Risk and Reward: What You Need to Know to Control Arthritis

By Adam Swenson & Amy Vergin

Arthritis has been with us forever, it seems. It’s a disease you may remember your grandparents complaining of (or, more likely, bearing in silence). It’s nothing exotic or rare, just the accumulation of wear on joints.

Or so we thought. New discoveries, however, are undermining some of what we once took for granted about this all-too-common debilitating condition.

What arthritis is

Simply put, arthritis is joint inflammation. It comes in two main flavors, osteoarthritis and rheumatoid arthritis, though there are actually over 100 types, including gout. Osteoarthritis is the type of arthritis you get from wear and tear on joints over the years: The cartilage wears down and you’ve got bone on bone. This type of arthritis can also be sped up a great deal by joint injuries like a torn ACL.

Rheumatoid arthritis, on the other hand, is a type of autoimmune disorder in which the body’s own immune system attacks the joints. Whereas osteoarthritis sets in later in life (you need time for all that wear and tear to occur!), rheumatoid arthritis can even show up in children.

The CDC says that 46 million adults have arthritis in the US now, making it the most common cause of disability—and that number will hit 67 million by 2030. Osteoarthritis is over ten times as common as rheumatoid: From 1990 to 2005 cases of osteoarthritis in the US population rose from 21 to 27 million; rheumatoid arthritis actually declined from 2.1 to 1.3 million; and gout rose from 2.1 to 3 million.

Risk factors for arthritis

Genetics are a risk factor for both osteo and rheumatoid arthritis. Age, unfortunately, is another—the likelihood of having arthritis rises as we get older. Gender can bias you toward a certain type of arthritis as women are much more likely than men to have rheumatoid arthritis, whereas men are more likely to have gout.

You can’t do much about those risk factors: Now let’s look at a few you can control. As mentioned earlier, joint injuries create a major target for arthritis, so take care of your joints! Be careful about activities that will tear or strain ligaments and tendons you might wish you had later. We’re not saying not to have fun or exercise—just be smart about it.

Obesity is also a major risk factor for arthritis for two reasons: First, carrying around all those extra pounds puts a good deal of extra strain (and thus more wear) on the joints, especially the knees, hips, and spine. This is the traditional understanding of the relationship between obesity and arthritis, one that has been around a long time. What researchers are just discovering, however, is that the link between obesity and arthritis may be a little more complex.

An obese person develops arthritis in the knees in their late 40s—this is in line with the theory. But studies show that osteoarthritis is also twice as common in the hands of obese people. The hands are not load-bearing and thus face no added pressure from the obesity, so why is this?

Cutting down on inflammation

As Alex Hutchinson writes in a column for The Globe and Mail, “The new view is that fat isn't just a blob of inert tissue; it’s metabolically active, ‘a rich source of pro-inflammatory endocrine factors’ that circulate throughout the body. The joints contain receptors that are sensitive to these inflammatory signals, and that interaction could contribute to the risk of developing osteoarthritis.”

Further muddying the waters for the traditionalists is a new long-term study of 90,000 runners showing that running may actually help your joints. Long thought to be one of the worst activities for developing arthritis later in life (they don’t call it “pounding the pavement” for nothing), this study found those who ran 7.5 miles per week or more were 18 percent less likely to develop arthritis. A 2008 Stanford study followed 45 runners and 53 non-runners for 18 years: 32 percent of the non-runners developed arthritis compared to just 20 percent of the runners.

But the running issue may be a red herring. Paul Williams, PhD, studied the group of 90,000. His analysis was that the protective effect of running was due to the fact that it kept the body fat down in that group. While exercise is certainly good for you in a multitude of ways, exercise that would save pounding on the joints is preferable: So biking, swimming, or cross-country skiing would be better than running. But if you love to run and it keeps your weight down, then have at it.

While Dr. Williams said that the protective effects he observed in runners were likely due to lower BMI, the Arthritis Foundation also cites a study of healthy men between the ages of 65 and 74 that showed that the more physically fit you are, the fewer inflammatory chemicals your cells produce. One thought is that working out controls the chemicals that cause inflammation. The truth is that exercise is valuable in both respects, and is one of your best tools to keep arthritis at bay.

