Expert Advice on Arthritis

By Dr. Tori Hudson, ND

Dr. Hudson is a member of Pharmaca’s Integrative Health Advisory Board and Medical Director of A Woman’s Time Clinic in Portland, Ore.

In my women’s health practice, we frequently see cases of miscellaneous joint aches, injury-related pains, swelling of the bursa (called bursitis), and bona fide osteoarthritis and rheumatoid arthritis. There are other causes of joint pains of course…but they are less common.

Joint inflammation and/or degeneration are not generally considered “women’s conditions.” But it’s important to note that arthritis and other joint conditions are far more common in women than in men, and are therefore on the top 10 list of health concerns for many women. In fact, nearly twice as many women (26 million) suffer from arthritis than men (14.2 million).

These conditions can have dramatic effects on a person’s quality of the life, causing pain, limiting activities, and sometimes causing depression and insomnia because of the pain. Joint pain and stiffness can turn otherwise pleasant and enjoyable activities into unpleasant ordeals. Day-to-day activities—like kneeling in the garden, opening jars and cans in the kitchen, swinging a golf club, writing letters, playing the piano, knitting, needlework and other hobbies—can become more and more difficult.

Osteoarthritis, also known as degenerative joint disease, is the most common form of joint disease and is characterized by erosion of the articular cartilage—and after the age of 45, it’s more common in women than in men. Osteoarthritis often comes with aging and wear and tear of the joint, or from factors like an inherited abnormality of the joint, fractures along the joint surface or previous inflammatory disease of the joints.

Osteoarthritis was previously considered a degenerative disorder, in which the joint “just wears out.” But recent research has shown that the joint cartilage is very active—at least in the early part of the disease—and continues to repair itself. It is now thought that the disease can be halted and may even be reversible, at least in some individuals.

Rheumatoid arthritis, on the other hand, is a chronic inflammatory condition that affects the joints and sometimes other parts of the body as well. Women suffer from rheumatoid arthritis about three times as frequently as men. Rheumatoid arthritis is an autoimmune reaction in which the body’s immune system attacks the joint tissues. Just what triggers this autoimmune reaction remains largely unknown, although it is most likely contributable to more than one factor.

Rheumatoid arthritis can begin at any age, but is usually first diagnosed in women between the ages of 20-40. The typical onset of rheumatoid arthritis is gradual, but occasionally it can come on suddenly. Although swollen, stiff, painful joints are the hallmarks of the disease, fatigue, weakness and fever may also precede the joint problems. As the disease progresses, the joints of the hands and feet can even become deformed.

Weight management, physical activity that does not traumatize the joints and a low-inflammatory diet are fundamental to managing joint pain. A low-inflammatory diet is low in saturated fats and trans-fatty acids while emphasizing good fats from fish, as well as whole grains, fruits and vegetables (except the nightshade family—potatoes, eggplant, peppers and tomatoes), and deemphasizing foods high in arachidonic acid (e.g. egg yolks, dark poultry meat).

It’s also important to identify any food allergies and sensitivities, especially in the case of rheumatoid arthritis. Eliminating allergenic foods will very often offer significant benefit to many individuals with rheumatoid arthritis. Almost any food can aggravate this condition, but common offenders are wheat, corn, dairy products, beef, food additives and nightshade-family foods (as noted above). Avoiding the nightshades also seems to help many women with osteoarthritis. In fact, reducing my own twice-weekly intake of the “lover’s eggplant” dish at my favorite Chinese restaurant cured me of my own joint pains.

Supplementation with key nutrients and herbs is the next step to reducing pain from these types of arthritis.

Lubricate the joints with good fats
In addition to changes in diet and exercise, I usually prescribe a combination of supplements with therapeutic effects for the joints. I commonly start with essential fatty acids, including borage, evening primrose, black currant and fish oils. I typically receive good feedback from my patients on these oils, and some even say they just feel like their joints are “better lubricated.”

Quality oils and fats are as important as vitamins and minerals in maintaining our health and in the prevention of many chronic diseases, not just arthritic conditions.  They are therefore a valuable addition to any diet, but are especially important for people with arthritis.

Additional supplements
In addition to essential fatty acids, I regularly use many other nutritional supplements and herbs for therapeutic benefit, including niacinamide, glucosamine sulfate, chondroitin sulfate, SAMe and herbs such as devil’s claw, yucca, ginger, boswellia and curcumin.

Curcumin is a constituent of the plant turmeric, and is receiving a lot of attention and research these days for its use in arthritis pain. Even in a condition as potentially daunting as rheumatoid arthritis, curcumin is showing positive benefits. Look for high-absorption/high bio-availability curcumin products on the market.

A multi-faceted approach
Treating joint pain requires patience and a multi-faceted approach. The first step is determining the cause of your joint pain. A qualified practitioner and perhaps even a rheumatology specialist should be able to offer a reliable diagnosis.

Pain management may involve using some of the conventional pharmaceutical medications, even if only intermittently. Nutritional and herbal supplements are very useful in all kinds of joint pains, but remember they are not “magic bullets.” And the fundamentals of diet, exercise and weight management can be a very important addition to your regimen.

Although additional research is needed in the area of alternative treatments for joint disease, the evidence that we do have is very encouraging. My own observations and experience in clinical practice are also very rewarding in terms of patient feedback. Their improved quality of life, increased activity and improvement in many day-to-day symptoms are a frequent reminder of the wisdom of nature and the ability of the body to heal.

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