What Is Known About Osteoarthritis
From Dr. Deborah's Desk
Updated October 21, 2015
Some mornings, the pain is bearable. You creak out of bed and tough it out for another day. Other times, the achy stiffness, joint pain, and swelling are cripplingly intense.
If you're one of the 27 million Americans suffering from osteoarthritis, you know this diagnosis was once considered equivalent to a life sentence of chronic pain. Today, however, the outcome may be more hopeful.
Studies show it is possible not only to relieve pain but to actually reverse the damage to joint cartilage caused by osteoarthritis. Making key lifestyle and dietary changes, along with taking the proper supplements, could kick your osteoarthritis to the sidelines for good.
What Is Known About Osteoarthritis
Osteoarthritis is the most common form of joint disease and is thought to arise out of wear and tear on the joints, whether arising due to age or in younger folks after trauma or repetitive stress. Obesity, genetics, and metabolic disorders have also been known to cause secondary osteoarthritis.
This degenerative joint disease afflicts the ends of your fingers and toes (distal joints) rather than the middle joints. The pain comes from your bones grating together as cartilage becomes damaged and your joint-lubricating synovial fluid decreases.
Newest research questions whether there might indeed be an auto-immune component to osteoarthritis, long thought to be contributory to other arthritis, but not osteoarthritis. Autoimmune arthritis occurs when the body mounts an inflammatory response to exposed cartilage, treating the cartilage as if it’s a foreign invader, sending white blood cells out to attack (inflame) the tissue. The possible existence of an auto-immune mechanism suggests possible new lines of treatment possibilities, see Full Program below.
Traditionally, osteoarthritis patients have relied on nonsteroidal anti-inflammatory drugs (NSAIDs) like aspirin and ibuprofen, which can cause gastrointestinal damage, or high-risk immunosuppressive pharmaceuticals like Methotrexate to manage their pain. Even acetaminophen (Tylenol), commonly thought to be innocuous, has been associated with liver damage.
You may be able to achieve permanent healing without resorting to drugs for pain relief. Exciting findings show the joint cartilage in osteoarthritis patients is metabolically active and that damage can be halted or reversed, especially if you’re in the early stages of the disease. Many who have implemented recommendations such as those outlined below have experienced a 40-percent reduction in inflammation levels.
Healthy Steps: Osteoarthritis—First Steps
For the greatest improvement with the fewest steps, do the following:
- Stop sugar completely to reduce inflammation. Consider a trial month off of grains (or at least gluten) as well.
- Integrative Therapeutics Curcumax Pro. Take 2 daily of this combined with Boswellia and Turmeric anti-stiffness formula.
- Integrative Therapeutics Glucosamine Sulfate and Chondroitin. 1 tablet three times daily, taken with Thorne Research Niacinamide, take one 500 mg tablet three times daily. This form of B3 does not produce flushing when taken in large amounts.
- Omega 3 fatty acids can help reduce inflammation. Try Barlean's Omega Swirl, 1 Tbsp or 1000 mg daily.
Healthy Steps: Osteoarthritis—Full Program
A comprehensive program involves many areas in which action steps can be taken, gradually or all at once. Start by following basic nutrition and healthy lifestyle guidelines, with the following modifications:
Savor Helpful Foods
- Fish. Enjoy a variety of fish especially wild Alaskan salmon, herring, anchovies, oysters and others. See Monterey Bay Aquarium's guide to seafood.
- Pasture-raised lamb, available at Costco and from your local farmer, which is high in omega3's. Be sure to eat the fat. Animal-based omega-3 fatty acids are crucial because they produce the anti-inflammatory compounds resolvin and protectin.
- Turmeric. Curcuminoids are the major substances that give the spice turmeric its yellow color. Curry powder, found extensively in Indian cuisine, is largely made of turmeric and other spices, or turmeric can be added to foods on its own. Turmeric has proven anti-inflammatory effects, and its curcumin extract is strongly advised for osteoarthritis sufferers. A study published in Arthritis and Rheumatism reported on the benefits of turmeric in an experimental setting.
- Ginger. Chopped ginger makes a delicious addition to your vegetables, meat, or fish.
- Pineapple. Eat fresh and often for the enzyme Bromelain, which is a natural anti-inflammatory.
- Gelatin. An easy way to enjoy gelatin is to make bone broth soup (see Recipe in Real Food section). Drink the broth on its own, or use it as the liquid in other soups or recipes.
Avoid Problematic Foods
- Large amounts of fruit will add to inflammation. Keep fruit and fructose to two half cups daily or one full cup a day at most. Berries and small amounts of pineapple are best as they are the highest in anti-inflammatories.
