Arthritis Pain: More Than Medicine Can Help
Arthritis is a word I hear people use when they come to see me at my physiotherapy clinic. Whether it is for neck pain, back pain, hip pain, knee pain, or shoulder pain, they might say, “My doctor says I have arthritis,” or “My x-rays show arthritis.” Sometimes the client even tells me physiotherapy was not advised because the pain is from arthritis; instead, the person is given is an anti-inflammatory medication to treat the symptoms of the arthritis.
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The Arthritis Society of Canada‘s website explains there are 100 different types of arthritis that affect about 4.6 million adult Canadians and cost the health-care system 33 billion dollars each year. These figures are expected to grow. It is also more common in women. It is not just for old retired people; 3/5 are reportedly of working age.
What shocked me the most was that on the website, it says “There is no cure for arthritis.” It sounds like a death sentence. You might as well tell someone they are going to live with this pain for the rest of their life.
My clients often do feel this way when they come to see me. Some have been told this. Many feel like being told they have arthritis means that, it is going to get worse, and they are going to end up crippled and dysfunctional in a wheelchair.
My experience lies mainly with the osteoarthritis.Osteoarthritis is the term used for inflammation of the joint caused from wearing down of the bone.
Bone is covered by a smooth surface called cartilage. Cartilage has no nerve endings and when intact protects the underlying bone surface. The cartilage can be damaged a number of ways. You may have fallen or had an impact injury that damaged the cartilage. There could be muscle imbalances that have caused the joint to be misaligned slightly, causing a wearing of the joint over time. This is common for the hip joints. Or it could be related to inflammation in the body.
What are you willing to change?
I asked a few clients what was one or two issues they wanted help with when it came to managing their arthritic symptoms. The first client said he wanted to know what foods might aggravate and what foods might help. This surprised me, but I was pleased, as I have been doing a great deal of reading in this area. There are so many great books out on this topic.
The top six foods that people often have a sensitivity to include:
- Gluten: breads, baked goods, pastas, cereals that are made from gluten flours
- Dairy products: cows milk, cheese, creams
- Corn and corn products
- Soy: sauces, tofu
When people have a sensitivity to a food, it will cause an inflammatory response in the body. Then there are certain foods or food products that have been associated with arthritis. These include:
- Sugar (by any name)
- Trans fats
- Cows Milk
- Cured meats/red meats
- White grains/wheat
- Food additives: MSG, sulfates
Changing what you eat can be challenging. These were some of the comments I heard today:
- “Food is my comfort.”
- “It would seem that life would be no fun if I had to give up all that.”
- “I am a sugar addict.”
The last person was the one who inquired about the foods, and who admitted his arthritic pain was getting worse, but he had not yet tried giving up sugar. I did have one client who was able to give up her arthritic medication when she stopped eating gluten products. This saved her a lot in therapy costs.
Will it ever get better?
Start with food. The Arthritis Society of Canada website links their nutrition information to Canada’s food guide, which is really not a great guide for eating an anti-inflammatory diet. Get a book called Meals That Heal Inflammation, by Julie Daniluk. And work with someone who can guide and support you, be it a naturopath or nutritionist.
Also, ask yourself what is the cause of the pain. I have a number of clients who come in with so called “arthritic” pain, who leave without it after I release the tight muscles that are compressing the joints together or keeping the joint in an abnormal position.
Try this: If you put your hands together and rub them, you feel heat from the friction. Now press them harder together and rub, and what do you feel? More heat and friction. This is what is happening in the joint when they are compressed or misaligned.
Sometimes the pain in the joint is actually only pain being referred to the joint from a tight muscles. Both my colleague and I experienced this with pain in our acromioclavicular joints (AC joint) in the shoulder. Once we released the strained rotator cuff muscles (the supraspinatus), the AC joint pain went away. This also worked extremely well on a client. I wonder if he needed the acromioplasty (surgical scrapping and cutting away of the joint to reduce the pain thought to be arthritis in nature). The xray showed arthritis, but he came to me because he was still having excruciating pain more than 6 months post-operatively. His pain is now minimal after releasing so many of the tight and reactive muscles and we have been able to start the shoulder-retraining program.
I see this is with knee pain, secondary to tightness in the quadriceps (thigh muscles), or even the calf and hamstrings (back of the knee).
Anything is possible
My client who reported being diagnosed with osteoarthritis of the back (which she does have) and living with intense pain for 20 years. Once she was brave enough to let me use my intramuscular stimulation (IMS) technique to release some extremely tight muscles in her back, she started to have periods and even days without the pain—or the first time in 20 years.
Don’t give up hope. Anything is possible. These are the messages I give my clients. There are ways to manage or eliminate pain often termed “arthritic” pain.
