Smorgasbord Health Column – Family Health A-Z – Arthritis (osteo and gout) by Sally Cronin

Although the focus has been on Covid this last year… there are still other health issues that have not gone away. Many are improved with simple treatments and dietary changes and in this series I am going to look at some of the more common issues.

I know that many of you who follow the blog will have seen the arthritis posts before but for those new to Smorgasbord, I hope you find useful.

Last week I covered rheumatoid arthritis and today a look at two more of the over 200 forms of the disease.

Osteoarthritis and Gout.

Osteoarthritis or degenerative joint disease is one of the oldest types of arthritis. It is basically wear and tear. It is the breakdown of the joint’s cartilage. Cartilage is the cushion in the joint that prevents the two ends of the bones from rubbing together. When this pad of cushioning is worn away and the fluid that normally lubricates the joint has gone – the two ends grind together causing pain and inflammation.

The actual physical process is an increase in water content of the cartilage and a reduction of protein in the tissue as we age. It mainly affects the weight bearing joints such as the ankles, lower back, knees and hips but can also affect the hands. Those most likely to suffer from the condition are middle aged or elderly. In some cases however if a younger person has had a very physically demanding lifestyle the symptoms can set in earlier.

A wearing down of the cushion in the joint where the two bones meet. – Pixabay.com

What are the most common causes of this type of arthritis?

You can be affected by being overweight most of your life as I was, or leading a particularly energetic sporting life – football, rugby or athletics. It is most common as we get into our 40’s and 50’s when a lifetime of activity can catch up with us. People you have suffered accidents in the past with broken bones may find that the damage is worsened as they get older.

There is a school of thought that believes there is a genetic pre-disposition to Osteoarthritis particularly when it develops in the hands. It could be caused by defective cartilage or defects in the way the bones join together.

What are some of the symptoms of osteoarthritis?

It is purely a disease of the joints. Unlike rheumatoid arthritis it does not affect the organs of the body. The most common symptom is pain in the joint particularly after a lot of activity. It is usually worse later in the day obviously. Also you may find that your back and hips and knees are painful after sitting for long periods of time and that getting up in the morning is painful and takes some time for you to regain mobility. Some of the joints will swell, especially if you have twisted the joint during activity. Knees are particularly vulnerable to stairs and explains why the sale of stair lifts is on the increase. It is not uncommon for the symptoms to come and go depending on a number of factors: Weight, heat and activity levels.

What happens if the condition is not treated?

If the pain and the immobility becomes too severe there are now some surgical options. There are new techniques available that are less extreme than joint replacement but that needs to be assessed on an individual basis. Depending on the type of joint replacement, they will last around the 15 to 17 years. This means that if you have surgery in your 50’s you are probably facing another in your 70’s and 80’s.

The problem is that the friction between the bone ends causes mobility problems which often lead to more weight gain which is one of the leading causes of the condition in the first place.

Also inflammation of the cartilage can sometimes stimulate new bone outgrowths called spurs around the joint, which cause even more discomfort and lack of mobility.

The bottom line is that it is a very painful condition and most sufferers are forced into taking very strong painkillers such as cortisone.

What about nutrition and osteoarthritis

Collagen needs to be maintained both between the joints and as connective tissue such tendons and ligaments. Normally when we damage connective tissue the body will produce collagen to repair them. However, if you look at connective tissue that is attached to proteins that you are preparing to cook; you will see that they tend to be very pale in colour… This is because there is a poor blood supply to them. This means that the components necessary to heal them completely are unable to reach them effectively.

Collagen is also a component of our skin so as our face begins to wrinkle and loose formation the process is mirrored internally.

To assist the body in producing new collagen for a more youthful looking skin and healthier joint padding, ligaments and tendons that hold that joint in place; you need a diet rich in the following elements.

Vitamin C rich foods are essential. Part of the issue with age related connective tissue damage is that we tend to eat less food as we age. This is not just related to a lack of appetite but the condition of our teeth. How many of you have noticed that you avoid certain fruits such as apples and pears because they are now tough to eat and chew? If this is the case then you need to substitute other softer but high vitamin C vegetables and fruit. You also need to explore options with your dentist to improve your ability to chew all foods as this is a fundamental part of the digestive process.

If you do not have rheumatoid arthritis you can enjoy the nightshade family such as red peppers, tomatoes and potatoes but also berries, watermelon, broccoli and papaya. Citrus fruits such as mandarins which are less acidic are also excellent.

Protein is also a very important component and you should be including sufficient daily including lean meats, oily fish, poultry, eggs, as well as beans and vegetables such as squash.

