Karissa Sellman used to love biking for hours on the trails outside of San Francisco. But those long excursions are a thing of the past. A technical writer, Sellman suffers from joint pain in her fingers, wrists, elbows, and shoulders — the result of repetitive stress injury (RSI) associated with years of heavy typing.

She isn't alone. Joint pain is an everyday reality for millions of Americans. And cardiovascular and gastrointestinal risks associated with nonsteroidal anti-inflammatory drugs (NSAID), such as Aleve, and newer pain-inhibiting drugs, such as Celebrex, have sent many looking for relief from safer alternatives. Fortunately natural diet and lifestyle changes can help. Here are a few to try.

Eat to eliminate pain

Whether you're suffering from osteoarthritis or RSI, eating the right foods — and avoiding the wrong ones — can help ease pain. “Because cartilage, tendons, ligaments, bones, and muscles are primarily made up of the structural protein collagen, eating to slow the breakdown of collagen or enhance its rebuilding is going to help no matter which type of tissue is at the root of your problem,” says Shawn Talbott, PhD, author of Natural Solutions for Pain-Free Living (Currant, 2006).

Include more whole grains in your diet and fewer refined carbohydrates, such as white bread and sugar, which set off a chain reaction of oxidation and inflammation in the body, says Talbott. He also recommends consuming lots of brightly colored fruits and vegetables — particularly berries, tomatoes, and carrots, which are packed with carotenoids, flavonoids, and other important antioxidants.

Working in the right fats, such as the omega-3 fatty acids found in salmon, flaxseed, and walnuts, can also help decrease inflammation. Avoid trans fats (in processed and fried foods) and saturated fats (in red meat and dairy products), which boost levels of pro-inflammatory cytokines. Of all the omega-3s, EPA — found in deep-water fish and fish-oil supplements — tends to be the best anti-inflammatory, says Jason Theodosakis, MD, author of The Arthritis Cure (St. Martin's Griffin, revised 2004). For recommended doses, see sidebar below.

Take proven supplements

Glucosamine and chondroitin are the most popular joint-related supplements in the United States — for good reason. The National Institutes of Health conducted the Glucosamine/Chondroitin Arthritis Intervention Trial in 2005 to compare the effect of these supplements with that of Celebrex on joint pain. The study found that combining glucosamine and chondroitin provided the most relief for people with moderate to severe pain.

Herbal supplements can also reduce pain and help joint tissues heal. Boswellia (Boswellia serrata) and scullcap (Scutellaria lateriflora), for instance, are known to interfere with enzymes that contribute to inflammation. “These two work well together to inhibit the main inflammatory pain enzymes, COX-2 (cycloxygenase-2) and 5LO (5-lipoxygenase),” Talbott says.

Move more, stress less

Although it's often difficult for people with joint pain to be active, proper exercise helps control inflammation and pain. “It is also the best way to deliver nutrients to your tissues and rid them of debris from the rebuilding process,” Talbott says.

For people with arthritis in their knees or hips, Theodosakis recommends cycling outside or on a stationary bike, which has been shown to stimulate cartilage cells and strengthen the structures around joints. Start slow and work up to 30-45 minutes four or five times a week.

Managing stress through exercise, meditation, journaling, or yoga can also help alleviate joint discomfort, Talbott says. “When you are stressed, your body produces cortisol, and chronic exposure to cortisol leads to more inflammation.”

TOP PAIN-RELIEVING SUPPLEMENTS

  • ASU (avocado-soybean unsaponifiables)

    Modifies the body's inflammatory response. ASU has been shown to reduce the need for anti-inflammatory drugs, alleviate pain, and improve joint function. Takes 30-60 days to reach full effectiveness. DOSE: 300 mg daily

  • Boswellia (Boswellia serrata)

    Boswellic acids interfere with COX-2 and other enzymes that contribute to inflammation and pain. DOSE: 400-1,200 mg daily (depending on strength)

  • Chondroitin

    A natural lubricant that helps maintain cartilage elasticity and transport nutrients to joints, halting the long-term loss of cartilage. Takes approximately six months to reach full effectiveness. Some benefit may be apparent sooner. DOSE: 1,200 mg daily (often taken with glucosamine)

  • Fish oil

    The omega-3 fatty acids EPA and DHA found in fish encourage the production of anti-inflammatory prostaglandins; EPA is the most beneficial for easing joint inflammation and pain. Takes about 12 weeks to reach full effectiveness. DOSE: 1,000-2,000 mg EPA daily

  • Glucosamine

    Glucosamine sulfate, or HCL, reduces inflammation and prevents joint deterioration. Takes about six months to reach full effectiveness. Take in a single dose (not split over the day) for the most benefit. DOSE: 1,500 mg daily (often taken with chondroitin)

  • SAM-e (S-adenosylmethionine)

    Shown to have an equivalent effect on relieving osteoarthritis pain and improving joint function as low-dose NSAID. May take up to three months to reach full effectiveness. DOSE: 800-1,600 mg daily

  • Scullcap (Scutellaria lateriflora)

    Another herbal COX-2 inhibitor that works well in combination with boswellia. DOSE: 250-500 mg daily

Sources: Jason Theodosakis, MD, author of The Arthritis Cure (St. Martin's Griffin, revised 2004); and Shawn Talbott, PhD, author of Natural Solutions for Pain-Free Living (Currant, 2006).