Debilitating, exhausting, and depressing. Those are the words my patients often use when describing living with arthritis. Yet often, it is what follows in response to the pain that diminishes quality of life even more: the natural tendency to become sedentary.
This week, Jane Brody’s New York Times article explains why staying active—and avoiding the sedentary trap—is the best way to stay ahead of arthritis. Decreasing physical activity often leads to a spiral of chronic health problems, such as heart disease and diabetes. It also leads to progressive weakness, which makes doing daily activities and enjoying life even harder.
Pain may limit some of the activities you once loved. Yet rather than simply dodging those activities, Jane Brody offers a proven solution that has worked for her: manage the pain from arthritis by finding new activities that keep you moving. In my practice, this has proven to be sound advice.
There is no cure for arthritis. Treatment options for managing pain are limited—and include pain medication, injections, or surgery. While these options are effective and sometimes necessary, I find that natural ways of reducing pain and improving function with arthritis are often underutilized.
Build supporting muscles
Your entire joint is affected by osteoarthritis. Although you cannot replace the joint cartilage that thins with arthritis, you can strengthen the muscles and other supporting structures in your joints.
Many studies show this is an effective approach. A review that included forty four of the highest quality ones found that in a pooled sample of over 3500 patients, exercise reduced pain by an equivalent of 12 points and improved physical function by an equivalent of 10 point on a 0 -100 scale.
What type of exercise is best for arthritis? The best exercise plan is one that is individualized to your needs and preferences. It can depend on whether you have arthritis in one or multiple joints, if your arthritis is mild or severe, or if you have other medical problems that affect your ability to exercise. I often recommend aquatic exercises because they take advantage of buoyancy. Tai Chi is another low impact exercise that puts minimal stress on muscles and joints while building strength and flexibility.
If fear of causing further damage is holding you back from exercising, you may find it helpful to know that the opposite is the case. Leisure activities such as walking, bicycling, and gardening do not accelerate arthritis or increase your chances of needing knee or hip replacement. Walking, in particular, may have a protective effect. This is according to a large Swedish study that followed 28,000 people for eleven years.
A good rule of thumb: while some pain from exercise can be normal with arthritis, pain for two or more hours after an activity can be a sign that you probably over did it.
Protect your joints
How often do you stop to think about the position you are in when you are using your mobile device or reaching for an object? The way you use your muscles and joints may cause inflammation, pain, and damage to your joints.
The premise behind protecting joints through posture and alignment is simple body mechanics. Joints like to be in their anatomically neutral position. When they are not in alignment, weight is distributed unevenly across a joint, which accelerates degeneration. Torqueing, slumping or slouching, as I often catch myself doing, places extra wear and tear on joints and surrounding muscle.
A 2014 study in the journal Surgical Technology International, found that your head, which on average weighs 10 to 12 pounds, can exert 60 pounds of pressure on your cervical spine when you are looking down at a 60-degree angle—such as when you look at your mobile phone.
In order to reduce pain and progression of arthritis, try pretending you are being pulled to sit tall by a puppet string. You should notice the natural C-shaped curves in your neck and low back. Your shoulders, hips, and knees should be symmetric.
I know what you are thinking—easier said than done. When it comes to your joints, however, even small changes in weight translate to large differences in your joints.
It comes down to physics. Your knees feel nearly three to six times your body weight while you are walking. So gaining five extra pounds places 15 to 30 pounds of force on your knees.
The good news that it works both ways. A study in the Journal of the American Medical Association that included 454 overweight and obese adults with osteoarthritis in their knees found that those who lost 11.4% of their body weight over 18 months through an assigned diet and exercise plan felt a dramatic 51% reduction in their pain.
A good starting goal is to target losing 10% of your body weight. This amount has been shown to significantly reduce knee pain, improve mobility, and help you walk faster.
Improve your general health
You have probably heard of osteoarthritis as developing from ‘wear and tear’. Biomechanics, or the forces that directly impact your joints, are only part of the story. Osteoarthritis also develops as a result of inflammation in response to chemical signals and hormones in your body.
Chronic conditions such as diabetes and heart disease promote inflammation and can damage the tiny blood vessels that carry oxygen and nutrients to your joints. Rather than narrowly focusing on treating arthritis through factors that directly impact joints, it’s important to take a whole body approach to reduce inflammation through improving your health.
Follow an anti-inflammatory diet
Since osteoarthritis is a whole body inflammatory process, your diet is an integral part of the comprehensive approach you need to take to managing pain.
Anti-inflammatory foods, many of which are part of Mediterranean diet, are associated with reducing inflammation and improving joint health. Here are a few:
Salmon: 2 times a week
High in vitamin D, which is necessary for bone health, salmon is also rich in omega 3 fatty acids that can lower inflammation.
A 2012 meta-analysis in patients with rheumatoid arthritis showed that fish oil supplements, when taken at a dose of over 2.7 grams a day for over 3 months, reduced pain and the need to take non-steroidal anti-inflammatory medications (NSAIDs). Preliminary evidence suggests fish oil may do the same for osteoarthritis.
Olive oil: use it as your primary oil
Virgin olive oil contains numerous phenolic compounds that have potent anti-inflammatory effects. One of the most potent, oleocanthal, has similar anti-inflammatory properties as ibuprofen.
Fruits and vegetables: 3- 5 servings a day
A colorful array of fruits and vegetable is high in antioxidants, which can reduce the oxidative damage that can promote inflammation.
Although arthritis is common—and afflicts an estimated 52.5 million Americans according to the Centers for Disease Control—staying active and taking a whole body approach can help you avert debilitating pain, continue your daily activities, and maintain your independence.