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Wednesday, 24 February 2016

Most Common Disease of elder: The Clinical trials and Studies of Musculo-Skeletal disorders(MSDs) - Rheumatoid Arthritis: Willow bark in TCM

Kyle J. Norton (Scholar, Master of Nutrients, All right reserved)
Health article writer and researcher; Over 10.000 articles and research papers have been written and published on line, including world wide health, ezine articles, article base, healthblogs, selfgrowth, best before it's news, the karate GB daily, etc.,.
Named TOP 50 MEDICAL ESSAYS FOR ARTISTS & AUTHORS TO READ by Disilgold.com Named 50 of the best health Tweeters Canada - Huffington Post
Nominated for shorty award over last 4 years
Some articles have been used as references in medical research, such as international journal Pharma and Bio science, ISSN 0975-6299.

Musculoskeletal disorders (MSDs) are medical condition mostly caused by work related occupations and working environment, affecting patients’ muscles, joints, tendons, ligaments and nerves and developing over time. A community sample of 73 females and 32 males aged 85 and over underwent a standardised examination at home. Musculoskeletal pain was reported by 57% of those interviewed. A major restriction of joint movement range was frequent in the shoulder but uncommon in other joints(1).

Types of Musculo-Skeletal disorders in elder(2)
1. Osteoarthritis
2. Gout
3. Rheumatoid Arthritis
4. Polymalagia Arthritis
5. Cervical myleopathy and spinal canal stenosis
6. Osteoporosis
7. Low back pain
8. Fibromyalgia


                      Rheumatoid Arthritis

Rheumatoid Arthritis is defined a chronic disorder as a result of inflammation, affecting mostly the flexible (synovial) joints and tissues and organs in the body. The disease affects more women than men and generally occurs after the ages of 40, causing diminished quality of life of many elders(1). According to CDC, Musculoskeletal disorders (MSDs) affects over 52 millions of adults in the US alone, including 294,000 children under age 18 with some form of arthritis or rheumatic conditions(2). Rheumatoid Arthritis can induced bone loss through elevating bone resorption without increasing bone formation(4). A cross-sectional population-based study of 1042 patients with rheumatoid arthritis showed that RA patients had an increased risk of death from various causes(4a).


                          The Treatment

B. Treatment in herbal and traditional Chinese medicine

B.8. Herbal and Traditional Chinese medicine 
Many herbal medicine have been found effectively for reduction of symptoms and treatment for patient with osteoarthritis(340), including
B.8.1. Individual herb
3. Willow bark
A herbal medicine used over thousands of years for treatment as an anti-inflammatory, antipyretic, and analgesic advocate in many culture(433, 350) and may be a potential agent for inhibition of pro inflammatory cytokines(351)(352) due to its phytochemical polyphenols(351).
Unfortunately, according to randomized double-blind controlled trials, willow bark extract showed no relevant efficacy in patients with OA and with RA(353).
In support to above, study conducted by the Columbia University showed that ethanolic extracts from willow bark with daily doses up to 240 mg salicin over periods of up to six weeks exhibits no significant improvement in patients with rheumatoid arthritis(354).

(1) 8 Areas of Age-Related Change(NIH)
(2) Arthritis-Related Statistics(CDC)
(3) Valgus deformities of the feet and characteristics of gait in patients who have rheumatoid arthritis by Keenan MA1, Peabody TD, Gronley JK, Perry J.(PubMed)
(4) Serum Sclerostin Level Among Egyptian Rheumatoid Arthritis Patients: Relation to Disease Activity ,Bone Mineral Density and Radiological Grading by Mehaney DA, Eissa M, Anwar S, El-Din SF(PubMed)
(4a) Death rates and causes of death in patients with rheumatoid arthritis: a population-based study by Sihvonen S1, Korpela M, Laippala P, Mustonen J, Pasternack A(PubMed(340) Expert consensus on the treatment of rheumatoid arthritis with Chinese patent medicines by Zhao J1, Zha Q, Jiang M, Cao H, Lu A(PubMed)
(350)
(351) Inhibition of proinflammatory biomarkers in THP1 macrophages by polyphenols derived from chamomile, meadowsweet and willow bark by Drummond EM1, Harbourne N, Marete E, Martyn D, Jacquier J, O'Riordan D, Gibney ER.(PubMed)
(352) An in vivo study examining the antiinflammatory effects of chamomile, meadowsweet, and willow bark in a novel functional beverage by Drummond EM1, Harbourne N, Marete E, Jacquier JC, O'Riordan D, Gibney ER.(PubMed)
(353) Efficacy and safety of willow bark extract in the treatment of osteoarthritis and rheumatoid arthritis: results of 2 randomized double-blind controlled trials by Biegert C1, Wagner I, Lüdtke R, Kötter I, Lohmüller C, Günaydin I, Taxis K, Heide L(PubMed)
(354) A systematic review on the effectiveness of willow bark for musculoskeletal pain by Vlachojannis JE1, Cameron M, Chrubasik S.(PubMed)