Say No To Arthritis (Optimum Nutrition Handbook
Reduce pain and inflammation without drugs.
Identify and eliminate the causes of arthritis.
Recover and gain mobility.
Prevent arthritis and stop it progressing.
Prevent osteoporosis and improve your bone density.
Reduce muscle pain and prevent fibromyalgia.
CHAPTER 1
GETTING THE RIGHT DIAGNOSIS
There are two major kinds of arthritis, and many, less common, arthritis-like conditions. The most common kind is osteoarthritis (sometimes called OA). This ‘wear and tear’ disease affects joints that have been injured or simply worn out, often through poor posture and/or lack of mobility, which is necessary to keep joints flexible and healthy. This is much more common in people over the age of 50. Rheumatoid arthritis (sometimes called RA), however, is less common and more complex, but can strike at any age – even in childhood. It affects younger people and is ‘systemic’, meaning that the whole body’s immune system and inflammatory responses go into overdrive, perhaps nudged by hereditary factors and infections, as well as by diet and lifestyle
OSTEOARTHRITIS
About 80 per cent of people over the age of 50 show osteoarthritis-like joint damage, and a quarter of them experience pain. By the age of 60, over 90 per cent of people show evidence on X-ray of arthritis-like joint damage. Whereas osteoarthritis occurs later in life, painful and stiff knee problems – often diagnosed as chondromalacia (an abnormal softening or degeneration of joint cartilage, especially of the knee) – occur frequently in people under 40.Under the age of 45, osteoarthritis is more common in men; over the age of 45, it’s more common in women, probably due to reduced calcium absorption after the menopause. It starts as stiffness, usually of the weight-bearing joints such as the knees, hips and back, and progresses to pain on movement. The joints then become increasingly swollen and inflexible.
Figure 2 – How arthritis develops
The cause of this form of arthritis is more mysterious, but it may be due to immune system problems, perhaps triggered by a viral or bacterial infection, or a genetic weakness (it is thought that rheumatoid arthritis is, in part, hereditary). Rheumatoid arthritis often starts and flares up when nutrition is under par, probably because good nutrition is vital for immune strength. Most rheumatoid arthritis sufferers develop antibodies that attack normal components of the body, as if the immune system has malfunctioned. This is why rheumatoid arthritis is called an autoimmune condition – there is evidence that the body’s own immune system attacks the joints. Rheumatoid arthritis can be mild, or severe and active most of the time, last for many years, and lead to serious joint damage and disability. It is so disabling that half of all patients have to stop working within ten years of diagnosis.
ANKYLOSING SPONDYLITIS
The condition ankylosing spondylitis differs from other arthritic conditions in that it starts with inflammation of the ends of the ligaments, where they attach to the bones. This most commonly starts in the sacroiliac joint, where the pelvis and spine meet. As the disease progresses, the vertebrae at the base of the spine start to fuse together. The symptoms are lower back pain and stiffness. As the area becomes more and more inflamed, joint pain and stiffness may also occur in other parts of the body.When there is evidence of spinal fusion, but no pain or inflammation, the condition is called spondylosis.
GOUT
One in every 200 people will suffer from gout. It is caused by a build-up of uric acid, a substance in the blood that should be excreted from the body via the kidneys. Excess uric acid can form crystals that lodge in joints and tissue, most commonly the big toe, causing localised pain. When gout is present there is usually increased inflammation, which may affect other joints.
OSTEOPOROSIS
The condition osteoporosis is the gradual loss of bone density. As such it is not specifically a disease of the joints, but of the bones themselves. However, the health of bones does affect joints, and many underlying mechanisms that are now thought to contribute to osteoporosis are shared with osteoarthritis.
Osteoporosis is thought to affect over two million people in the UK. It occurs twice as commonly in women, and is most prevalent in women after the menopause. One in three women and one in 12 men have a fracture as a result of osteoporosis by the age of 70. It is usually identified only when a fracture occurs – often of the hip – and it is therefore considered a hidden epidemic. Forty people die every day as a result of fractures caused by osteoporosis.
Loss of bone density occurs because calcium is not being properly deposited in bone, or is actively being removed. Many factors are known to upset the calcium balance in bone. These include excess protein consumption, excess tea, coffee or alcohol, blood sugar problems, thyroid or parathyroid hormone imbalances, stress, loss of oestrogen and progesterone in the menopausal years, lack of weight-bearing exercise, lack of magnesium, and lack of vitamin D or sunlight. These factors are covered in more detail in Part 3, and Chapter 17 gives you a strategy for preventing and reversing osteoporosis.