I do truly believe this statement. I believe in the body’s ability to heal itself if you give it the right conditions. What you choose to put into your mouth affect the body at the cellular level. I recommend The Biology of Belief, by Bruce Lipton to learn about how the environment and our thoughts affect our health at the cellular level.
Stephen Cherniske has written a wonderful summary on the acid-alkaline issue. I have taken a couple of paragraphs that stood out in summary for review here:
“We now know, however, that there are significant adverse consequences to anyone consuming the Standard American Diet (abbreviated SAD) because it is extremely acid-forming. Food consumption surveys reveal that Americans are now consuming more soft drinks than any other beverage including water. Add coffee to that (including decaf) and you have a metabolic disaster in the making. And that’s only the beginning. Americans consume meat and poultry products at an average of two meals a day every day, and the grains we consume have all had the alkaline minerals refined away.
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At the same time, consumption of alkaline-forming vegetables and fruit is at an all-time low. The result is widespread acidosis that accelerates catabolic damage and impairs anabolic repair processes. Perhaps the best example of this is the effect of acid / alkaline factors on bone health. It has long been known that high protein diets increase risk for osteoporosis. Numerous theories have been proposed to explain this, but it now appears that a high intake of acid-forming foods (primarily meat, poultry, and eggs) over the course of a lifetime, may accelerate the loss of alkaline minerals (calcium, magnesium, potassium) from the bones. In other words, the body may deplete one system (the skeleton) in order to maintain balance in another more sensitive system (the blood).”
Glucosamine and Chondrotin Can You Really Repair the Damage?
These natural compounds have been reported to be helpful in repairing the cartilage damage associated with osteoarthritis, although clinical trial results are varied as reported in Curr Rheumatol Rep. 2013 Oct;15(10):361. Cherniske reports that “Annals of the Rheumatic Diseases doi:10.1136/ard.2010.140848, showing that ingesting 800 mg/day of chondroitin sulfate produced significant benefits in patients with osteoarthritis of the knee. Importantly, these improvements were clearly visible on MRI, not just from a patient questionnaire.” Again you can find his full review here, or contact me for more information.
I have some clients and customers who report benefit from taking these supplements and some who report little or no benefit. Perhaps it comes down to their body’s ability to absorb what they are taking, or to the quality of the product they are taking. The term for this is bioavailability.
What are your best coping strategies?
This question came to me from an active grandmother (AG). She is in her 60s and is diagnosed with arthritis, mostly related to the spine. She has two very active grandchildren. She plays with these younger children, which at times includes lifting them. She is active with yard work and gardening. She maintains a healthy eating plan, which includes greens. She does not like taking anti-inflammatories, so will use a natural product containing tumeric (watch for bioavailability as tumeric is volatile and does not maintain its medicinal properties unless protected). Here is my list for AG:
- Exercise and be consistent with the program. There is evidence to suggest exercise on a consistent basis is better for the body all around than infrequent and intense exercise. Your exercise program should include at least 20-30 minutes of cardiovascular activity, strengthening, and stretching. I am not talking about going to boot camp. I recommend working with someone trained in the area of rehabilitation exercises.
- Try the elimination diet plan. Take out all of the top 6 foods related to sensitivities for 2 weeks (from the Science of Integrative Medicine). Then add one back into your diet for a day. See how you feel. Repeat this with the rest, one food group at a time.
- Eliminate dairy, white grains, and sugar from your diet, along with other potential inflammatory foods. Once symptoms
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are significantly reduced or eliminated, you may try adding them back in, only in small quantities. After I eliminated gluten for 9 months, I found that I tolerate it in small amounts, but my body lets me know when I have overdone it. I had a white chocolate, white flour, raspberry scone the other night after my hockey game. I woke up the next morning feeling slightly hungover.
- Add in the good foods. This is termed crowding out. My friend Brianne tells her children to eat their growing food first. Make it a habit to eat your vegetables before going for the snack food. Add as much dark green vegetables as your stomach can hold. For me, this involves my daily green smoothie, with celery, cucumber, kale, spinach, and my greens supplement powder. The days I don’t drink my smoothie are the days my body craves more carbohydrates and sugar. Eat other anti-inflammatory foods, such as salmon (and a few other fish), turmeric, ginger, and certain oils, like olive oil that contain omega 3 fatty acids.
- Get Balanced. Reduce the strain on your muscles and joints with the help of a physiotherapist, massage therapist, athletic therapist, and chiropractor. Acupuncture has also been shown to be beneficial for help with joint pain and inflammation.
- Reduce Stress. The balance also refers to finding ways to reduce the effects of stress on your body. Practicing yoga, meditation, and getting adequate sleep go hand in hand with the above recommendations.
What are you willing to change to live without the pain often associated with arthritis?