Exercise and arthritis  |  Diet and arthritis  |  References


Arthritis

arthritisArthritis is a common condition that causes pain, stiffness and inflammation within a joint. In the UK, around 10 million people have arthritis, with the most common type being osteoarthritis. Medical treatments may help the pain but do not cure the underlying joint disease and have long-term effects on the heart, kidneys and stomach. Conversely, the lifestyle, exercise and nutritional advice on these pages offer a longer-term approach by targetting the overall well-being of the body’s joints. These measures have been proven to be effective at treating both osteoarthritis, and other less common forms of the condition, such as rheumatoid and psoriasis-related arthritis.

 


Lifestyle factors which affect the development and progression of arthritis:

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                                     Diet and arthritis

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                                    Exercise and arthritis

Consequences of Arthritis

Osteoarthritis initially affects the smooth cartilage lining of a joint. Once the cartilage lining starts to roughen and thin out, the tendons and ligaments have to work harder. This can cause swelling, and the formation of bony spurs called osteophytes. Severe loss of cartilage can lead to bone rubbing on bone, altering the shape of the joint and forcing the bones out of their normal position. This may lead to deformity and compression on the nerve roots of the spine, causing neuralgia (e.g. Sciatica). Not only is the swelling, pain and stiffness associated with arthritis troublesome, but, by restricting an individual’s ability to move freely, it can also exacerbate other conditions including obesity, heart disease, diabetes and cancer. Restricted mobility can also have a profound effect on mood,  lead to depression, and increase the incidence of hot flushes and other menopausal symptoms.

Who gets osteoarthritis?

Osteoarthritis typically develops in adults who are in their late 40s or older. It’s also more common among women and people with a family history of the condition. Joint discomfort usually begins soon after cancer treatment, affecting people regardless of age and for a longer period of their life. Over 55% of people experience symptoms consistent with early-stage arthritis after cancer treatments such as surgery, chemotherapy, and ongoing hormone or biological treatments like Herceptin [Pegram].

Treatments

Analgesia: Simple analgesics include paracetamol, non-steroidal anti-inflammatory agents and, if severe, stronger painkillers such as opioids. Although helpful, they have significant long-term cardiovascular and gastrointestinal risks and several unwelcome side-effects.

Invasive procedures: Surgical interventions such as joint fusion and replacement prosthesis remain effective but intrusive [Reddy]. Steroid injections can provide initial relief, but cannot be repeated often.

Integrative therapies (Non-nutritional): In addition to improving exercise levels,  Yoga and Pilates have demonstrated some effectiveness in helping relieve joint pain and improving mobility [Haslock]. Weight reduction, if overweight, does have benefits by reducing the load on weight-bearing joints, even if joint pains have already started [Felson]. Physical complementary interventions such as acupuncture, reflexology, chiropractic, osteopathy and massage offer emotional support, and there are some reports of improved relief from pain and stiffness [Thomas].

Exercise strategies: click here

Nutritional strategies: click here

Topical chilli pepper extract (Capsaicin): Three randomised trials, involving over 400 participants, have investigated the effectiveness of topical application of capsaicin gel in treating arthralgia. Doses varying between 0.025 – 0.075% were applied four times a day for a treatment period ranging between 4 and 12 weeks [Altman, Mcleane, Kosuwon], and a placebo gel was used as a control. In all three trials, summarised in a systemic review, capsaicin was found to be about four times more effective than the placebo gel at improving pain, stiffness, joint tenderness and function in participants [Mason]. Significantly more participants using capsaicin cream reported a reduction in pain, joint tenderness and use of self-medicated and prescribed analgesics.

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Types of arthritis:

  • Osteoarthritis – Usually age-related
  • Rheumatoid arthritis – The immune system attacks the bost’s joints and tendons
  • Ankylosing spondylitis – A genetic condition mainly affecting the spine, leading to joint fusion
  • Cervical spondylosis –  Affects the neck, leading to pain and pressure on the nerves to the arms and hands
  • Fibromyalgia – Affects the elderly and causes pain in the body’s muscles, ligaments and tendons. Typically treated with steroids
  • Systemic Lupus Erythematosus (SLE) – An autoimmune condition that can affect many different organs.
  • Gout – Caused by too much uric acid in the body, leading to intense pain which often starts in the big toe
  • Psoriatic arthritis – An inflammatory joint condition that can affect people with psoriasis
  • Enteropathic arthritis – A form of chronic, inflammatory arthritis associated with inflammatory bowel disease (IBD)
  • Reactive arthritis  Affecting the joints, eyes and urethra, and triggered by an infection of the bowel, genital tract or throat
  • Secondary arthritis – Follows joint injury, sometimes occurring many years after the initial trauma
  • Polymyalgia rheumatica – Affecting people over 50 years, it involves the immune system causing muscle pain and stiffness

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