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Arthritis: Ways to Improve Your Mobility

Arthritis refers to any number of conditions causing joint pain, swelling, and stiffness resulting in disability.

According to the Public Health Agency of Canada, arthritis affects 16% of Canadians over the age of 15.[1] There are several different types of “arthrides,” including osteoarthritis (“wear-and-tear” arthritis), rheumatoid and other types of autoimmune arthritis, juvenile arthritis, systemic lupus erythematosus (SLE), and gout. The pain and joint damage associated with arthritis are caused by the presence of uncontrolled inflammation. Therefore, the goal of treatment is to reduce inflammation and promote joint healing. Many people depend on painkillers and other medications in order to function normally; however, there are a variety of natural therapies that offer relief from chronic pain.

Dietary factors can be a source of inflammatory triggers. Alterations in digestive function, specifically the development of “leaky gut,” have been identified in a number of chronic inflammatory conditions including fibromyalgia, juvenile arthritis, lupus, and ankylosing spondylitis (AS).[2][3][4] When gut-barrier function is impaired, food proteins that are not normally allowed to pass across into the blood may do so, triggering an immune reaction and the development of immune hyperreactivity. Studies of patients with fibromyalgia suggest higher rates of gluten intolerance,[5] and studies of patients with rheumatoid arthritis show increased levels of food-⁠specific antibodies present in their intestinal fluid.[6] The involved foods included proteins from cow’s milk (alpha-⁠lactalbumin, beta-⁠lactoglobulin, casein), cereals, hen’s egg (ovalbumin), cod fish, and pork meat.[6] Plants from the nightshade family (potatoes, tomatoes, peppers, eggplant) as well as other inflammatory foods have been implicated in osteoarthritis.

Although it may seem counterintuitive, exercise has been shown to improve the pain and stiffness associated with osteoarthritis.

Exercise can help with achieving a healthy weight, minimizing the weight-⁠bearing stress on the joints. Exercise simultaneously improves the strength of the muscles supporting the joint, and improves the flexibility and range of motion of noncontractile tissues, such as tendons and ligaments, that are also involved in supporting joints. A recent study, for instance, found that use of an exercise program for the hip significantly reduced pain among women with osteoarthritis of the hip.[7] Results showed that pain declined over 30% from baseline, while joint function and health-⁠related quality of life improved slightly. Leg extensor (a muscle group) strength increased by 20%, and hip extension range of motion increased by 30%.[7]

Anti-inflammatory supplements also have a role to play in managing arthritis.

The omega-⁠3 fatty acids found in fish oil, eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), are powerful anti-inflammatory nutrients. EPA and DHA block the proinflammatory action of the cyclooxygenase-⁠2 (COX-⁠2) enzyme and the lipooxygenase (LOX) enzyme. These enzymes metabolize fats in the cell membrane to inflammatory chemicals in the body. COX-⁠2 metabolizes arachidonic acid (AA) into proinflammatory prostaglandins (PGE2) and leukotrienes.[8] However, when COX-⁠2 uses EPA as its fuel, it produces anti-inflammatory chemicals such as PGE3 and LTB5. In this way, fish oil has similar effects as nonsteroidal anti-inflammatories (NSAIDs, e.g. aspirin), but without the gastrointestinal side effects.

Natural eggshell membrane (NEM®) has been shown to improve joint pain and stiffness associated with osteoarthritis. NEM® is a new, proprietary extract with pilot studies and a randomized, controlled trial demonstrating sizeable improvements as early as seven days.[9][10] Supplementation with 500 mg of NEM® for eight weeks was shown to reduce knee pain and stiffness compared to placebo at all time points. After only ten days, pain was reduced by 15% compared to placebo.[10]

Boswellia, an Ayurvedic herb also known as frankincense, has been shown to reduce inflammation associated with osteoarthritis of the knee. Boswellic acids inhibit 5-⁠lipoxygenase (5-⁠LOX), the enzyme responsible for the production of proinflammatory leukotrienes from arachidonic acid.[11] In clinical trials, boswellia extract has repeatedly been shown to improve pain and functional ability as early as seven days.[11]

