Arthritis

General Medical

Dr. Sam Hay

Arthritis is a very common condition affecting many people of different ages, and all walks of life. It’s estimated it affects about one in eight Aussies, some with symptoms that are barely noticeable, others with symptoms that are completely debilitating.
 
The term ‘arthritis’ simply means inflammation or swelling of the joints, and it’s a general name given to a big cluster of conditions. Whilst there are over a hundred conditions that fall under the ‘arthritis’ banner, over 95% are caused by osteoarthritis,  rheumatoid arthritis, and gout. Regardless of the underlying cause, the main symptoms are relatively standard – joint pain, swelling, and stiffness.  Damage to the joint and cartilage lining eventually leads to weakness, instability and deformities.
 
Arthritis, no matter what the cause is not curable, but, it’s definitely manageable. Plus, early intervention can delay progression and greatly improve patient comfort, pain, and their day to day enjoyment of life. 


So how can we make living with arthritis easier?   

SUPPLEMENTS 

It is often suggested that those suffering arthritis should take a ‘supplement’ for their arthritis, with many thinking it’s a ‘natural’ option. I am all for taking supplements, as long as there’s evidence they make a difference. 
 
For patients with heart conditions, it is also important to know that some of these supplements can interfere with heart drugs such as warfarin, so while it might seem "natural" please don't start taking anything until you check with your doctor first. 
 
Glucosamine - The jury is still out on this one, but when we look at all the research and big studies, glucosamine does seem to have a small effect on improving symptoms. BUT, it has to be the right form and in the right dose. Medical experts and studies have found a daily dose of glucosamine sulphate 1500mg to be optimal.  Throw another compound called chondroitin (800mg) in, and the results are a little better. Some studies also indicate that glucosamine and chondroitin may prevent cartilage breakdown in osteoarthritis, but not rheumatoid arthritis. My experience with patients is that glucosamine either works, or it doesn’t.  So give it a try, but if you don’t feel any effect then save your money.
 
Fish Oil - Fish oil has been shown to have positive benefits for rheumatoid arthritis, but not osteoarthritis, plus the benefits are very small.  My advice? Make sure you’re eating plenty of fish each week.
 
Vitamin D -  A daily dose of Vitamin D will help keep your bones strong, but it does nothing for the joints and arthritis. 

DIET
 
There’s no evidence that eliminating particular groups of foods from your diet does anything to manage any type of arthritis. The common ones I hear are people avoiding acidic foods (lemons and oranges) and dairy.  Cutting these out of your daily diet won't do anything. In fact you could be depriving yourself of other necessary nutrients. Adding plenty of fish jam packed with omega-3 fatty acids will certainly offer some benefit for rheumatoid arthritis.
 
MEDICAL INTERVENTION 

There is a range of ways your doctor can help manage your arthritic pain, from paracetamol and non steroid anti-inflammatory tablets through to steroid injections (that calm the inflammation in the joints) and, for extreme cases, even joint replacement surgery. Unfortunately there's not a "one size fits all" solution when it comes to what modern medicine can do to help. But if the pain is getting progressively worse and impacting on your ability to do day to day activities, speak to your GP about what else you can do.
 
GET MOVING 

Arthritis can be a vicious cycle for many of my patients. The pain makes it difficult to exercise, but being overweight, or not moving can make the situation worse. Weight Loss. A loss of at least 10 percent of your body weight through a combination of diet and exercises has been associated with a 50 percent reduction in pain scores.  That’s a massive result for a relatively small loss of weight!
 
Exercise. Exercises have been shown to have effects of similar magnitude to anti-inflammatory tablets for many patients.  By maximising the strength and function of muscles that support joints, you can take unnecessary pressure away from the joint, improving pain, reduce swelling, and even slow down any wear and tear in the joint.
 
A combination of aerobic and strengthening exercises is usually needed to address the whole spectrum of disability associated with arthritis, but exactly what’s required should be tailored to each individual. Your GP can help you find a good exercise physiologist who will work closely with you.

My advice - get moving as much as you can. Long term - it will be to your benefit. 

BRACES AND SPLINTS

Walking aids (sticks and frames) and even certain braces for patients with joints that don’t align properly (eg the knee) may improve pain, and should be considered as extra treatments for many. In addition, splints are particularly recommended for the treatment of arthritis in smaller joints such as at the base of the thumb.
 
GETTING TOASTY 

While not a long term solution, warming the joints will give short term relief.  Many patients say their arthritis becomes worse in winter, some even saying they can predict rain or a storm based on how painful their arthritis gets! While that's likely to be all tied into a change in barometric pressure - there's no doubt that cold days make for more painful joints, so a warm soak or heat pack could offer some relief.
 
BECOME INVENTIVE

Being unable to perform many of their day to day activities, especially as they get older, many of my patients have become really inventive. The best tips I have seen to date are using a rubber hair roller around a fork or spoon so they are easiest to grip; or, popping a rubber stopper on the end of a pencil to push buttons on the oven, dishwasher or remote control.

BMedSci, MBBS(Hons), FRACGP, GDipSpMed, DCH
Director Your Doctors®

  


Please note: Dr. Sam's blog is general advice only. For further information on this topic please consult your healthcare professional.

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