- All processed foods. Avoid any food that comes packaged in a can, box, or jar, and avoid any with chemical additives, or any unrecognizable ingredient. Many additives are in fact MSG, to be avoided along with most preservatives, dyes, and any added sugar. Baked goods made with white flour are often highly processed and may increase your joint pain. Shop around the perimeter of the store where all the whole foods are located. Better yet, shop at your local farmers market or buy straight from the farmer if possible.
- Foods you are allergic to. Allergic reactions can contribute to arthritis symptoms. Targeting and eliminating food allergens has been shown to reduce arthritis symptoms by as much as 30 percent for some people.
- The most common trigger is gluten, or for some people, wheat itself. Besides gluten, other possible triggers include corn, dairy, beef, eggs, onions, chocolate, coffee, tea, citrus, potatoes, soy, peanuts, yeast, pork chops, and oats. You may have an allergic reaction to more than one of these foods.
- The other concern may be for those people who have symptoms from eating foods in the nightshade family. The nightshade foods are tomatoes, potatoes, eggplant, bell pepper and tobacco. Some people improve significantly after avoiding these foods for 6-9 months.
- The most definitive method of discovering which foods you are allergic to is by testing them on yourself. RAST testing and other allergy tests may point the way, but are not absolutely reliable See our Allergy Elimination Diet.
Supplements can Help
- Omega 3 fatty acids can help reduce inflammation. Try Barlean's Omega Swirl, 1 Tbsp or 1000 mg daily. In the
pastI have recommended Green Pastures Fermented Cod Liver Oil, and although that works well for some, others have found it inflammatory, so I no longer recommend it generally.
- Pure Encapsulations Evening Primrose Oil. Take 1 daily.
- Pure Encapsulations Vitamin D 5000 I.U's. Take 1 daily.
- NOW Foods Astaxanthin. Take 4mg twice daily or 10 mg once daily. A strong antioxidant from microalgae. Present in krill oil and fish such as salmon, this carotenoid antioxidant has proven especially helpful in treating osteoarthritis.
- Integrative Therapeutics Glucosamine Sulfate and Chondroitin. Take 1 tablet three times daily. Glucosamine Sulfate is a powerful ingredient for joint health and builds joint cartilage. Studies show it is even more effective when combined with omega-3s. The benefits are further enhanced by combining with Thorne Research Niacinamide 500mg tablets three times daily. This form of B3 does not produce flushing when taken in large amounts.
- Integrative Therapeutics Curcumax Pro. Take 2 daily of this combined Boswellia and Turmeric anti-stiffness formula.
- Synergy Pure Radiance Vitamin C. Take 3 with meals daily. This supplement is based on whole foods so you will not see the high dosages associated with common ascorbic acid and other synthetic vitamin C products.
- Undenatured Chicken Cartilage, most easily taken as a Collagen Powder from Great Lakes or Vital Proteins. Sounds like a mouthful doesn’t it! Part of what’s helpful in bone broth soup, cartilage packed into a pill or capsule convinces the body to back off its immune response to damaged cartilage, or so the theory goes. There is some early research as well as anecdotal evidence that indicate this can be very helpful in some people.
- The amino acid metabolite S-Adenosylmethionine (SAMe) been used to successfully treat osteoarthritis, providing extra anti-inflammatory effects particularly useful in some individuals. You should know a little about your methylation genes before taking very much SAMe.
Topical treatments may be your best choice if you have one or two joints that continue to hurt despite the above recommendations.
- Homeopathic Traumeel Cream. A simple and safe topical application to try, it has helped many people with mild to moderate arthritic pain limited to one or two joints.
- Capsaicin-containing creams. Commercially available products such as Zostrix have been studied and found to provide relief for some people with arthritis pain.
- Topical non-steroidal anti-inflammatories. Certain oral anti-inflammatory medications have been prepared in a topical form and are available in regular pharmacies, such as Voltaren, or through compounding pharmacies in many forms.
Daily Life Choices
NormalizeWeight. In addition to added weight on the joints, the adipose (fat) tissue itself is a source of potent inflammatory molecules that aggravate the problem. See the Low Carb Weight Loss in the Real Food section for information on losing weight.
- Special Shoes: Sole Provisions Orthaheel. You may be interested in trying these special shoes that have orthotics built in. They can help balance your body and thus provide some relief for joint pain especially knee pain. (Reactions to these shoes are mixed: some find relief and others find it shifts the stress from one joint to another.)
- Exercise. Avoid doing anything that will be aggravating to your joint pain. Exercise is wonderful and will help you in the long run but not if it inflames the joints further. Swimming can be most beneficial as it will be unlikely to cause stress on the joints while allowing you to freely move your body. Water that is not icy cold and does not have chlorine in it will be best. Swimming in warm salt water may be the best.
