The omega-3 fatty acids can reduce inflammation by altering the balance of pain producing prostaglandins and leukotrienes (Wein Klin Wochenschr, 1986; 98: 104-6, N Eng J Med, 1985; 312: 1217-23). Omega-6 fatty acids in the form of either borage oil or blackcurrant oil may also help reduce inflammation (Am J Clin Nutri, 1992; 55: 39-45).

WDDTY panellist Harald Gaier has found that Urarthone (available from the Nutri Centre, Tel: 0171-436 5122) is quick and effective in alleviating joint problems. It's a mixture of some 18 different natural ingredients, which should be taken in water twice a day.

Another of our panellists, osteopath Dr. David Charlaff, cautions: "Bursitis usually involves a number of different tissues and other elements around the pain site, and not simply the fluid filled sac between muscles, muscles and tendons, and tendons and bones, called the bursa."

He suggests first trying local and distal acupuncture particularly effective with electro stimulation. Secondly, if the pain is bilateral (on both sides), it could have a spinal cause, which osteopathy could deal with effectively. To reduce inflammation, he suggests homoeopathy initially using remedies such as Arnica, Ruta grav and Rhus tox in 6th or 30th potencies, depending on the indication. If they don't work, he would then use herbal medicine.

There is good research to show the efficacy of herbal preparations in cases of bursitis. There are, for instance, hundreds of papers on the applications of bromelain in cases of inflammation due to arthritis, sports injury or trauma (J Ethnopharmacol, 1988; 22: 191-203). Bromelain has been shown to stimulate the production of anti inflammatory prostaglandin E1 (Med Hypoth, 1980; 6: 99-104) and may inhibit the synthesis of pro inflammatory prostaglandin E2 (Arzneim Forsch, 1986; 36: 110-12).

Curcumin, the pigment and active component of turmeric (Curcuma longa), has long been used in Ayurvedic medicine, locally and internally, for sprains and inflammation. The recommended dose is 400 to 600 mg three times daily (Agents Actions, 1989; 28: 298-303).

Feverfew may also be effective in reducing the synthesis of prostaglandin E2 and the formation of leukotrienes and thromboxane, all of which are involved in the inflammatory and pain process (Lancet, 1985; i: 1071-4). Feverfew's efficacy is dependent on the level of parthenolide in the preparation used. Most clinical trials have a parthenolide content of 0.4-0.66 per cent.

David Charlaff also recommends remedial exercise, such as simple yoga or the Pilates method. A recent review shows that gentle stretching exercises, combined with nutritional supplements, may be the best way of keeping joints in good shape (Townsend Letter for Docs and Patients, April 1998). Be aware that it can take up to 18 months for pain to disappear completely. If the pain lasts longer, you may need to have further analysis, such as ultrasound, to determine the cause. However, Charlaff acknowledges that there is a certain amount of trial and error in whatever method one uses. Although removing your amalgam fillings was probably a good first step, detoxification can take some time particularly if you had many fillings in your mouth for a long period of time.

Finally, you may want to reconsider your use of blue green algae, also known as AFA (Aphanizommenon flosaquae). Recent reports are that some algae products, particularly those harvested from the Klamath Lake region of Oregon in the US have produced undesirable side effects such as nausea, vomiting chills and malaise symptoms usually associated with the presence of toxins (Proof!, 1998, 2: 20), causing or exacerbating chronic pain.