POLYMYALGIA AND FIBROMYALGIA
An increasingly common problem, polymyalgia mainly affects older women, in which muscles (rather than joints) become stiff and painful. The onset is usually rapid and suggests that the problem may be triggered by a virus or by accumulated stress – ‘the straw that breaks the camel’s back’ – thus initiating a rheumatoid-like condition, marked by inflammation. The recommendations given in this book for reducing inflammation without drugs are often helpful (see Part 2).
Another debilitating condition causing muscle aches, pain and stiffness is fibromyalgia. This is different from polymyalgia in that it is not characterised by inflammation. The pain is thought to be caused by problems with energy production within cells, leading to muscle tension. These conditions are discussed fully in Chapter 18
OSTEOMALACIA OR RICKETS
The disease osteomalacia (in adults), or rickets (in children), is caused by a deficiency in vitamin D. We need this vitamin in order to use calcium properly. A lack of it leads to weak and pliable bones, resulting in bone deformities such as bow legs or bent fingers and toes. Vitamin D is made in the skin in the presence of sunlight, so both diet and exposure of the skin to the sun play a part. People with dark skin, who get little direct exposure to sunlight, and who also eat a vegan diet (without eggs, dairy products, meat or fish), are most at risk..
DISPLACED INTERVERTEBRAL DISC
Often wrongly referred to as a ‘slipped disc’, displaced inter-vertebral disc occurs when two vertebrae in the spine are out of alignment. This can put pressure on the spinal nerve that runs through the spinal column. Poor spinal alignment can also lead to rupture of the synovial sac between vertebrae, causing tremendous pain both from inflammation and through nerve compression. Eventually the vertebrae can fuse together.
BURSITIS, TENDONITIS AND TENOSYNOVITIS
These three inflammatory conditions do not affect joints as such. Bursitis refers to inflammation of the fluid-filled cushions that separate muscle from bone. The most common sites are in the shoulders, elbows and knees. Tendonitis is inflammation where the tendons attach to bone, and tenosynovitis is inflammation of the sheath surrounding the tendon.Terms such as lumbago (back ache) and rheumatism (systemic joint and muscle ache) usually refer to symptoms that can be described more accurately by one of the above types of arthritic condition.degeneration
.
Figure 4 – How your body’s chemistry makes pain
Because of the gastrointestinal problems mentioned above, the thinking was that the ideal NSAID would be one that blocked only COX-2 and left COX-1 alone. And the launch of drugs such as Vioxx in 1999 caused huge excitement because that’s exactly what they did. But problems with these drugs began emerging a few years after they appeared on the scene. Blocking an element – such as an enzyme – that is part of a network as complex as the body almost never has just one effect, which is why drugs nearly always have damaging side effects.
In 2004, Merck voluntarily withdrew Vioxx from the market because of concerns about increased risk of heart attack and stroke associated with long-term, high-dosage use. The precise details of the case have been chewed over in the courts for years, but whatever the legal niceties it’s clear that behind the scenes and in the medical literature, alarm bells had been ringing for years about the link with heart attacks. It’s just that they had been deliberately ignored. You can read more about this shocking scandal in my book Food is Better Medicine than Drugs, with Jerome Burne
Using anti-inflammatory drugs in the short term can improve healing – as long as the problem that triggered the inflammation in the first place has gone. Eventually, if pain and inflammation persist over the long term, body tissues will begin to break down. In the case of arthritis, for example, the joint becomes increasingly hard and stiffened – calcified – until you can’t use it at all.
If you have joint problems, you may have had your erythrocyte sedimentation rate (ESR) measured. A high ESR means that your body is in a state of inflammation, as does a high level of c-reactive protein (CRP).
INTRODUCTION
According to Dr Robert Bingham, a specialist in the treatment of arthritis, ‘No person who is in good nutritional health develops rheumatoid or osteoarthritis.’ Yet, by the age of 60, nine in every ten people in the UK have arthritis. According to the Arthritis Research Campaign, nearly 9 million adults in the UK (that’s 19 per cent of the adult population) have seen their GP in the last year for arthritis or a related condition, and 45 per cent experience symptoms. For all sufferers, arthritis means living with pain and stiffness. For some, it is a living hell and can be life-threatening. Yet arthritis is not an inevitable consequence of ageing. Arthritis can be prevented and the underlying causes can be eliminated. This book tells you how to:Reduce pain and inflammation without drugs.
Identify and eliminate the causes of arthritis.
Recover and gain mobility.
Prevent arthritis and stop it progressing.
Prevent osteoporosis and improve your bone density.
Reduce muscle pain and prevent fibromyalgia.
