16th January, 2005

Dr NICK HODGSON

"Wear and tear", "osteoarthritis", "degenerative joint disease", "arthritis", "spondylosis", “human rust”, “just getting old, Mrs Jones" - no matter what you call it, the pain and suffering caused by joints of any part of your body wearing out can be debilitating.

Progressively losing the abilities to participate in the activities we all love is no easy path to walk - whether it be loss of productivity in the workplace; restricted ability to maintain and clean your own home and gardens; reduction of sporting prowess; difficulty participating in social and family activities; or loss of general mobility and fitness.

NO WALKING?: Living with arthritis means adopting a range of strategies including regular exercise, healthy eating and keeping the stress levels down says Dr Hodgson. PICTURE: Bjarne Kvaale (www.sxc.hu)   "Rest and immobilisation can be useful during an acute short-lived “attack”, but as a long-term strategy both are detrimental for fitness, muscle tone, flexibility and coordination - the very things that need to be maintained and improved."

Sometimes we can cope with the slow reduction in our physical capacities with the passing of time but when we start to lose the ability to be involved in our most fulfilling roles in life, then our quality of life and state of wellbeing deteriorate proportionately.

Arthritis: the smooth cartilage lining of your joints thinning and cracking; bony joint edges calcifying and thickening; ligaments becoming inflamed, fibrous and shortened; limb and spinal movements becoming painful and restricted; muscles initially in spasm and shortened; then reaching the point of fatigue and weakness.

Initially the soreness is only periodic and temporary. Then you start to get more aching; especially after exercising, exertion, or paradoxically after being inactive. As things progress it gets harder to get out of bed in the morning, and can take longer and longer to get moving each day. Eventually the pain becomes more and more severe, and activities that once relieved and improved the problem, now seem to be the very things that aggravate the condition! Not an encouraging and positive picture.

For years the standard medical care for arthritic problems of any kind has been to rest and immobilise; prescribe paracetamol and stronger pain relieving medications if required; and/or recommend non-steroidal anti-inflammatory tablets. "Learn to live with it"; and when it gets bad enough, resort to surgery to scrape away some of the mess, or even to replace the joint with a synthetic alternative.

While these approaches can offer temporary relief and some improved quality of life, none of the above approaches are void of risk: rest and immobilisation can be useful during an acute short-lived “attack”, but as a long-term strategy both are detrimental for fitness, muscle tone, flexibility and coordination - the very things that need to be maintained and improved. Every medication carries a long list of side-effects and interactions. Surgery can be a miraculous last resort but the lists of risks from any aspect of these procedures are as long as the limb’s being repaired.

Only now is the medical community starting to catch on to more conservative strategies that have been utilised by chiropractors and natural therapists for decades. Here's some general advice for living with arthritis:

Chiropractic care

Adjustments, manipulation, soft tissue therapies and mobilisation can each be very effective in stretching the joints to increase their flexibility, stimulating the nerve endings in the joints providing pain relief, initiating healing mechanisms, and helping to relax the surrounding muscles as well as increasing the blood supply aiding repair, and stretching muscles which have become tight and contracted. Adjustments can also help to reduce any damage being done to the nervous system by the stiff, misaligned and at times deformed joints.

One of the most frustrating things for a chiropractor can be the number of patients suffering from arthritic problems who are advised by so-called experts not to have any hands-on therapies because of the arthritis. In fact these people should be among the first seeking professional chiropractic care to help with the problem.

Exercise
a) Weight-bearing: walking, cycling, low-impact aerobics, aqua-aerobics. Encouraging steady rhythmic movement in worn joints helps to nourish and repair the damaged tissues, increases the body's endorphins (the body's own natural painkillers) and promotes general fitness and feelings of wellbeing. If excess weight is an issue then exercise is the key to shedding some pounds.

b) Non-weight-bearing: swimming, stretching, rehab exercises. Movement without the stresses of gravity can be very beneficial in getting stiff, painful and tired joints moving again. If you have confirmed arthritic changes by X-ray analyses, then it is vital to keep all movements within comfortable ranges. Try not to stretch your affected joints into painful positions as aggravating any inflammation will only slow your recovery. On the other hand, it is important to move your joints in the variety of directions that each joint is able to stimulate circulation and stretch the tightening soft-tissues surrounding each joint. In other words, look for structured and supervised exercise classes.

Diet
A healthy and nutritious diet will help to reduce weight, improve circulation, provide correct nourishment to muscles, bones and joints, and minimise inflammation in the body:

a) Decrease sugars: don't add sugar to cereals, drinks and cooking. No lollies, cakes, or cookies. Reduce the intake of packaged/processed foods.

b) Decrease saturated fats: less land animal fats. Don't cook with dripping or butter - use cold-pressed olive oil instead. Trim skin and fat off all meats. Eat less red meat, more vegetables, more vegetable fats in cooking, more fish and seafood.

c) Increase complex carbohydrates: wholemeal, wholegrain, multigrain - pasta, rice, flours and bread. Eat more vegetables and fruit, and less processed/packaged foods.

d) Increase "live" foods: fresh meats, fruits and veggies, and raw salads without too much dressing.

Supplements
A well-chosen mixture of dietary supplements can help to naturally stimulate healing, reduce inflammation, and modulate pain:

a) Vitamins and minerals: acomprehensive multivitamin/mineral can overcome any deficiencies and ensure that the micronutrients for healing are present.

b) Omega 3 and 6 oils: cod liver oil, evening primrose oil, and flaxseed oil have anti-inflammatory actions.

c) Other supplements with anti-inflammatory and/or pain relieving action: phenylalanine (amino acid), bromelain (extract from pineapple stalks), bioflavenoids (helps vitamin C to work), glucosamine (such as shark fin, deer antler, cartilage extracts), chondroitin, celery seed.

Attitude
Stress leads to tense muscles as well as exhausting our natural painkillers, suppresses the immune system and generally wears down the body's coping mechanisms. So as you can imagine, positive attitude and effective stress management strategies can play a significant part in living with arthritis.

Food allergies
The presence of allergies or intolerances to certain foods has been implicated in the aggravation of pain, inflammation and the progression of arthritic conditions. Some of the most common suspects are dairy, wheat, and deadly nightshades (potato, tomato, capsicum, eggplant). Exclusion, elimination and/or rotation diets can be used to determine which foods are aggravating the condition. This will usually require the guidance of a health care professional to work through a process like this. Don’t be discouraged by the 'expert' who says that foods don’t cause arthritis: they are right in one sense. Foods don’t cause arthritis. But foods can definitely contribute to and exacerbate arthritic problems; and removing offensive food types can make significant positive changes in your pain and function.

Changes in any one of the above areas can make noticeable improvements for sufferers of arthritic conditions. Changes in all of the above areas can lead to massive breakthroughs in pain relief, affected joint function, and overall quality of life enjoyment.

So don’t lose it - move it!

The information contained in this article is of a general nature only. For advice on your specific situation, please consult your medical professional.

Dr Nick Hodgson is a chiropractor.
You can read more articles like this one at www.healthetalk.com.au

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