Life is challenging enough without arthritis pain. Defined as inflammation and swelling in one or more of our joints, there are actually 100 different types of arthritis. However, this article will cover only the most common type— Osteoarthritis.
The bad news is that 46 million people live with arthritis in the United States— half of them under 65-years-old. As we age, the risk factors that cause arthritis (mainly wear and tear, as well as obesity, overuse injury, lack of exercise, muscle weakness, etc.) have more time to take their toll on our joints, thus older individuals are more likely to end up with arthri- tis. The good news is that arthritis is not inevitable as we age.
X-rays, MRI scans and CT scans of arthritic joints show a loss of cartilage. Cartilage is the translucent elastic tissue (the white crunchy part on a chicken bone) that pads the joints and prevents bone from rubbing on bone. If one is not active, their joints are loose and not very strong. Muscle attaches to tendon, tendon attaches to bone, and ligament attaches bone-to- bone. When one exercises, he strengthens the muscle, which strengthens the tendon, and the ligaments become thicker, stronger and more resilient, thus keeping the joint tight and not allowing it to be hypermobile, which increases the risk of arthritis.
It is crucial in preventing osteoarthritis that we remain active and do both upper and lower body exercises. Once we already have arthritis, we can prevent its spread by exercising in a low- impact manner, such as with a stationary bicycle, swimming or weight lifting. However, the hard pounding of running may aggravate arthritis, depending upon its severity.
Obesity is a major risk factor for osteoarthritis. First of all, in our fat cells, we make inflammatory cells that can affect the joints. Second, the heavier we are, the more stress we put on our joints. For each one-pound increase in weight, the force across the knee joint increases two to three pounds. To lower our chances of getting osteoarthritis, we must keep close to our ideal body weight and stay there for the remainder of our lives.
Overuse will also increase the risk of osteoarthritis. Some of us have jobs that require repetitive motion. If that motion is performed in a non-ergonomic manner, the risk of osteoarthritis increases. For example, twisting a screwdriver repetitively will cause the elbow to become arthritic, as will any pulling or pushing exercise that involves twisting at the elbow joint. According to the Arthritis Foundation, running and high-intensity sports that directly impact joints seem to increase the risk of osteoarthritis. In order to decrease the risk of osteoarthritis while doing any high-impact sport, we should start gradually to build endurance, and we should do the proper stretching and strengthening in order to avoid injuries to a joint.
Any fractures or injuries that directly impact joints (fortunately, most fractures are on the shaft of the bone rather than at the joint) will also hurt cartilage over time and will increase the chance of developing osteoarthritis. Wearing protective gear is always important. Those of us who ride motorcycles know this all too well. Any high-risk activities such as riding a motorcycle or bicycle, skating, etc. put our joints at risk.
Now let’s talk about prevention. Many of us have relatively sedentary jobs. But even when we feel comfortable, it is important to get up, move around, stretch and keep the joints moving because the more we move around, the more blood circulation goes to the joints and the less stiffness we experience.
Don’t stretch before exercise. When we attempt to stretch cold muscles and tendons, they contract to avoid injury. We should always warm up by lightly doing the same activity that we are preparing to do. For example, if our activity is running, we should warm up by walking and then slowly jogging before getting to full speed. After a warm-up, stretching is appropriate. Personally, I like to stretch after each exercise activity. Stretching helps keep a full range of motion in your joints, which reduces stiffness and aids flexibility.
We must also strengthen our core muscles. With stronger abdominal and lower back muscles, we are more balanced and coordinated—less likely to trip and fall and injure a joint. Don’t forget, each flexion exercise must be matched with an extension exercise. The reason I am belaboring this point is that most people who go to a gym will work the middle and upper back and neglect the lower back. Most dieters will do abdominal crunches but no extension exercises, and this imbalance can create chronic back pain.
I should also mention that when we exercise, we should know the difference between good hurt and a bad hurt. When we exercise, muscle should hurt. However, joints, tendons and ligaments should not hurt, and if they do, you will need to see your healthcare professional or personal trainer and learn how to do the exercises without adversely affecting your joints.
Eating fish regularly or taking omega 3 fish oil has been shown to keep joints healthy, as well as reduce inflammation. Also, glucosamine is a natural compound that is found in healthy joint cartilage. Some studies have shown that glucosamine combined with chondroitin may provide some relief of osteoarthritis symptoms. In addition to glucosamine, the best scientific evidence is for SAMe, which some studies have shown to work better than popular anti-inflammatory drugs for osteoarthritic pain.
I would suggest trying these natural remedies one at a time for at least one month to see how they work for you, and then adding an additional one over time. If you do not feel any effect from one of these remedies, then you should discontinue its use.
Before I receive any nasty letters about this, you must remember that US medical doctors (including myself) are taught in medical school to prescribe drugs and to do surgery, and the drug companies sponsor scientists to discredit natural remedies. Most of the positive information we have on natural remedies comes from very good European studies. The bottom line is this: If it works, use it, but if it doesn’t work, discontinue it.
It is also important to get adequate calcium (1500 mg per day) and vitamin D (4000 to 6000 units per day), depending on your blood levels (remember optimal is between 70 to 100). I have already covered hormone replacement to maintain youthful levels in order to prevent and treat arthritis. Remember, when our hormone levels were optimal, none of us had osteoarthritis…
You don’t need to accept arthritis, and it is certainly not inevitable. You can start today by eating right, exercising and taking care of your body—eliminating the risk factors that cause osteoarthritis.
John G. Alevizos, D.O.