of this difficult to diagnose disease. Most patients see on average 16 doctors before they are diagnosed. I hope that you can help other people that ask for your expertise in the future.

Barb D.

I just wanted to say that I am very greatful for this website!! I have had a fusion in my rt foot and am finally getting a little bit better......


location unknown
Again, Thank you from the bottom of my heart for taking the time to answer my question....your an angel!


Thank you for your response. You have provided some great insight (to my question)....


location unknown
Thank-you so very much for responding so quickly and in such detail to my question!! I will give my surgeon a call today!! This website is terrific!!!! Thank-you again!


North Carolina
Many Thanks Dr Marc!
Thank you for your response. It sounds like a good plan to me. He did not cut the wart out first ...


location unknown

Thanks again doc for having this website and we STILL need qualified Podiatrists in beautiful sunny Tampa Bay (Bradenton) Florida.

Bessie Mae

Dear Dr. Mitnick, Thank you so very much for taking your time to answer my question. You have greatly relieved my anxiety related to the continual tingly I feel in my feet. I will share your response with my podiatrist next week. God bless you for having this question and answer page on your website! Most gratefully,

Lynne T.

location unknown
Your webpage is excellent, I commend you on sharing your knowledge to the public.


New Jersey

Thank you. you were more detailed than what others have told me they finally called from the last xrays and my son is now in a cast for 2 weeks he did have a fracture that was not noticeable.

a mom

location unknown

I have read your website and I have to admit that I am amazed at all the information that is on here. I have learned more than the three years I have been going to several doctors that I have seen!!


Lenoir, NC

Thank you so much Doc for a quick and thorough response!


Bellevue, WA

I cannot thank you enough for your response, opinion, and suggestions! I want you to know how much it means to me, and I'm sure everyone else who has ever asked you a question! I feel like you're a lifesaver and have empowered me to take a stronger role and stand up for myself and my feet!


location unknown

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