Arthritis is one of those classic examples where medicine not only doesn't sort out the problem but creates a new one besides. An estimated 8 per cent of the population suffers from rheumatoid arthritis and 12 per cent from osteoarthritis, making arthritis in all its forms one of the most common diseases in the West.Conventional medicine tends to take the view that there is no known cause or cure for arthritis, and therefore can only offer to alleviate your pain. The most common drug for both rheumatoid and osteoarthritis used to be aspirin at high doses. This is now rapidly being replaced by a class of drug entitled "non steroidal anti inflammatory drugs", or NSAIDs, as they're known in the trade. In the case of arthritis, this is a misnomer, since NSAIDs don't stop the progression of the disease, only its pain. In America, there are 14 such drugs on the market; in the past year one of them (ibuprofen) has even been taken off the list of prescribed drugs and made available over the counter. Increasingly doctors now turn to NSAIDs as a first port of call; in a 1984 study showed that nearly one in seven Americans was treated with one of these drugs, a figure that is now grossly out of date as they are prescribed for everything from headaches to period pains. Arthritis alone is a $10 billion industry.

But at such cost! Increasing evidence points to the fact that patients taking NSAIDs have a high risk of developing ulcers or other life threatening gastrointestinal problems, to the point where medicine has now developed a drug to treat the side effects of the drug used to treat the problem! Before long, undoubtedly we will see a third drug on the market to treat the side effects of the drug used to treat the side effects of the first. . . Here's a review of some of the problems with NSAIDs, with some safer options.

Arthritis actually refers to any inflammation of a joint. Osteoarthritis (OA), the milder form, is considered the result of "wear and tear", occurring with little or no inflammation. Commonly considered the inevitable disease of old age, it also strikes after infection or injury, and is mainly confined to the joints, usually weight bearing joints like the knees and hip joints and also those of the spine.

Rheumatoid arthritis (RA), on the other hand, is a young person's disease, most likely striking victims (usually women) between 20 and 40 years of age. Thought to be an auto immune disease, where the body reacts against itself, it not only affects one or a number of joints, such as those in the fingers elbows, wrists, ankles or knees, but spreads to other parts of the body. After the inner lining of the joint becomes severely inflamed, it becomes scarred, until scar tissue fills the space within the joint, deforming the underlying bony surfaces and wasting the muscles. This is not an inevitable progression, however; one in ten patients is thought to recover within two years.

With rheumatoid arthritis, the medicine attempts a two pronged attack, to alleviate symptoms and to stop the disease from causing permanent joint destruction. For inflammation and pain, doctors use either NSAIDs or SAIDs ie, steroidal anti inflammatory drugs. To try to treat the problem, they use what are called the anti rheumatic drugs anything from sulphasalazine to gold, anti malarial drugs to cytotoxic drugs (chemotherapy) to immuno suppressants, particularly those used during transplant operations. It is thought that these drugs will act to stop whatever auto immune destruction is going on. In every case, it is a decidedly hit and miss affair, with doctors coming upon something that seems to work in the course of treating something else.