Exercise tips for arthritics

>> Stretching: Stretching is a great benefit to those suffering from arthritis. It lubricates joints as well as enhancing your range of motion. But make sure you are stretching correctly—if done improperly you could be decreasing your muscle strength or, even worse, increasing the risk of injury.

If using the stretch and hold method, start with a five to 10 minute warm-up and then begin stretching. Remember to also stretch when the workout is over to maintain long-term flexibility.

Active stretching (known more commonly as sports-specific stretches) increases blood flow and muscle temperature, making the activity that will follow easier on the body. Side lunges, front lunges, half-squats, full squats, and high kicks are great ways to warm your body up!

>> Walking: Walking is one of the best ways to help your arthritis. Walking helps tone your muscles, and when you tone your muscles, your joints are better supported. The fluid found in your joints is able to circulate when you are moving. As you walk, the movement causes the fluid to bring oxygen and other nutrients to your joints.

Like stretching, walking gives you strength, flexibility, and increases your range of motion. More so, walking helps shift the pressure of your weight to the muscles instead of the joints, which in turn lessens the pain of arthritis.

Keep on a walking schedule by finding friends to walk with, trying new paths around your home, and having a good pair of shoes.

>> Swimming/water aerobics: Water helps lessen the impact on your joints considerably, making any type of aquatic sport a great exercise option. Start with the basics: Learn proper form to help minimize potential injuries and stick with the stroke that works best for you. No need to do the butterfly when the front crawl will do.

As for water aerobics, your upper body, lower body, and midsection are being worked just like regular aerobics, but because of the water, your joints receive 75 percent less impact that normal.

>> Golfing: Yes! Even golf is an activity that can help those suffering from arthritis. One reason is that golfing involves a lot of walking and, like we mentioned earlier, this helps tone your muscles and take the pressure off the joints. (Skip the golf cart.)

It’s important to wear walking shoes or golf shoes with soft spikes, as golf shoes with the traditional metal spikes could trip you up. Also, choose lightweight clubs with graphite shafts and perimeter-weighted heads. This will help absorb the shock of hitting the ball.

>> T'ai chi: T’ai chi is a great way to have fluid movements and naturally work on your arthritis symptoms. As an added bonus, t’ai chi has been shown to improve balance and reduce stress along with arthritic pain relief.

Paul Lam, MBBS, a family physician in Sydney, Australia, created a 12-step t’ai chi course, which is what the Arthritis Foundation bases their program on. You can check out their programs nearby or order the DVD for a more private setting.

Arthritis and food: the connection

Oddly enough (or maybe not odd at all) the dietary recommendations for arthritis are the same as for many other conditions. Since arthritis is a condition of inflammation, you need to eat foods that fight inflammation, or at least don’t actively contribute to it. A good place to start is with omega-3s. Eating salmon is great, but you could also just take fish or krill oil. Add fruits and vegetables (more veggies than fruits) and some nuts: a 2003 Swedish study found that arthritis sufferers eating the Mediterranean diet fared better than those who did not.

Avoid fried and processed foods as they are quite inflammatory. Also charred foods have AGEs (advanced glycation end products: sugar bound to a protein), which contribute to inflammation. Sugar is, as always, a prime culprit. Dairy can be a contributor for some. It would be wise to try an elimination diet: Cut out a certain element for three weeks and see if you have an appreciable change in symptoms.

Of course cease tobacco use (if you smoke) and limit alcohol consumption.

Aiding arthritis with supplements

Getting an appropriate amount of exercise is important in helping with arthritis symptoms, but taking supplements is also crucial. By taking the right vitamins and supplements, joint pain from osteoarthritis or rheumatoid arthritis can be controlled to a large extent. However, choosing the right supplement is important. Just because it claims that it “cures joint pain” doesn’t mean you should take it.

Sharon Plank, MD, an integrative medicine physician from the University of Pittsburgh Medical School Center, suggests the following supplements for arthritis:

 >> Chondroitin sulfate

 >> Glucosamine

 >> Calcium

 >> Vitamin D3

 >> Ginger

 >> Turmeric

 >> Omega-3

 >> Green tea

 >> Stinging nettle

 >> Vitamin E

 >> Devil’s claw

There are plenty other supplements that may help ease your pain. Depending on the type of arthritis you have, you may have to plan your supplement strategy accordingly. Talking with your healthcare professional will provide you the information you need to avoid unwanted reactions and achieve the best pain prevention.