- Strength training. Work with a physical therapist or a personal trainer to develop strength in the muscles around a painful joint.
- Maintain range of motion. Even sitting at your desk you can rotate your head and neck, lift and release your shoulders, stretch your arms across your body and up to the ceiling. Then stand up and lift your knees high. Pay attention to maintaining a full range of motion for all your joints, on a daily basis.
In general, homeopathic treatment for chronic conditions such as osteoarthritis is most effective in consultation with a professional homeopath. However, three remedies deserve mention and are most useful for intermittent episodes of pain. If either of these descriptions fits your symptoms, take the remedy in a 30C potency, a few pellets a day when the pain is bad. Limit remedy use to a few times a week.
Rhus Toxicodendron, the homeopathic remedy made from poison oak, can help some classic arthritis symptoms. There are two sets of symptoms that suggest this remedy might help you.
- Sore and swollen joints that are stiff when you first move, but ease up with motion then fatigue with exertion.
- Joint pain that is better from moist heat and worse from
- You might feel either anxious or overburdened when your pains are worse.
Calcarea Fluorata or Fluorica might be useful if you have pains caused by bone spurs around an arthritic joint.
Caulophyllum seems to work better for women.
- Stiff and swollen joints of the fingers and knuckles that are better from gentle motion and heat.
- Feet and toes might also be affected.
Conventional medical treatment for arthritis involves over the counter and prescription anti-inflammatories, which can relieve pain but not without side effects. If particular joints continue to cause problems despite the above protocol, consider seeking help from one of the following professionals.
- Acupuncture. Acupuncture has great success in dealing with osteoarthritis joint pain and inflammation.
- Prolotherapy. Prolotherapy can be helpful in treating weakened connective tissues and thereby relieve the stress on arthritic joints, as well as injecting the joint itself. Prolotherapists have injection options in addition to corticosteroids (which have a short-term benefit but long-term risks) to help soothe and even heal arthritic joints. Your physician can help you find a prolotherapist at www.getprolo.com.
- Conventional care. You can judge the quality of your orthopedist by how strongly they recommend that you take non-steroidal anti-inflammatories. Hint: you want an orthopedist who suggests that's not a great idea. Other treatments they offer are steroid injections (useful rarely for an acutely painful joint) or synthetic cartilage injections, most frequently used for osteoarthritis of the knee. Some people find significant relief for months or years, others not so much. It's a generally safe procedure. The last step is, of course, joint replacement. Surgical procedures are constantly improving, so consult a surgeon who specializes in the procedure.
Increasing mobility through exercise can bring relief to sufferers while also serving as a preventative measure. Because your hands are the most likely target for osteoarthritis, experts recommend hand yoga to stretch and strengthen your finger muscles. You can also relieve pain and boost your grip strength by squeezing a stress ball.
Extra pounds put you at risk for developing osteoarthritis. Following the Low Carb Weight Loss Plan will help you lose weight and practicing regular exercise will improve your joint functioning and bone density.
You can also strengthen your bones and joints by consuming bovine gelatin in homemade bone broth soup, which supplies your body with the collagen found in cartilage and bone. Eggshell membrane is an excellent source of collagen as well as elastin and glycosaminoglycans, all of which increase your flexibility and stability by helping your body build cartilage. Taking hyaluronic acid, an essential cartilage component, aids in cartilage repair.
The vitamins and supplements recommended in our Health Action section can fend off osteoarthritis. Because vitamin D deficiency causes cartilage loss, it should top your must-have list when seeking to prevent osteoarthritis.
The amino acid metabolite S-Adenosylmethionine (SAMe) been used to successfully treat osteoarthritis, and evidence suggests it may aid in prevention since it stimulates the synthesis of the proteoglycans present in connective tissue.
From Dr. Deborah's Desk
Do you remember your grandmother's hands? My grandmother lifted them high into the air when she played dramatic arpeggios on the grand piano I inherited from her but never played so well as she did. I inherited her arthritis, too, but am eager to tell my patients that luckily we have ways of helping reduce the aches and pains.
Despite her own arthritis, Carol is a devoted gardener and she refused to give it up. She reported evenings of severe
After a few weeks, she said she felt better, but admitted she was very hard on her hands and they still hurt her. She worked her way through several of the above-listed supplements which have helped other patients with arthritic complaints. She, however, reported no added relief and I was about to give up when Integrative Therapeutics came out with a high potency anti-inflammatory formula, which they call Curcumax Pro. The information I received described it as an Athlete Recovery formula, but I knew a gardener who'd give it a tough trial for me. After about two weeks, she had to smile, “Well this time I think you've found a winner: you'll have to keep stocking that one for me."