Online Help - November 2007
Arthritis Help Sheet
Osteopathy can help to relieve the pain of arthritis, improve mobility and prevent falls, but there is a lot patients can do for themselves to reduce pain.
We have put together this help sheet to try and give you the facts about what works for joint pain and stiffness
Weight – if you are overweight, losing weight helps to take pressure off the weight-bearing joints (ankles, knees and hips), which helps to reduce pain. When you put your weight on a joint, the effect is multiplied.
That means that a small loss in weight can have quite a big effect on the pressure on joints.
Below are some suggestions on achieving a healthy balanced diet (if you taking medication check with your doctor or NHS Direct before taking supplements – there can be contraindications).
Diet – as exercise is often difficult or painful for arthritis sufferers, diet must play a large part in losing weight. It can also help to improve the health of the joints and reduce pain in that way too. General guidelines are as follows:
- Reduce saturated fats, processed and fried foods – this will help you lose weight. Saturated fats and fried foods produce chemicals called free radicals in the body that increase inflammation and make your pain worse.
- Increase iron and calcium intake – the best source of iron is red meat. Free-range, lean cuts are healthiest and can be included in a varied diet. Sardines and other oily fish are a very good source of iron (women who are planning to have children should not have oily fish more than twice a week; otherwise, 3-4 times per week is recommended).
Iron is absorbed in the body easier in the presence of vitamin C so include some fruit, veg or salad with it. For vegetarians, pulses and dark green leafy vegetables are good sources of iron. Avoid drinking tea with meals or shortly before a meal as the tannin in tea reduces iron absorbtion. Calcium usually comes from dairy products.
Skimmed milk contains more calcium than full-fat; if you have soya milk use one which is fortified with calcium. It is especially important for post-menopausal women to increase their dietary calcium, and even more so if they have not had HRT. (Calcium also helps weight loss!) - Fish oils – provide EFA’s (essential fatty acids – ones that are essential in the diet because our bodies can’t make them). Omega 6 oils come from seeds and nuts or evening primrose oil supplements. Most people in the UK get plenty of omega 6 from their normal diet. Omega 3’s come from fish oils. Fish liver oils are a good source of EFA’s but also have a very high vitamin A content, which can be harmful – if you want to take cod liver oil, look for one which has less than 7500 micrograms (or 7.5mg) per daily dose. Women who are likely to become pregnant should not take liver oils.
- People with osteoarthritis should increase fresh fruit and veg, especially berries (contain bioflavonoids), fresh pineapple (contains bromelain) and ginger; decrease foods containing gluten, sugars and saturated fats; and cut out alcohol and caffeine. Fruit and vegetables contain vitamin C, that may help reduce cartilage loss and they are a rich source of antioxidants, e.g. vitamin E. It is recommended to eat a minimum of 5 different portions of fruit and vegetables per day.
- Brazil nuts are also a good source of another antioxidant: selenium, which is commonly low in the UK diet.
- Glucosamine Sulphate has been shown to have a statistically significant effect on osteoarthritis symptoms. Glucosamine is a building block of cartilage. Most forms are derived from sea-shell and are not to be taken if you have an allergy to shellfish, but you can get non-shellfish-derived glucosamine from Healthspan. The recommended dose is 500mg, 3 times per day (i.e. a daily dose of 1500mg). Beware – most over-the-counter glucosamine tablets are not strong enough so are a waste of money. If you want to order some we would recommend Healthspan. Go to www.healthspan.co.uk or ask us to order for you. Their supplements are much better quality and usually cheaper than high-street shops.
- Chondroitin sulphate (CS) inhibits the enzymes that destroy joint cartilage. In studies, CS has produced objective signs of healing in osteoarthritic joints. The recommended dose is 400mg 2-3 times per day. Chondroitin is an enzyme inhibitor which your body usually produces itself but can’t produce enough of in arthritic joints. When you take the supplement, you also inhibit your own body’s production of chondroitin, so you must take it continuously.
- Glucosamine + Chondroitin there is no evidence that taking both together gives any extra benefit, but because they act in different ways, you are effectively preventing further damage with the chondroitin and repairing the damage that’s already done with the glucosamine.
- Boron, zinc and copper are all trace elements, needed in tiny amounts for cellular function. Boron has been used in Germany since the 1970’s for treating OA. 6mg daily as sodium tetraborate decahydrate.
- Capsaicin cream – capsaicin is a compound found in cayenne pepper. It can be applied in a cream to the affected joint.
- A varied diet with lots of fruit and vegetables is essential for your general health, and if you are generally healthy, your body can heal itself more effectively.
- For women, increasing the amount of phytooestrogens in your diet may help and can be found in soy, fennel, celery, parsley, nuts, whole grains and apples.
- Some people find that eliminating foods of the Solanaceae family: tomatoes, potatoes, aubergines and peppers from their diet have made a positive difference to their arthritis, although this has not been backed up by research. However it may be tested individually by removing these foods for a month from your diet and then reintroducing them one by one to assess whether they affect your arthritis.
- The pain of arthritis may well lead to increased stress levels and low mood, which can in themselves increase pain levels. Learning relaxation skills helps to decrease muscle tension and stress, as well as increasing feelings of well being and control.
Jill is a qualified Naturopath and Victoria has a degree in Biochemistry so we are more than happy to discuss diet and supplements with you!
Exercise – swimming, aqua-aerobics, yoga and pilates are all very good for maintaining flexibility and strength.
Tai chi is also very good for balance and several of our patients have found it useful for keeping joints mobile. Walking is good for keeping joints mobile but don’t overdo it. Little and often is the key! The main thing with exercise is that it must be something you enjoy, will fit into your lifestyle and you can do on a regular basis.
Cambridge City council runs exercise classes for the over-50s that are designed for different levels of mobility. Please ask us for more details about types of exercise, we have lots of contacts and are more than happy to help you find something suitable.
As part of your treatment we may also give you specific exercises to do daily.
More advice can be sought from:
Arthritis Research Campaign (ARC) at www.arc.org.uk or by writing to The Arthritis Research Campaign, PO Box 177, Chesterfield, Derbyshire, S41 7TQ.
Arthritis Care, www.arthritiscare.org.uk, 18 Stephenson Way London NW1 2HD.
We hope this helps. There are, of course, many, many supplements that are purported to help arthritis sufferers. At the moment there is not much conclusive scientific evidence to support most of them.
We are happy to discuss different supplements with you during your treatment, or you can phone us on 01223 295345, or email info@victoriadavies.com.
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