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Arthritis is characterized by inflammation in your joints. In the United States, nearly a quarter of all adults—over 54 million people—have arthritis. Half of adults with arthritis have reduced activity and function due to their arthritis, and more than 1 in 4 adults with arthritis report severe joint pain.

Inflammation is the primary cause for joint pain, and includes swelling, and warmth in the affected area.

There are many kinds of arthritis. The most common form is osteoarthritis, caused by wear and tear, injury, and aging. There are also inflammatory forms of arthritis, such as rheumatoid arthritis and psoriatic arthritis that cause major joint destruction. Since osteoarthritis accounts for over 60% of all the types of arthritis, and many of the lifestyle tips that improve osteoarthritis symptoms will also be helpful for inflammatory arthritis, the focus of this blog will be on managing osteoarthritis, and I will save a discussion on treating inflammatory arthritis for a later date.

Dietary changes are effective at decreasing inflammation and reducing joint pain. The Mediterranean diet is an excellent example of a diet that reduces joint inflammation. In contrast, eating sugar and grain flours will raise blood sugar levels and increase systemic inflammation, increasing joint pain. The theme for an anti-inflammatory diet would be to eat more colorful vegetables, fruits, and beans, plus healthy fats like nuts, extra-virgin olive oil, cold water seafood, avocado, and nut oils. And to avoid consuming sugar, grain flours, and other processed foods.

Regular non-pounding exercise and joint motion is another effective way to reduce inflammation and decrease joint stiffness. Activities such as walking, swimming, cycling, yoga, or using an elliptical exercise machine reduce joint pain long-term and enhance joint mobility. Strength training activities will also support your joints and help to reduce joint pain over the long term. Yoga and general stretching will also reduce stiffness and enhance your mobility. While short-term rest can help calm an acutely flared arthritic joint, prolonged inactivity will result in joint stiffness, weakness, and joint damage.

Once you have arthritis in your joints, it typically progresses over time, and you will lose cartilage in your joints at a rate of 4% per year (as opposed to 0-1% per year if you don’t have arthritis.

If you take anti-inflammatory drugs on a regular basis to make your joints feel better, you will lose about 8% of your cartilage per year, double the normal loss in cartilage over time! Non-steroidal anti-inflammatory drugs, (commonly called NSAIDs) are some of the most commonly used medications, including Ibuprofen, Advil, Naprosyn, Aleve, Indocin, and Celebrex. Not only do these medications accelerate joint destruction if used long term, but they also increase the risk of serious GI bleeding and kidney damage. I always recommend that my own patients avoid these drugs whenever possible and limit their use to not more than 10-15 days per year.

Acetaminophen (Tylenol) is another common medication recommended for arthritis pain. When taken daily does not adversely impact joint cartilage, but it does deplete the body’s stores of glutathione, the master antioxidant in the body. Studies have shown that daily use of Acetaminophen is associated with an increased risk for memory loss, likely related to glutathione depletion. To offset this risk, some medical providers suggest that people taking Acetaminophen daily should also take N-acetyl cysteine to help replace stores of glutathione, but we do not have studies that confirm that this will work.

Anti-inflammatory supplements (such as Curcumin and fish oil) will reduce joint inflammation, reduce joint pain, and in contrast to the side effects noted above, they have other health benefits, not health risk. The quality of these supplements however is critical, as poor-quality Curcumin has very limited absorption and can cause gastro-intestinal symptoms. And poor-quality fish oil is often rancid and increases free radical overload. For joint arthritis, I recommend 1000 mg of EPA and DHA from high-quality fish oil, and 1000 mg of well-absorbed Curcumin. A product that combines fish oil and Curcumin with a high-quality multivitamin formula is “Joint Support”. Keep in mind that high-quality fish oil supports your heart and brain, while well-absorbed Curcumin has been shown in studies to improve cognitive function and is associated with cancer prevention, side effects that I like.

Cortisone injections are commonly offered by traditionally trained physicians as they make your joints feel better for 2-3 months, but they accelerate the loss of cartilage cells over the long-term and accelerate joint destruction if used repeatably over time. If you were planning for a joint replacement sometime soon and wanted a cortisone injection to help with the pain in the short term, then that would be a reasonable choice. Yet my hope is that if you followed the latest, state-of-the-art non-surgical options to treat arthritis symptoms, you would not need a joint replacement.

Non-surgical options for joint arthritis.

The first steps to reduce arthritis pain are to follow an anti-inflammatory diet, regular (non-pounding) exercise, and take anti-inflammatory supplements.

If these steps are not adequate to control your joint pain, please be aware that before using narcotics or considering invasive procedures or surgery, there are biological agents that are highly effective in reducing joint pain. Platelets and bone marrow cells can be collected from a person’s own blood or tissues and injected back into a person’s joints. These biological cell types promote healing and repair when exposed to damaged tissue, such as an arthritic joint.

Platelet and bone marrow cell therapies not only reduce joint pain, but if given annually, they appear to block the 4% loss in cartilage that occurs in people with osteoarthritis.

“For more information about non-surgical arthritis therapy options for osteoarthritis, please listen to my recent recorded conversation with Dr. James Leiber, DO by clicking here.

Dr. Leiber is a Regenerative Medicine Specialist and founder of New Regeneration Orthopedics of Florida comprised of Regenexx Tampa Bay (with clinics in Sarasota, Tampa, and St Pete) and Gold Coast Orthopedics located in North Miami, Florida, and my own Regenexx physician.  For more information regarding Dr. Leiber and his clinic, visit: www.newregenortho.com

The reality is that most of us will develop some degree of arthritis assuming we live long enough, and many people develop arthritis symptoms as early as 30-40 years of age. The good news is that we have new, non-surgical therapies that are available today so that we don’t have to suffer from arthritis or be disabled by it.

I wish you the best of health!

Steven Masley, MD, FAHA, FACN, CNS

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