Taking Charge of Arthritis

If you have arthritis and have been concentrating on simply coping with your condition, it is time to raise your sights: you are capable of doing much better. You can control your arthritis to a much greater degree than you have ever imagined.

Know your arthritis

Osteoarthritis (OA): Good cartilage gone bad. Osteoarthritis (OA) is by far the most common type of arthritis, affecting hands, knees and hips, in particular. Although it is called ‘old people’s arthritis’ or degenerative joint disease, it can affect younger people, too. The condition involves mainly cartilage, the protective tissue that covers and cushions the ends of the bones within the joint. In OA, the cartilage doesn’t function as it was intended and, for a variety of reasons, slowly breaks down. Bony swellings and spurs may develop around the edge of bones in response to pressure on them. These changes lead to pain, stiffness and a restricted range of motion.

Rheumatoid arthritis (RA): Fire in the joints. Rheumatoid arthritis (RA) is the most common type of inflammatory arthritis and usually affects many joints in the body. RA is much less common than osteoarthritis. RA is a systemic disease, meaning it can affect not only the joints but also the blood vessels, heart, skin, muscles and other parts of the body. Most people with RA must contend with daily pain and stiffness that may wax and wane. They often speak of having good and bad days, weeks, or months, and of enduring periods of depression, anxiety and helplessness.

Rheumatoid arthritis versus Osteoarthritis: Comparisons and contrasts

Age of occurrence: RA usually develops between the ages of 30 and 50, but can occur at any age. Osteoarthritis is a disease of middle and old age and rarely occurs before the age of 45.

Pattern of disease: RA often strikes symmetrically, meaning it affects both wrists, the knuckles on both hands, etc. OA rarely affects both joints at once.

Speed of onset: About 20% of RA cases develop suddenly, within weeks or months. OA develops slowly, with cartilage breakdown usually occurring over several years.

Extent of illness: In addition to causing joint damage, RA van cause fatigue, fever, anaemia and weight loss and can damage the heart and other organs. OA is limited to the joints.

Joints affected: RA usually affects many joints, including the wrists, knuckles, elbows, shoulders, ankles, feet and neck. OA most commonly affects the knees, hips, feet, hands and spine. It sometimes affects the knuckles and wrists, but rarely affects the elbows and shoulders.

Hand involvement: RA affects many of the hand joints, but usually not the end joints closest to the fingertips. OA affects the knuckles closest to the fingertips more often than other joints of the hand.

Morning stiffness: People with RA have prolonged morning stiffness, usually lasting for at least 30 minutes after they get up. With OA, morning stiffness lasts for less than 30 minutes.

Drugs and alternative therapy

A wide range of drugs is available to combat arthritis, and alternative therapies have also become more popular. Choosing the right treatment can mean the difference between living fully and being imprisoned by your condition.

All types of arthritis have two things in common – they affect the joints in some way, and they cause pain. So it’s not surprising that many of the drugs used to treat arthritis help to reduce that pain. They include paracetamol, NSAID’s, COX-2 inhibitors, corticosteroids, and DMARDs – all which can offer relief, but also at a price. That is why alternative therapies like dietary supplements are becoming more and more popular these days.

Glucosamine and chondroitin: Hope in a bottle: Studies have showed that glucosamine and chondroitin work at least as well as NSAIDs, and appear quite safe with very few side-effects noted. NSAIDs in particular can cause serious side-effects, especially when taken for long periods. That explains the increasing interest in glucosamine and chondroitin sulphate, which seems to be just as effective as certain NSAIDs, but much safer.

Evidence suggests that glucosamine and chondroitin sulphate may slow the progression of cartilage loss – and may even help rebuild cartilage that has started to break down.

Fish oils: Oils obtained from fatty cold-water fish are rich in omega-3 fatty acids, which have the ability to decrease inflammation.

The antioxidant advantage: Vitamins C, E and beta carotene: Free radicals are constantly forming within cells – in the joints and elsewhere – during normal metabolism as cells burn up oxygen to create energy. Studies have shown that these chemicals can damage cartilage and may contribute to the damage that occurs in arthritic joints. So eating a diet that is rich in antioxidant vitamins – or taking them in the form of supplements – can help you to ward off OA or at least ease its symptoms.

MSM: The dietary supplement MSM (methyl sulfonyl methane) is being promoted for treating arthritis and many other health problems. This sulphur compound is found in a number of foods including milk, fish, grains and fresh fruits and vegetables. Sulphur is an important element in the chemicals that make up cartilage – and MSM is destroyed when food is processed.

Eating to Beat Arthritis

Current evidence for dietary cures is sparse
There is no substantial scientific evidence that would support a person with arthritis avoiding particular foods, unless that person has specifically shown intolerance to them (the exception is gout). However, as research reveals more connections between diet and health, it is possible that stronger connections between particular foods and arthritis may emerge.

With some foods - such as tomatoes, potatoes, eggplants and peppers - there is much anecdotal evidence (stories about individuals), but again there is no strong scientific evidence.

If you think a particular food may aggravate your arthritis, it can be useful to keep a food diary. After a month, you may have some idea about which food could be provoking symptoms. You could then try eliminating that food from your diet for two weeks to see what happens. Don't cut out a whole food category, and make sure you are getting the vitamins and minerals that this food provides from other sources.

Remember that remission may be coincidental.
The symptoms of arthritis, particularly the inflammatory types, can wax and wane for no apparent reason. If you are experimenting with a dietary change, don't automatically assume the remission or reduction of symptoms was due to what you did or didn't eat.

Basic Guidelines

* Reduce your weight if you are overweight
* Try to follow a basic healthy eating plan
* Increase your intake of:
o Wholegrain cereals
o Fresh fruit and vegetables
o Oily fish and additional omega 3 fats
o Ensure adequate intake of Zinc and antioxidants vitamin C and E. Good sources are oysters, sunflower seeds, citrus fruits, nuts, and seeds.
o Folic acid and vitamin B12 may supplement the anti-inflammatory medications you take. Good sources are green leafy vegetables, Brussels sprouts, broccoli, pulses and lean meat, poultry, fish and eggs.
o Vitamin D, taken in doses up to twice the RDA (recommended daily allowance), may protect against disease advancement. The best source of vitamin D is sunlight.
* Cut down on:
o Highly refined foods
o Processed foods
o Saturated animal fats
o Sugar
o Salt
* Increase your activity level