What is arthritis?
The term arthritis describes a group of conditions that affect the
cartilage (the smooth protective surface covering joints) in joints. Degeneration of cartilage can cause pain,
inflammation, and decreased mobility in affected joints.
Osteoarthritis is the most common form of arthritis, affecting millions
of Americans. It used to be thought
that osteoarthritis was the result of “normal wear and tear” in joints. Evidence is growing, however, that
biomechanical factors such as muscle control, muscle weakness, and obesity play
a significant role in the development and progression of the disorder.[i] Since chiropractic treatment restores
function to joints, it is a wonderful tool for preventing arthritis. In joints that are already arthritic,
chiropractic is the treatment of choice to rehabilitate and delay or arrest
further degenerative change. It has
also been found that in some cases diet may play a role. This information has led to a great deal of
research about the role of exercise and diet in the treatment and prevention of
I thought exercise caused my joints to “wear out”.
It is true that long-term practice of certain high impact sports
(soccer, football) may increase the incidence of osteoarthritis.[ii] It is also true that exercise is one of the
best proven long-term treatments for osteoarthritis. In fact, muscle weakness has been shown to be an accurate
predictor of future disability in people with osteoarthritis of the knee. Movement provides joints with nutrients
needed for repair and healthy function.
There is very little blood supply to cartilage—regular movement serves
to “squeeze out” nutrient depleted fluids and “draw in” fresh, nutrient rich
Walking and resistance training have been shown to both decrease pain
associated with osteoarthritis of the knee and increase physical function (i.e.
rising from a chair, walking up stairs).[iii]
The key to building a successful exercise program with osteoarthritis
is to find activities that do not aggravate the condition. Activities should target muscle groups that
cross the affected joint (for example the quadriceps for osteoarthritis of the
knee). Consider non weight-bearing
exercises (i.e. leg extensions for the knee rather than squats) when developing
a resistance routine. When picking an
aerobic exercise consider low impact choices (elliptical trainer, swimming,
walking) rather than high impact (basketball, running). Exercises that cause either a significant
increase in pain, or an increase in pain that lasts greater than 2 hours after
the exercise, should be avoided. If
exercise involving movement is too painful, consider beginning with isometric
[vii] Use gentle, controlled stretching techniques
to maintain joint mobility.
Chiropractic Care and Arthritis
Chiropractors are experts in joint mechanics and movement. If your joints move too much or too little
they will experience forces that lead to early breakdown and arthritis. Regular chiropractic care ensures the best
possible movement patterns in your joints.
Chiropractic care combined with exercise allows joint tissue access to
the nutrients needed to maintain health.
What about diet?
Being overweight is the single most important modifiable risk factor
for osteoarthritis. Studies show that
losing weight decreases risk and also improves symptoms in people who have
osteoarthritis in the weight-bearing joints (hips, knees, ankles). Losing as little as 10 pounds can have a
The “nightshade free diet” is reported to reduce osteoarthritis
symptoms in many people, although more research needs to be done. The nightshade family includes tomatoes,
white potatoes (not yams or sweet potatoes), eggplant, hot and sweet peppers,
and tobacco. This food group contains
natural toxins including solanine that may be capable of causing joint problems
in sensitive people. It is reported
that abstaining from these foods for up to 6 months may be necessary to obtain
Are there any supplements that will help?
Yes! Several studies have shown
that glucosamine sulfate is very effective in relieving pain associated
with osteoarthritis. Some studies show
that taking this supplement can cause joint cartilage to rebuild and repair
itself. This is especially noteworthy
because while one gets about the same pain relief from glucosamine sulfate as
with NSAIDs[x] (i.e.
ibuprofen), many NSAIDs have been shown to be destructive to joint cartilage! [xi]
Most studies have used 1500mg of
glucosamine sulfate 1 time per day.
This supplement takes about 2 weeks to take effect.
An herbal supplement that has undergone a great deal of research and
which I have used with fantastic results in my practice is Zyflammend. This product is a blend of several herbs
It has been shown to
be about 90% as effective as prescription anti-inflammatories, but without the
side effects. In fact, whereas
pharmaceutical anti-inflammatories pose a great risk to your digestive track
and your cardiovascualr system, Zyflammend is beneficial to both systems.