CHAPTER 1
GETTING THE RIGHT DIAGNOSIS
There are two major kinds of arthritis, and many, less common, arthritis-like conditions. The most common kind is osteoarthritis (sometimes called OA). This ‘wear and tear’ disease affects joints that have been injured or simply worn out, often through poor posture and/or lack of mobility, which is necessary to keep joints flexible and healthy. This is much more common in people over the age of 50. Rheumatoid arthritis (sometimes called RA), however, is less common and more complex, but can strike at any age – even in childhood. It affects younger people and is ‘systemic’, meaning that the whole body’s immune system and inflammatory responses go into overdrive, perhaps nudged by hereditary factors and infections, as well as by diet and lifestyle
OSTEOARTHRITIS
About 80 per cent of people over the age of 50 show osteoarthritis-like joint damage, and a quarter of them experience pain. By the age of 60, over 90 per cent of people show evidence on X-ray of arthritis-like joint damage. Whereas osteoarthritis occurs later in life, painful and stiff knee problems – often diagnosed as chondromalacia (an abnormal softening or degeneration of joint cartilage, especially of the knee) – occur frequently in people under 40.Under the age of 45, osteoarthritis is more common in men; over the age of 45, it’s more common in women, probably due to reduced calcium absorption after the menopause. It starts as stiffness, usually of the weight-bearing joints such as the knees, hips and back, and progresses to pain on movement. The joints then become increasingly swollen and inflexible.
Figure 2 – How arthritis develops
The cause of this form of arthritis is more mysterious, but it may be due to immune system problems, perhaps triggered by a viral or bacterial infection, or a genetic weakness (it is thought that rheumatoid arthritis is, in part, hereditary). Rheumatoid arthritis often starts and flares up when nutrition is under par, probably because good nutrition is vital for immune strength. Most rheumatoid arthritis sufferers develop antibodies that attack normal components of the body, as if the immune system has malfunctioned. This is why rheumatoid arthritis is called an autoimmune condition – there is evidence that the body’s own immune system attacks the joints. Rheumatoid arthritis can be mild, or severe and active most of the time, last for many years, and lead to serious joint damage and disability. It is so disabling that half of all patients have to stop working within ten years of diagnosis.
ANKYLOSING SPONDYLITIS
The condition ankylosing spondylitis differs from other arthritic conditions in that it starts with inflammation of the ends of the ligaments, where they attach to the bones. This most commonly starts in the sacroiliac joint, where the pelvis and spine meet. As the disease progresses, the vertebrae at the base of the spine start to fuse together. The symptoms are lower back pain and stiffness. As the area becomes more and more inflamed, joint pain and stiffness may also occur in other parts of the body.When there is evidence of spinal fusion, but no pain or inflammation, the condition is called spondylosis.
GOUT
One in every 200 people will suffer from gout. It is caused by a build-up of uric acid, a substance in the blood that should be excreted from the body via the kidneys. Excess uric acid can form crystals that lodge in joints and tissue, most commonly the big toe, causing localised pain. When gout is present there is usually increased inflammation, which may affect other joints.
OSTEOPOROSIS
The condition osteoporosis is the gradual loss of bone density. As such it is not specifically a disease of the joints, but of the bones themselves. However, the health of bones does affect joints, and many underlying mechanisms that are now thought to contribute to osteoporosis are shared with osteoarthritis.
Osteoporosis is thought to affect over two million people in the UK. It occurs twice as commonly in women, and is most prevalent in women after the menopause. One in three women and one in 12 men have a fracture as a result of osteoporosis by the age of 70. It is usually identified only when a fracture occurs – often of the hip – and it is therefore considered a hidden epidemic. Forty people die every day as a result of fractures caused by osteoporosis.
Loss of bone density occurs because calcium is not being properly deposited in bone, or is actively being removed. Many factors are known to upset the calcium balance in bone. These include excess protein consumption, excess tea, coffee or alcohol, blood sugar problems, thyroid or parathyroid hormone imbalances, stress, loss of oestrogen and progesterone in the menopausal years, lack of weight-bearing exercise, lack of magnesium, and lack of vitamin D or sunlight. These factors are covered in more detail in Part 3, and Chapter 17 gives you a strategy for preventing and reversing osteoporosis.
POLYMYALGIA AND FIBROMYALGIA
An increasingly common problem, polymyalgia mainly affects older women, in which muscles (rather than joints) become stiff and painful. The onset is usually rapid and suggests that the problem may be triggered by a virus or by accumulated stress – ‘the straw that breaks the camel’s back’ – thus initiating a rheumatoid-like condition, marked by inflammation. The recommendations given in this book for reducing inflammation without drugs are often helpful (see Part 2).
