Functional Medicine for Arthritis
What is arthritis
Arthritis describes conditions that cause joint pain, stiffness and sometimes inflammation. It can affect people of different ages, including children. [1]
The two most prevalent kinds of arthritis are osteoarthritis and rheumatoid arthritis.
Osteoarthritis
Osteoarthritis is a common joint condition. It becomes more common with age but can also affect younger people, particularly after injury. [1]
In addition, women and those with a family history of the illness are more likely to experience it. However, it can happen at any age as a result of an accident or be linked to other joint-related diseases like gout or rheumatoid arthritis.
The smooth cartilage that lines the joint is initially impacted by osteoarthritis. Movement becomes more challenging than usual as a result, resulting in discomfort and stiffness.
The tendons and ligaments must work harder when the cartilage lining begins to deteriorate and become rougher.
Osteophytes, which are bone spurs, may occur as well as swelling. Grave cartilage loss can cause the bones to rub against one another, changing the form of the joint and displacing the bones from their natural positions.
The joints that are most frequently impacted are those in the:
- hands
- spine
- knees
- hips
Rheumatoid arthritis
Rheumatoid arthritis is an inflammatory autoimmune condition. It can start at different ages and needs timely medical assessment. [2]
In rheumatoid arthritis, inflammation affects the synovium, the tissue lining the joint. Persistent inflammation can damage cartilage and bone and may affect other organs. [2]
Other types of arthritis and related conditions
- ankylosing spondylitis – a long-term inflammatory condition that mainly affects the bones, muscles and ligaments of the spine, leading to stiffness and joints fusing together. Other problems can include the swelling of tendons, eyes and large joints
- Cervical spondylosis means age-related changes in the bones and joints of the neck; it is distinct from inflammatory spondylitis. [1]
- fibromyalgia – causes pain in the body's muscles, ligaments and tendons
- lupus – an autoimmune condition that can affect many different organs and the body's tissues
- gout – a type of arthritis caused by too much uric acid in the body. This can be left in joints (usually affecting the big toe), but can develop in any joint. It causes intense pain, redness and swelling
- psoriatic arthritis – an inflammatory joint condition that can affect people with psoriasis
- Enteropathic arthritis is joint inflammation associated with inflammatory bowel disease, including Crohn’s disease and ulcerative colitis. It can affect limb joints or the spine. [1]
- reactive arthritis – this can cause inflammation of the joints, eyes and the tube that urine passes through (urethra). It develops shortly after an infection of the bowel, genital tract or, less frequently, after a throat infection
- secondary arthritis – a type of arthritis that can develop after a joint injury and sometimes occurs many years afterwards
- polymyalgia rheumatica – a condition that almost always affects people over 50 years of age, where the immune system causes muscle pain and stiffness, usually across the shoulders and tops of the legs. It can also cause joint inflammation
What are the symptoms of arthritis
The symptoms you experience will vary depending on the type you have.
This is why it's important to have an accurate diagnosis if you have:
- joint pain, tenderness and stiffness
- inflammation in and around the joints
- restricted movement of the joints
- warm red skin over the affected joint
- weakness and muscle wasting
How functional medicine can help with arthritis
Nutrition and lifestyle support may complement arthritis care, but food or supplements cannot be promised to regenerate damaged cartilage. [3]
Natural products may cause adverse effects or interact with medicines. They are not automatically safer than prescribed treatment. [4]
Diet advice should support adequate nutrition and general health; a supplement should not be assumed to control joint inflammation. [3]
Gut symptoms may need their own assessment. Treating the gut has not been established as a replacement for arthritis treatment. [2]
• Find out what underlying issues or imbalances might be causing your arthritic symptoms, and take care of them.
Avoid broad exclusion diets unless there is a clear clinical reason and appropriate nutritional support. [3]
Assess a suspected nutritional deficiency on its own merits. Do not assume that a deficiency explains an established arthritis diagnosis. [3]
Tests are selected to answer a specific question. The list below is not a routine arthritis panel; saliva, heavy-metal and specialist nutrient tests need a separate clinical indication. [3]
- · Thyroid function test
- · Digestive system testing
- · Blood testing
- · Urine testing
- · Saliva Testing
- · Heavy Metal testing
- · Fatty Acid testing
- · Anti-Oxidents
- · Minerals and Vitamin testing
Dr Stavy can prepare a personalised treatment plan for you based on a comprehensive analysis which can include:
- · Advice on nutrition
- · A plan and advice for exercising
- · Medication
- · A lifestyle change and recommendations
Treating arthritis
Treatment depends on the type of arthritis. Exercise and, where appropriate, weight management are core osteoarthritis measures. Suspected rheumatoid arthritis needs prompt specialist assessment and disease-modifying treatment when indicated; lifestyle measures do not replace it. [2]
Eating well
If you have arthritis, eating a healthy, balanced diet is crucial. You may get all the nutrients you need and keep a healthy weight by eating a balanced diet. All five food groups should be included in your diet in a variety of items. Which are:
- fruit and vegetables
- starchy foods – such as bread, rice, potatoes and pasta
- meat, fish, eggs and beans
- milk and dairy foods
- Small amounts of unsaturated fats; limit foods high in added sugar. [3]
8 food and drinks to stay away from if you have arthritis
The heading below reflects the older article. There is no universal eight-food exclusion diet for arthritis. Food choices should be tailored to the person; do not remove whole food groups without a sound reason. [3]
1. Sugars added in
No matter what, but especially if you have arthritis, you should limit your intake of sugar. Candy, soda, ice cream, and many more foods—including less visible ones like barbecue sauce—all include added sugars. Additionally, drinking sugary drinks like soda may greatly raise your risk.