Other supplements that have been shown to be helpful are:
q MSM 2250mg/day[xvi]
q SAMe 1200mg/day[xvii]
q Capsaicin ointment .025%-.075%[xviii]: This can be applied to superficial joints
like the hands and feet. It is applied
4 times per day and may take up to 4 weeks to become effective. It does not penetrate deep enough to treat
deep joints such as the spine or hip.
What can I do to deal with flare-ups?
During flare-ups ice and rest are your best friends. You can ice a joint with an ice pack or a
bag of frozen vegetables. Ice for 15-20
minutes and be sure to have a layer (like a shirt or pants between your skin
and the ice pack. Do not ice more than
As you are able to, begin isometric exercises (exercises during which
the joint does not move). As you make a
comeback to exercise ice after your workout to minimize inflammation and
Take the time to try the various strategies outlined above. I find that exercise, chiropractic care, and supplementation alleviates most patients' arthritic pain. This translates to more ease of movement and a higher quality of life. You deserve the best, make a commitment to implementing these strategies.
[i] Felson D. Osteoarthritis: New Insights. Annals of Internal Medicine. 2000;133:726-737.
[ii] Spector TD,
Harris PA, Hart DJ, et al. Risk of osteoarthritis associated with long-term
weight-bearing sports. Arth Rheum 1996;39:988-95.
[iii] Kovar PA,
et al. Supervised fitness walking in
patients with osteoarthritis of the knee.
Annals of Internal Medicine. 1992;116:529-34.
[iv] Thomas K, Muir K, Doherty
M, Jones A, O’Reilly S, Bassey E. Home
based exercise programme for knee pain and knee osteoarthritis: randomized
controlled trial. British Medical Journal. 2002:325(5).
[v] Topp R, Wooley S et
al. The effects of dynamic versus
isometric resistance training on pain and functioning among adults with
ostroarthritis of the knee. Arch Phys Med Rehabil 2002;83:1187-95.
R. Exercise for older patients with
chronic disease. The Physician and
Sports Medicine. 1999:27;11.
R. Exercises for patients with knee
osteoarthritis. The Physician and
Sports Medicine. 1999:27;11.
NF. A relationship of arthritis to the solanaceae (nightshades). J Internat
Acad Pre Med 1982;Nov:31–37.
NF, Margoles MS. An apparent relation of nightshades (Solanaceae) to arthritis.
J Neurol Orthop Med Surg. 1993;14:227–31.
Muller-Fassbender H, Bach G, Haase W, Rovati L, Setnikar I. Glucosamine
sulfate compared to ibuprofen in osteoarthritis of the knee. Osteoarthritis Cartilage. 1994
[xi] Brooks PM,
et al. NSAID and osteoarthritis: help or hindrance? Journal of
[xii] Brandt KD,
Palmoski MJ. Effect of salicylates and other non-steroidal anti-inflammatory
drugs on articular cartilage. Am J Med. 1984;77:65-69.
[xiii] Rashad S,
Hemingway A, Rainsford K, Revell P, Low F, Walker Fl. Effect of non-steroidal
anti-inflammatory drugs on the course of osteoarthritis. Lancet.1989; (8662):520-22.
[xiv] Dingle JT.
The effect of NSAIDs on human articular cartilage glycosaminoglycan synthesis.
Eur J Rheum Inflam 1996;16:47-52.
[xv] Brandt KD.
Should nonsteroidal anti-inflammatory drugs be used to treat osteoarthritis? Rheum
Dis Clin N Am. 1993;19:697-712.
RM. Methylsulfonylmethane (MSM): a double-blind study of its use in
degenerative arthritis. Int J of Anti-Aging Med. 1998 July;1(1):50.
F, Fumagalli M, Sarzi Puttini P, et al. Double-blind study of S-adenosyl-methionine
versus placebo in hip and knee arthrosis. Clin Rheumatology. 1985;4:484–85.
GM, McCarty DJ. Effect of topical capsaicin in the therapy of painful
osteoarthritis of the hands. J