Another debilitating condition causing muscle aches, pain and stiffness is fibromyalgia. This is different from polymyalgia in that it is not characterised by inflammation. The pain is thought to be caused by problems with energy production within cells, leading to muscle tension. These conditions are discussed fully in Chapter 18
OSTEOMALACIA OR RICKETS
The disease osteomalacia (in adults), or rickets (in children), is caused by a deficiency in vitamin D. We need this vitamin in order to use calcium properly. A lack of it leads to weak and pliable bones, resulting in bone deformities such as bow legs or bent fingers and toes. Vitamin D is made in the skin in the presence of sunlight, so both diet and exposure of the skin to the sun play a part. People with dark skin, who get little direct exposure to sunlight, and who also eat a vegan diet (without eggs, dairy products, meat or fish), are most at risk..
DISPLACED INTERVERTEBRAL DISC
Often wrongly referred to as a ‘slipped disc’, displaced inter-vertebral disc occurs when two vertebrae in the spine are out of alignment. This can put pressure on the spinal nerve that runs through the spinal column. Poor spinal alignment can also lead to rupture of the synovial sac between vertebrae, causing tremendous pain both from inflammation and through nerve compression. Eventually the vertebrae can fuse together.
BURSITIS, TENDONITIS AND TENOSYNOVITIS
These three inflammatory conditions do not affect joints as such. Bursitis refers to inflammation of the fluid-filled cushions that separate muscle from bone. The most common sites are in the shoulders, elbows and knees. Tendonitis is inflammation where the tendons attach to bone, and tenosynovitis is inflammation of the sheath surrounding the tendon.Terms such as lumbago (back ache) and rheumatism (systemic joint and muscle ache) usually refer to symptoms that can be described more accurately by one of the above types of arthritic condition.degeneration
.
Figure 4 – How your body’s chemistry makes pain
Because of the gastrointestinal problems mentioned above, the thinking was that the ideal NSAID would be one that blocked only COX-2 and left COX-1 alone. And the launch of drugs such as Vioxx in 1999 caused huge excitement because that’s exactly what they did. But problems with these drugs began emerging a few years after they appeared on the scene. Blocking an element – such as an enzyme – that is part of a network as complex as the body almost never has just one effect, which is why drugs nearly always have damaging side effects.
In 2004, Merck voluntarily withdrew Vioxx from the market because of concerns about increased risk of heart attack and stroke associated with long-term, high-dosage use. The precise details of the case have been chewed over in the courts for years, but whatever the legal niceties it’s clear that behind the scenes and in the medical literature, alarm bells had been ringing for years about the link with heart attacks. It’s just that they had been deliberately ignored. You can read more about this shocking scandal in my book Food is Better Medicine than Drugs, with Jerome Burne
NEW DISCOVERY
Scientists have focused on the COX-1 and COX-2 enzymes, but another pain-causing enzyme called 5-lipoxygenase (5-LOX) has been largely ignored. Scientists at the University of British Columbia found that combinations of COX and 5-LOX inhibitors were more effective than single inhibitors. Some nutrients – boswellic acid and curcumin, for example – have been found to inhibit this enzyme. Although 5-LOX is only just beginning to receive the attention it deserves among researchers, some pioneering work on the nature of this powerful enzyme suggests that levels tend to increase as we age.7 What is even more exciting is that the effect of various nutrients working together is only just starting to become known. When you combine some nutrients in a certain way the pain-relieving effect is multiplied.Using anti-inflammatory drugs in the short term can improve healing – as long as the problem that triggered the inflammation in the first place has gone. Eventually, if pain and inflammation persist over the long term, body tissues will begin to break down. In the case of arthritis, for example, the joint becomes increasingly hard and stiffened – calcified – until you can’t use it at all.
If you have joint problems, you may have had your erythrocyte sedimentation rate (ESR) measured. A high ESR means that your body is in a state of inflammation, as does a high level of c-reactive protein (CRP).
How is inflammation usually treated?
The most common medical treatment for inflammation is anti-inflammatory drugs. These drugs are effective symptom suppressors, providing pain relief but doing nothing to address the causes of the inflammation. According to Dr Jeffrey Bland, a pioneer in new approaches to dealing with inflammation, instead of thinking pain means drug, inflammation is the body’s way of saying something is wrong. Inflammation is a systemic problem, not just a localised phenomenon, in which the body’s physiology is shifted into an ‘alarm state’. It’s as if there is a series of underlying imbalances in the body’s chemistry that build up and then burst forth, once the body can no longer cope. The actual symptoms, or pain, are the wave breaking, but the wave is a long time coming.
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