Managing Arthritis

“God is our refuge and strength, a very present help in trouble.” Psalm 46:1

If you don’t have arthritis yet, it is likely that you may one day have it despite your best efforts. 😞

Arthritis is not actually one disease, but many. There are actually over 100 types of arthritis. 90% of cases are osteoarthritis. It is a variable condition and 2 people with the same damage will have different symptoms and respond to it differently. I hope if you are suffering as well, some of this information will be helpful to you.

My back pain saga continues. The beginnings can be found here in Part 1 and Part 2. I was recently allowed to get an MRI. The results were not what I was expecting. 🤔  (Proverbs 16:9) I was diagnosed with 4 bulging disks, a cyst, arthritis of the facet joints, moderate spinal stenosis and bilateral foraminal stenosis . This is a narrowing of the space that surrounds the spinal cord and the spaces from where the nerve roots emerge. All caused, my orthopedist believes, by osteoarthritis. Boo.

Both of my doctors say there is nothing I can do, I couldn’t have done anything differently to avoid it and there’s no way to know how it will progress. It could become quite severe or it could just stay as it is. It seems most people over 50 have a bit of stenosis, however it is so mild they don’t even realize it.

I am not one to jump at drugs (even OTC), injections or surgery except as a last resort, so that has led me to do this research for some natural ways to manage this mess.

The bad news is that my orthopedist said she sees as many healthy people as unhealthy people develop OA. Changing your diet can neither prevent OA nor bring it about. Neither can the weather. So, apparently you cannot control whether you get arthritis.

The good news is that because I have been doing the right things, it is not worse…considering. So wait, there IS something you can do? Pain rises and falls, flares come and go. Clearly something is affecting it. So far I have seen the intensity affected by weather, hormones, activity and diet. How can I affect it in a healthier way?

There are two main types of arthritis

The first type of arthritis is inflammatory. This is an autoimmune form of arthritis. You know these as RA, psoriasis, lupus, ibd, scleroderma, etc. Women tend to get forms such as RA and lupus, while men tend to get gout and ankylosing spondylitis.

The second form is osteoarthritis. This is a degenerative form of arthritis from “wear and tear”, although some researches believe there may be an inflammatory component to it.

For the purposes of this blog I am going to mainly be addressing osteoarthritis, however many of the principles apply to inflammatory types of arthritis as well.

Osteoarthritis

Osteoarthritis (OA) is the most common joint problem.  The average age of the onset of arthritis is 47. Most people experience it in the hands and knees.

OA is the wearing away of cartilage that cushions the ends of the bones. The cartilage eventually wears away and the bones touch and rub causing pain. This can cause cysts and bone spurs which could be the body trying to stabilize the degrading joint. By the time you feel pain, permanent damage has been done. That’s because it takes years to develop.

Tendonitis and bursitis can be mistaken for OA since they are located near joints.

Causes

Unfortunately, the don’t really understand exactly what causes OA. They believe the causes can be divided into two groups- direct causes and indirect causes.

Direct causes are genetics and wear and tear.

Indirect causes are trauma. Either a major trauma or many little ones. This sets off a reaction that can take years to develop.

Risk factors

Genetics– OA tends to run in families.

Age– Arthritis is common in people over age 50.

Gender– Women are more likely to get arthritis, especially after menopause.

Sports injuries– Young people who have had joint injuries are 5x more likely to get OA

Previous injury or repeated trauma– Numerous “little insults” can lead to OA, such as falling, repeated jarring, or repeated occupational insults such a using a jackhammer or using your knees in laying carpet, tennis, kneeling, gardening, swatting as well as poor technique during exercise.

Overweight– This is the leading cause of OA in women and the 2nd in men.

Muscle weakness– causes poor joint stability.

Bone diseases-Such as Paget’s disease, joint hypermobility, TMJ

Poor joint alignment

Inflammation – Inflammation is the underlying cause of a host of diseases such as cancer, heart disease, Alzheimers and others including arthritis. Temporary (acute) inflammation is good, chronic (systemic) inflammation is bad. For more information on inflammation read here.

The Inflammation Cascade

In his book, The New Science of Overcoming Arthritis, Dr Vangsness explains that the inflammatory cascade is a complicated series of reactions.  A 2011 study aimed to show how “an initial insult could trigger a cascade of low-grade inflammatory activity in the joint that could result in the cartilage destruction that is OA, sometimes years after the injury.” The cascade can also be triggered by bacterial and viral infections.