2. Processed and red meats
Limiting processed meat can form part of a balanced diet. This does not establish that avoiding all red meat treats an individual’s arthritis. [3]
3. Foods containing gluten
Gluten is present in wheat, barley and rye. A gluten-free diet is needed for coeliac disease, but it is not a general arthritis treatment. [3]
If coeliac disease is suspected, ask about testing before cutting out gluten, because restriction can affect the results. [5]
4. Highly processed foods
A balanced diet can limit foods high in salt, added sugar and saturated fat. “Processed” alone does not show that a food causes a person’s joint symptoms. [3]
5. Alcohol
Alcohol advice depends on health, medicines and the type of arthritis. Discuss interactions and individual limits with the prescribing team. [2]
6. Specific plant oils
Omega-3 and omega-6 fats have roles in normal nutrition. A fixed ratio or avoidance of all vegetable oils is not an established arthritis treatment. [3]
7. Foods high in salt
For those who have arthritis, reducing salt intake may be a wise decision. Shrimp, canned soup, pizza, some cheeses, processed meats, and several other processed foods are examples of foods high in salt.
8. AGE-rich foods
Molecules called advanced glycation end products (AGEs) are produced when proteins or lipids react with sugars. They are naturally present in raw animal foods and are created through specific cooking techniques.
One of the richest dietary sources of AGEs is high protein, high fat animal dishes that are fried, roasted, grilled, seared, or broiled. These include bacon, grilled or roasted poultry, steak that has been pan-fried, and hot dogs that have been broiled.
Research on advanced glycation end products does not establish a proven arthritis exclusion diet. Avoid turning laboratory or observational findings into a promise of symptom relief. [3]
Exercise
If your arthritis is painful, you may not feel like exercising. However, being active can help reduce and prevent pain. Regular exercise can also:
- improve your range of movement and joint mobility
- increase muscle strength
- reduce stiffness
- boost your energy
Exercise should be tailored to your condition and capacity. Some discomfort can occur when starting, but new marked swelling, injury or severe worsening pain needs review. Seek advice about the appropriate type and amount of activity. [3]
At home
It can be difficult to complete duties around the house if you have arthritis. But things ought to get easier if you make some useful adjustments to your house and your working habits. The following helpful advice is practical:
- keeping things in easy reach
- using a hand rail to help you get up and down the stairs
- using long-handled tools to pick things up or to clean
- fitting levers to taps to make them easier to turn
- using electric kitchen equipment, such as tin openers, when preparing food
Supplements
Evidence and safety differ between supplements. They should not replace disease-modifying treatment for inflammatory arthritis or the core treatments for osteoarthritis. [3]
The products below have been studied, but none should be described as a natural cure or as free of side effects. [4]
Glucosamine and Chondroitin
Glucosamine and chondroitin are marketed for joints. NICE advises against offering glucosamine for osteoarthritis; marketing claims do not establish cartilage repair. [3]
Fish oil
Fish oil contains long-chain omega-3 fats. Any possible symptom benefit does not replace rheumatoid arthritis medicines, and supplement use needs an interaction check. [2]
SAM-e
SAM-e has been studied for osteoarthritis, but it cannot be described as equivalent to an anti-inflammatory medicine without its side effects. Discuss risks and interactions before use. [4]
Curcumin
Curcumin is a component of turmeric. Laboratory anti-inflammatory activity does not show that a turmeric supplement is clinically equivalent to celecoxib. Products and doses vary, and adverse effects or interactions can occur. [4]
Vitamins
Several vitamins have been studied for their effects on arthritis, including the antioxidant vitamins A, C, and E, and vitamins D and K. So far there’s no evidence that taking antioxidant vitamins improves arthritis symptoms, although eating a diet rich in these nutrients is healthy overall. Vitamins D and K are both important for bone strength, and vitamin K is involved in cartilage structure. Supplementing these two nutrients may be helpful if you’re deficient in them.
For more information or if you would like to discuss treatment and management for arthritis with Dr Stavy then please contact us via email: info@drstavy.com