October 12th-20th was Bone and Joint National Action week. The goal is to raise awareness of the possibilities for prevention, management and treatment of all forms of arthritis. We decided it was a good time for a blog on Arthritis.
Arthritis is the leading cause of physical disability today. Currently, 22.2 % of Americans over 18 have been diagnosed with arthritis. The 22.2% number corresponds to about 50 million Americans, and the numbers are expected to grow in the next 20 years as life expectancy continues to increase. The cost of Arthritis is estimated $128 billion annually1.
The exact causes of arthritis are unknown, and it is sometimes considered a normal consequence of aging. Some potential causes include: heredity, joint injury, repeated overuse, inactivity and obesity2. According the CDC report, almost 30% of obese patients have reported arthritis. It is well known that excess weight puts an extra strain on your joints. Diet, aside from the obesity factor, can play a major role in your levels of pain and disability-more on this later.
One item that didn’t make the list is smoking, but the statistics indicate it may warrant further study. In regards to smoking, 23.7% of regular smokers, and 25.4% of former smokers have been diagnosed with arthritis3. It’s clear from the numbers that there are lifestyle factors that may contribute to arthritis.
The key thing to remember about arthritis is that it is an inflammatory condition. In order to treat it, you must reduce the inflammation. While there is no cure for arthritis, there are steps you can take to help reduce its impact and limit the risk factors for developing arthritis.
So what can you do?
If you smoke, quit now! It will help every area of your health. Dietary modifications are an important part of limiting inflammation, so let’s discuss how you can modify your diet to make it anti-inflammatory. Eat plenty of fresh vegetables, fruits, healthy fats and lean protein, from meat that is not treated with hormones or antibiotics. Try to buy organic if you can. If not, avoid hormone or antibiotic treated foods.
Avoid sugar, refined grains and refined carbohydrates. For an excellent source of anti-inflammatory diet information, please see Dr. Weil’s Anti-inflammatory food pyramid at http://www.drweil.com/drw/u/ART02995/Dr-Weil-Anti-Inflammatory-Food-Pyramid.html. (one caveat- if you are currently attempting to lose weight, you may need to make some adjustments to his recommendations)
Spices also make an excellent addition to your diet. Known spices with anti-inflammatory properties include: cinnamon, garlic, ginger, turmeric, basil, rosemary, and black pepper. These spices have minimal caloric impact, no side effects and can help you flavor your meals! Not coincidentally, many of these spices are the active ingredients in some of the Chinese herbs we use to treat arthritis.
If you want to take a nutritional supplement, we recommend an Omega-3 fish oil supplement with DHA and EPA. Omega 3’s are powerful anti-inflammatory agents. They not only help with inflammation but are beneficial for your heart.
Current Treatment Options
The common treatment options for Arthritis are painkillers and anti-inflammatories. These medications can cause side effects with the heart and stomach if used for too long(remember Vioxx?). Another popular approach is to supplement with Glucosamine and Chondroitin, commonly combined into one supplement. Patients spent two billion dollars on Glucosamine supplements in 2008.4 While studies have historically been contradictory, some patients swear by them. A recent meta-analysis of these studies, looking specifically at pain levels and narrowing of joint space, showed that Glucosamine and Chondroitin supplements do not work. In severe cases, joint replacement is becoming more common- especially in the areas of hip, knees and shoulders.
Are there any other treatment options?
Great question. One effective method is Chinese Medicine (surprise- an endorsement of acupuncture on an acupuncture website!) In our clinic, we use a combination of acupuncture and Chinese herbal medicine to treat all forms of arthritis at all stages. We’ve talked repeatedly in other blogs posts about acupuncture’s ability to reduce pain and inflammation. Chinese herbs also have a long history of being used in the treatment of pain conditions. There are many Chinese herbs that have anti-inflammatory and analgesic (pain killing) properties. By using Chinese herbs, which come from nature, you can eliminate the side effects associated with pharmaceutical level anti-inflammatory medications.
A meta analysis of ten randomized controlled trials on the use of acupuncture for osteoarthritis of the knees concluded: “These studies provide evidence that acupuncture is an effective treatment for pain and physical dysfunction associated with osteoarthritis of the knee5”. Another study concluded that “manual and electroacupuncture causes a significant improvement in the symptoms of osteoarthritis of the knee, either on its own or as an adjunct therapy, with no loss of benefit after one month6”.
As you can see from these trials, treatments can result in improved range of motion, pain reduction and improvement in activities of daily living (particularly important in the elderly population).
What else can you do?
It’s key to stay active and keep moving if you have arthritis. It is equally important to find activities that don’t cause you more pain. For example, if you have arthritis of the knee, don’t run. Use an elliptical machine or ride a bike instead.
Making changes to your diet, activity levels and type of activity can help to reduce pain, inflammation, improve range of motion and overall quality of life.
1. http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5939a1.htm. Prevalence of Doctor-Diagnosed Arthritis and Arthritis-Attributable Activity Limitation — United States, 2007—2009. October 8, 2010 / 59(39);1261-1265
2. Arthritis Foundation. Osteoarthritis Fact Sheet. Arthritis.org
3. http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5939a1.htm. Prevalence of Doctor-Diagnosed Arthritis and Arthritis-Attributable Activity Limitation — United States, 2007—2009. October 8, 2010 / 59(39);1261-1265
4. “Effects of glucosamine, chondroitin, or placebo in patients with osteoarthritis of hip or knee: network meta-analysis”
Simon Wandel, Peter Jüni, Britta Tendal, Eveline Nüesch, Peter M Villiger, Nicky J Welton, Stephan Reichenbach, Sven Trelle
BMJ 2010; 341:c4675 doi: 10.1136/bmj.c4675 (Published 16 September 2010)
5. Fam Community Health. 2008 Jul-Sep;31(3):247-54. Acupuncture and osteoarthritis of the knee: a review of randomized, controlled trials. Selfe TK, Taylor AG. School of Nursing and the Center for the Study of Complementary and Alternative Therapies, University of Virginia Health System, Charlottesville, VA 22908, USA.
6. The effect of acupuncture on the symptoms of knee osteoarthritis–an open randomized controlled study. Tukmachi E, Jubb R, Dempsey E, Jones P. Selly Oak Hospital, Birmingham, UK. Acupunct Med. 2004 Mar;22(1):14-22.