Curcumin, an extract of turmeric, has been shown to decrease inflammatory chemicals in patients with osteoarthritis. Administration of curcumin to 100 patients with osteoarthritis resulted in significant decreases in a series of inflammatory markers including interleukin (IL)-⁠1beta, IL-⁠6, soluble CD40 ligand (sCD40L), soluble vascular cell adhesion molecule (sVCAM)-⁠1, and erythrocyte sedimentation rate (ESR).[12] There were also significant improvements in joint pain, stiffness, and range of motion, as well as improvements in the distance that patients were able to walk on a treadmill test.[12]

Natural therapies can help keep you healthy, pain-free, and active.

NEM® is a registered trademark of ESM Technologies, LLC.

References

  1. Public Health Agency of Canada. Life with arthritis in Canada: A personal and public health challenge. Chapter One: What is arthritis and how common is it? · http://www.phac-aspc.gc.ca/cd-mc/arthritis-arthrite/lwaic-vaaac-10/3-eng.php · Updated 2011-⁠11-⁠10 · Accessed 2017-⁠01-⁠25.
  2. Goebel, A., et al. “Altered intestinal permeability in patients with primary fibromyalgia and in patients with complex regional pain syndrome.” Rheumatology. Vol. 47, No. 8 (2008): 1223–1227.
  3. Picco, P., et al. “Increased gut permeability in juvenile chronic arthritides. A multivariate analysis of the diagnostic parameters.” Clinical and Experimental Rheumatology. Vol. 18, No. 6 (2000): 773–778.
  4. Fresko, I., et al. “Intestinal permeability in Behçet’s syndrome.” Annals of the Rheumathic Disease. Vol. 60, No. 1 (2001): 65–66.
  5. Tovoli, F., et al. “Fibromyalgia and coeliac disease: a media hype or an emerging clinical problem?” Clinical and Experimental Rheumatology. Vol. 31, No. 6, Suppl. 79 (2013): S50–S52.
  6. Hvatum, M., et al. “The gut-joint axis: Cross reactive food antibodies in rheumatoid arthritis.” Gut. Vol. 55, No. 9 (2006): 1240–1247.
  7. Uusi-Rasi, K., et al. “Exercise training in treatment and rehabilitation of hip osteoarthritis: A 12-Week Pilot Trial.” Journal of Osteoporosis. Vol. 2017 (2017): 3905492. doi: 10.1155/2017/3905492. [Epub 2017 Jan 1]
  8. Caughey, G.E., et al. “Fish oil supplementation increases the cyclooxygenase inhibitory activity of paracetamol in rheumatoid arthritis patients.” Complementary Therapies in Medicine. Vol. 18, No. 3–4 (2010): 171–174.
  9. Ruff, K.J., et al. “Eggshell membrane: A possible new natural therapeutic for joint and connective tissue disorders. Results from two open-label human clinical studies.” Clinical Interventions in Aging. Vol. 4 (2009): 235–240.
  10. Ruff, K.J., et al. “Eggshell membrane in the treatment of pain and stiffness from osteoarthritis of the knee: A randomized, multicenter, double-blind, placebo-controlled clinical study.” Clinical Rheumatology. Vol. 28, No. 8 (2009): 907–914.
  11. Sengupta, K., et al. “Comparative efficacy and tolerability of 5-⁠loxin and aflapin against osteoarthritis of the knee: a double blind, randomized, placebo controlled clinical study.” International Journal of Medical Sciences. Vol. 7, No. 6 (2010): 366–377.
  12. Belcaro, G., et al. “Efficacy and safety of Meriva®, a curcumin-phosphatidylcholine complex, during extended administration in osteoarthritis patients.” Alternative Medicine Review. Vol. 15, No. 4 (2010): 337–344.