According to neuroscientist, James Joseph, “inflammation is the evil twin of oxidation, where you find one you will find the other.” For more on free radicals, click here.

An Action Plan- Areas To Focus On

While there is no cure for any type of arthritis, there are many steps you can take to manage and reduce the pain and inflammation.

Increased activity– Exercise! I know that seems like the last thing you want to do when you’re in pain, but the temptation to avoid activity or motion actually causes more pain. If you already exercise, don’t stop, just do it differently.

Activity moves the joint’s synovial fluid which stimulates cartilage. Lack of movement causes you to become stiff, causing loss of mobility and more pain. Exercise improves balance, improves mood and it is a natural relaxer for sleep. Move 30 minutes a day. Don’t over do it. Rest in between. Never walk with weights, it can make your arthritis worse. Poor technique creates joint problems.

Exercise made a big improvement in my pain. Stick with the physical therapy and do your home exercises regularly. You should do low impact (no more jumping for me), aerobic exercises for 2 1/2 hours total over the course of the week. Examples would be walking, biking, swimming, etc. (more on benefits of exercise)

Use heat packs before exercise and ice packs after.

Weight management– This is very important for arthritis. If your BMI is over 25, strongly consider losing weight. If it is over 30 you have significant risk factors regarding your health. (Tips for weight loss)

This is interesting. The type of fat makes a difference. Those who carry fat in the belly (causing metabolic syndrome) are more likely to have more severe OA on non-load bearing joints such as hands and spine. Weight reduction decreases the risk of OA of the knee. It decreases the impact force of the weight. 10 lbs above the waist = an extra 100 lbs of pressure on the knees.

Stretching– Promotes synovial fluid flow, proper alignment of joints, prevents injury, increases range of motion and improves balance. An example would be yoga.

Strength training– Keep muscles strong! Strong muscles support joints. Movements should be controlled, not overly vigorous to avoid damaging your joints further. Water exercises are excellent, a heated pool is even better.

Proper nutrition– Nutrition does not cause OA, but it plays a role in managing it. It is important to reduce systemic inflammation and maintain proper weight. There is no one size fits all diet. Experiment to see what works best for you. Anti-inflammatory diets are shown to lower inflammation. These are most similar to the Mediterranean diet. (anti-inflammatory diet and habits, click here)

Supplements– To promote healthy joints. There are several options. For more details see this post on supplements and herbs.

Proper hydration– Drink plenty of water to keep your joints well lubricated and your disks hydrated.

Posture– In the case of arthritis of the spine, posture is very important. Learning how to stand and walk correctly is something that will go a long way to reduce pain. Also “lifting” your upper body to reduce the feeling of your spine compressing is something I found helpful. It is tiring to constantly be thinking about how you are walking and standing, but I am hoping it will soon become second nature.

While walking bent over may relieve your pain, it may also cause your spine to stiffen up, your hip flexors to tighten and make it more difficult to straighten up in the long run. Try to avoid that.

Acupuncture– Many people find relief using this. It now an accepted treatment and many insurance companies cover it. Needle placement releases stress relieving hormones called endorphins. The relaxation can reduce the pain. It may also trigger a hormone that fights inflammation which is why back pain is relieved. It may take a few treatments.

Dr. Vangsness states that if you are not convinced of the benefits you will not succeed. You should be establishing a new lifestyle not dabbling in a new hobby. Be patient and don’t give up too soon. Things take time. Give it the appropriate time to gain the rewards. Everyone is different and what works for one person may not work for another. We need to be good stewards of the body God gave us but in the end, we can only be as healthy as the Lord allows.

Next in this series, I will address supplements for arthritis and chronic inflammation along with anti-inflammatory foods and habits.

Do you have OA or other form of arthritis?

How are you managing it?  What works for you?

Resources:

Aesoph, Lauri ND. How to Eat Away Arthritis.

Allen, Barbara. Conquering Arthritis: What Doctors Don’t Tell You Because They Don’t Know.

Rippe, James MD. The Joint Health Prescription.

 Vangsness, C. Thomas MD. The New Science of Overcoming Arthritis.