Taking action in managing your arthritis

Arthritis affects about 21 million Americans. Because of the concern for negative side effects from many of the pain medications used for arthritis, many people are seeking other ways to manage their symptoms.

There are two major forms of arthritis - osteoarthritis and rheumatoid arthritis. The first increases in incidence as we age. It results from a breakdown of cartilage, allowing bones to rub together, which causes pain. Rheumatoid arthritis is an autoimmune disease that affects about 2 million Americans. With this form, the body begins attacking its own bone tissue, which causes inflammation and pain.

Since extra body weight puts additional stress on already painful joints, weight loss can be a good goal for overweight individuals (in addition to all the other health benefits it provides). Even losing a few pounds can make a big difference. Losing one pound of weight reduces the load on your knees by four pounds. Being at a healthier body weight can also reduce the risk of developing osteoarthritis in the first place.

Regular exercise is another action you can take. This not only can help with weight control, but it allows for improvements in joint function. Range of motion exercises keeps joints more flexible and allows for continued exercise. In the research, weight loss paired with exercise appears to be a winning combination to reduce pain.

A lack of regular exercise can almost guarantee decreases in joint function and increased pain. Plan an exercise program that includes range-of-motion exercise (stretching and flexibility), strengthening exercises (helps muscles and bones), and endurance (cardiovascular) exercises. Work with a physical therapist who can guide you through exercises that are just right for you. It is important to exercise safely. Drinking enough water is necessary for the health of all body tissues and the amount consumed should increase as exercise increases.

There are some dietary approaches to reducing the risk of inflammation. Omega-3 fatty acids (such as those found in fish oils), are known for their anti-inflammatory properties. Specifically, fish oils have been shown to decrease joint pain and stiffness, delay fatigue, and improve overall mobility. Higher levels of these can be consumed by eating fish or by taking supplements. Some other sources include ground flax seed/flax seed oil, canola oil and walnuts. If you choose to take a supplement, take about 3 grams of EPA/DHA. A diet high in omega-6 fatty acids can increase inflammation, so decrease your intake of the fats found in animal products and many processed foods. The current American diet contains a much higher level of these fats than in past decades.

A recent study has also suggested that a substance in olive oil is also anti-inflammatory. Previous studies had shown a benefit to people following a Mediterranean diet - high in fruits, vegetables, beans, olive oil, whole grains and fish, with limited amounts of saturated fats (animal-based fats).

Some researches found that a diet high in colorful fruits and vegetables (red, orange, and yellow) - which contain carotenoids and zeaxanthin - were less likely to develop rheumatoid arthritis. Vitamin C is another important nutrient in the arthritis picture. Drinking orange juice daily would help you to get both these benefits.

Numerous supplements are touted to help with arthritis. Of these, glucosamine and chondroitin appear to have the most potential for osteoarthritis. Anecdotally, many people state these two supplements, used alone or together, have shown benefit. To date, however, the National Arthritis Foundation claims it wants to see more concrete evidence before it can recommend taking these supplements. If you choose to take these supplements, the recommended doses are glucosamine sulfate (1200 mg/day) and chondroitin (1500 mg/day).

Vitamin D is another nutrient that may help. Some studies have shown that osteoarthritis progresses much faster in people who are deficient in vitamin D. The bone pain that results from a vitamin D deficiency can also be mistaken for arthritis. Older adults should try to get at least 600-800 IU of vitamin D per day. This can also help maintain bone density.

Remember that dietary changes and supplements generally work more gradually than medications. Do not expect immediate results. The benefit to including these dietary changes, is that they also help to reduce the risk of other medical concerns - so you can’t lose. As in treating many other medical conditions, there are a number of action steps that can choose to take.

So the bottom line is to maintain a regular habit of exercise, eat meat and poultry less often and replace them with oily fish or plant sources of protein such as beans, nuts, or seeds. Use olive or canola oil. Make fruits and vegetables a large part of your day. Add supplements as needed, such as vitamins C and D or fish oils, and drink plenty of water.

Pamela Stuppy is a registered, licensed dietitian with nutrition counseling offices in York, Maine, and at Whole Life Health Care in Newington. She is also the nutritionist for Phillips Exeter Academy.