Arthritis is one of our top 10 chronic diseases, affecting 3.85 million Australians. Last year alone it cost our health system $4.2 billion. But arthritis doesn't have to be an inevitable part of ageing, says Caitlin Reid.
Arthritis is not a single disease but a collective name for a group of conditions that affect just about every joint in the body. Arthritis – meaning inflammation of the joints – usually results in pain and stiffness, limiting movement and function. There are more than 100 types of arthritis and it affects young and old alike.
Most common types of arthritis
By far the most common form of arthritis, it is most prevalent in people over the age of 45. Usually caused by wear and tear, osteoarthritis can also develop in younger people. It occurs when the cartilage around the joint becomes thin, leaving the ends of the bone unprotected. This makes movement painful.
This is an auto-immune disease in which the immune system attacks the lining of the joints, causing inflammation and damage. The joints in the hands and feet are commonly affected, but the hips and knees can also be affected.
Uric acid is a waste product usually eliminated by our kidneys but if this acid is not removed fast enough, it can build up and form small crystals in and around joints, causing inflammation, pain and swelling. The big toe is often the first joint to be affected.
Symptoms of arthritis
Arthritis affects people in different ways, but the most common symptoms are:
Stiffness or reduced movement
Redness and warmth
The seven-step plan
While there is no cure for arthritis, health professionals have devised a seven-step plan to slow it down and minimise its effects.
1. Work with your health-care team
There isn't just one way to manage arthritis – each person needs to work out a treatment plan that best suits them. The plan should incorporate all aspects of your wellbeing and may involve rheumatologists and other specialists, pharmacists, physiotherapists, podiatrists, dietitians, psychologists and chiropractors. You'll need to work with your GP and monitor your symptoms in order to develop the most effective treatment plan.
Ainslie Cahill, CEO of Arthritis Australia, says, "The person suffering from arthritis plays the biggest part in the health-care team. If the patient is unable to establish and maintain good communication, their treatment and progress can suffer."
2. Weight management
Many people with arthritis, particularly osteoarthritis, are overweight, while others may become overweight as a result of their limited movement. Being overweight puts extra strain on already burdened joints, especially the ankles, knees, hips, feet and spine. Maintaining a healthy weight can help relieve the tension in your joints, reduce pain and maintain or improve mobility. Weight loss can also help slow down the progression of arthritis.
Certain activities can be very beneficial for arthritis sufferers, but it's important the right type of exercise is chosen for your condition. Consult your doctor or exercise physiologist to find out what's right for you. Some types of exercises that may be helpful include walking, yoga, tai chi and water aerobics.
"Arthritic people who exercise have higher levels of fitness, better muscle strength, a greater ability to do daily tasks and improved mood and emotional wellbeing," explains Cahill. Exercise also helps to maintain a healthy heart and blood vessels, and some specific exercises may help to improve bone strength.
Except for gout, diet seems to have little effect on the stiffness and pain experienced by arthritis sufferers. Some studies show foods high in omega-3 essential fatty acids, such as seafood and some nuts and seeds, can reduce inflammation. But a healthy, balanced diet is important for overall wellbeing and to maintain a healthy weight.
The symptoms of arthritis vary from day to day, which makes it hard to know if a change is the result of a change in diet. If you think certain foods are causing you problems, discuss it with an accredited practising dietitian before making any decisions.
People with rheumatoid arthritis often lose their appetite. If you experience this, try to eat small, frequent meals throughout the day and avoid fasting or crash diets. Drugs used to control rheumatoid arthritis may have nutritional side effects or increase the risk of a nutritional deficiency, so if you are taking medication, see a dietitian to make sure your nutritional needs are being met.
5. Complementary medicine
Glucosamine and chondroitin are the most well-known supplements used to treat arthritis. Both are natural substances found in the body: glucosamine is one of the building blocks for cartilage; chondroitin is a substance that helps keep the cartilage spongy and healthy by drawing water into it. These supplements can be helpful for people with osteoarthritis, as they can relieve pain and prevent or slow the breakdown of cartilage. However, it's best to talk to your doctor or pharmacist before taking any supplements.
6. Manage your pain
Even when you manage your weight, eat a healthy balanced diet, exercise, take medications and seek professional assistance, there may still be times when you experience arthritis-related pain. You need to develop some techniques for managing pain: try applying an ice pack, taking a warm bath, listening to music or doing meditation and deep breathing exercises. You may need to experiment until you find what works best for you.
Arthritis Australia recommends that arthritis sufferers "talk to people who have gone through what you are experiencing. Their experiences may not be identical, but they can tell you about the things that help them".
7. Keep a positive outlook
People with arthritis can easily become frustrated and depressed by their condition. The debilitating effects of arthritis can limit your ability to live normally. When this happens to people in their prime, they can feel angry at the world. A major part of learning to live with arthritis is to accept there may be some things you may not be able to do any more, and to focus on what you can do. Start new activities and set yourself some new goals to achieve. Accomplishing these will boost your self-esteem and improve your overall well-being, all of which will make your treatment plan that much more effective.
Sufferers of arthritis are often advised to make certain dietary changes such as avoiding dairy products and vegetables of the nightshade family, which include tomatoes, potatoes, eggplant and capsicum. There are claims both these food groups can aggravate inflammation but there is little scientific evidence backing these claims. If anything, people with arthritis are at risk of developing osteoporosis so it's important they eat dairy products on a regular basis.
'Acidic foods' such as lemons, limes and other citrus fruits are also said to cause inflammation. But while these may taste acidic, once they have been digested they lose their acidity and actually have an alkalising effect on the body. These foods are also often rich in vitamin C, which is important for a healthy immune system. Therefore, avoiding these foods may end up doing you more harm than good.
Research shows tai chi can help elderly people with arthritis move more freely. An ancient Chinese practice, tai chi promotes mental and physical relaxation, strengthens muscles by about 15-20% and improves cardiovascular fitness. In 1997, Paul Lam, a Sydney-based physician and internationally respected tai chi teacher, developed a tai chi program specifically for sufferers of arthritis. This program is now endorsed by Arthritis Australia. Visit Tai Chi Australia or Tai Chi for Arthritis Program for more information.
Food for gout
Gout is usually caused by the body's inability to remove uric acid. Drinking plenty of water - two to three litres a day - can help flush the acid crystals from the body. Avoiding alcohol is beneficial as alcohol increases uric acid levels and can interfere with medications. Limiting foods high in purine, a substance that is converted into uric acid by the body, can also help relieve this condition. These foods include: mussels, anchovies, scallops, mackerel, sardines, beer, liver, kidneys, brains, mushrooms, lentils and other dried beans.
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