Whenever we talk about arthritis, it’s important to define it and discuss the different types of arthritis. Arthritis means inflammation of the joints and there are two main categories of arthritis: autoimmune arthritis (rheumatoid arthritis, lupus, psoriatic arthritis) and osteoarthritis.
Autoimmune arthritis usually begins in the thirties or forties, although we have been seeing it more often in younger people as well. A hallmark of autoimmune arthritis is that the pain and swelling are the same on both sides. There can be more pronounced swelling with autoimmune arthritis than osteoarthritis and sometimes there are other symptoms present like fatigue or rashes. Autoimmune arthritis also usually causes morning stiffness for at least an hour.
Osteoarthritis tends to become symptomatic later in life, it is often one-sided and can be related to overuse or joint deformity. Both autoimmune arthritis and osteoarthritis run in families. Osteoarthritis often gets worse in cold and wet weather and it can cause morning stiffness as well but more often people experience pain during movement.
In order to differentiate between different types of arthritis, we take a thorough history and ask about specific triggers for pain. We examine the joint for swelling and/or enlargement. If needed, we order lab tests to determine whether arthritis is autoimmune. These lab tests look for antibodies which are messengers that the immune system uses to tag things that need to be attacked by the immune system. In autoimmune arthritis, these tags are made of proteins that are part of the human body and that signals the immune system to attack the joints.
There is no way to get rid of these antibodies or non-surgically repair a joint that has been affected by arthritis but there are many ways to improve symptoms and prevent the progression of autoimmune arthritis and osteoarthritis.
Dietary Treatments for Arthritis
Just like I always say, the answer is often vegetables and exercise and arthritis is no exception. People often feel less pain and stiffness when they eat less sugary foods and processed foods because these foods promote inflammation. Some people notice that they have significant improvement when they avoid nightshade vegetables (tomatoes, potatoes, eggplants, peppers, and tobacco) and some people do not notice any improvement with avoiding nightshades. There is enough of a chance that avoiding nightshades will relieve arthritis pain without medication that most patients deem a one-month trial of avoiding these foods a worthwhile experiment.
When we treat autoimmune diseases, we often address them through immune system modulation by using supplements like probiotics and fish oil as well as lifestyle modifications like meditation and stress reduction. Often people with autoimmune arthritis will require disease-modifying drugs or steroids in order to protect their joints but we can help keep that need for medication low so that people can use low doses of the first-line (more gentle) medications.
Herbal Treatments for Arthritis
Many people are treated for osteoarthritis with non-steroidal anti-inflammatories like ibuprofen, naproxen, celecoxib, and diclofenac or pain relievers like acetaminophen. These medications often greatly reduce joint pain but they can have severe side effects including changes in the stomach lining, kidney problems, increased blood pressure and liver damage. We often use herbs like turmeric and Boswellia along with anti-inflammatory diets in order to reduce inflammation and pain. The nice thing about using these herbs instead of NSAIDs is that they have other benefits including anti-cancer effects and beneficial cardiovascular effects.
Exercise and Movement
Another important part of treatment for arthritis that is often overlooked is exercise and movement. Swimming, biking, and water aerobics are on the top of the list for people with arthritis because they do not involve as much impact on the joints. In the next few weeks, I will be interviewing local organizations that support people in exercising in ways that are supportive of joint health. My goal as a medical provider for treating people with arthritis is to help them live with less pain and greater ability to engage in and enjoy physical activity. Often we can attain that goal without medication or with rare need for medication.