Vitamins A, B-Complex, C and E are very important anti-oxidants but also have an anti-inflammatory effect on the body which reduces swelling. These can be found in whole grains, oily fish, brightly coloured vegetables and fruit

Most people understand that keeping hydrated is very important for the suppleness of our skin and this applies to our internal collagen health as well. Please do not listen to the aqua sceptics! Although you do take in good amounts of fluids from most of the foods that we eat, it is not sufficient to counteract central heating, air conditioning, exercise and the high levels of sugar and salt in our diets.

However….. do not drink fizzy chemical concoctions as they are loaded with additives and sugars that are not naturally found in any of our connective tissues and will only compound the damage.

Aim for eight cups of tea, coffee, herbal teas and pure water per day… The occasional glass of juice is okay as long as it is freshly made and diluted with water. I drink diluted cranberry juice once a day.

Supplementation

Glucosamine in supplements is often used to treat joint pain along with another ingredient, Chondroitin; both naturally occurring in connective tissue. There is research into the effectiveness of taking in supplementary form but do make sure that your research the brands carefully and cheap is not necessarily the best option. Sometimes the added fillers in the tablets can cause side effects.

Some people take Aloe Vera gel daily as it is very nutritional and great for a number of health issues, but it does also contain glucosamine and I find more effective taken in this type of carrier than in tablet form. Aloe Vera also has other minerals that help promote enzyme reactions in the joints which may help them heal faster. It also has an anti-inflammatory effect that helps relieve the pain.

Is there any specific health advice for someone who is suffering from this form of the disease?

Hard though it may seem for someone who suffers from Osteoarthritis- exercise is one of the ways to help improve flexibility and increase muscle strength to support the effected joints. Obviously sports that require flexing of the joints such as tennis or squash are not a good idea, golf could also be a struggle as you are using your lower back, hips and knees. Walking and swimming are usually very helpful although you will need to adjust your leg movements for certain swimming styles. Do remember that you need to rest as well as exercise and if you have a very active daily routine, even brisk walking, you are putting strain on your joints. Add a form of exercise, such as swimming that reduces the amount of stress on the joints.

Gout can effect just the big toe or the whole foot which becomes inflamed and painful – Pixabay.com

What is gout?

Gout, contrary to popular belief, does not just affect old men who drink too much port. The actual condition is caused by crystals of uric acid depositing themselves into the tissues of the body.

When the condition is chronic hard lumps of uric acid are deposited in and around the joints – these lumps can also lodge in the kidneys leading to decreased kidney function and kidney stones.

It can be hereditary – an inherited abnormality in the body’s ability to process uric acid. We all produce Uric acid, which is a by-product of purines, which are present in most of the foods that we eat.

Which part of the body does gout normally affect?

The kidney problems are separate – it becomes gout when one of the joints is affected. It is usually in the foot and particularly the big toe. But other joints can be affected too.

Unlike the other forms of arthritis – this is a more sudden onset of the problem and is usually linked to immediate causes rather than a systemic problem. The reason the joint at the base of the big toe is most affected is that as the uric acid crystals are carried through the system they collect at the lowest point of the body – i.e. the big toe. Some people will also suffer a fever with the outbreak and the attack can last anything from a few hours to weeks or months. It is recurring depending on how acute the condition and largely down to your lifestyle.

It really is prevention rather than cure with this one. And particularly keeping the correct fluid balance. This is essential for your kidneys anyway to ensure that all the toxins that you are taking in are flushed out. If you are dehydrated uric acid will build up and crystallise so that is why taking in sufficient fluid rich foods and liquids each day is important.

It is also important to maintain a healthy weight with less sugar in your diet. Sugar is acidic and disrupts our natural alkaline/acid balance in the blood which is of course flowing around the body including the joint areas.

What about nutrition and Gout?

For this type of arthritis, Purine rich foods can increase the production of uric acid so some of the foods to avoid are shellfish, liver and kidneys. Funnily enough, dairy intake has been shown to be beneficial in some research.

Protein from vegetable sources such as broccoli does not seem to have the same effect as Purine from animal protein so lots of fresh fruit and vegetables are essential.

Alcohol however does cause increased risk of uric acid output particularly beer and spirits. Wine did not seem to be as much of a problem. Again I think that gout attacks in the past have been more associated with the dehydrating effects of alcohol rather than drinking too much Port. Plus the fact that the usual sufferers tended to be wealthy males who consumed large amounts of meats at every meal.

What else can we do to ease the symptoms of arthritis?

All three of the arthritis strains will benefit from some physical support such as Acupuncture – I had that for a time and it certainly was beneficial in the healing process. Yoga, which involves gentle stretching, is excellent provided you have a good teacher and also the same with Tai Chi.

A warm bath using mineral salts to relax and ease muscles can be helpful.

Exercise is essential both for weight management and to build a strong muscle structure to compensate for the joint weakness. Also endorphins are released during exercise which acts as a natural painkiller. Remember to rest and to take care of your structural health.

©Sally Cronin Just Food for Health 1998 – 2021

I am a qualified nutritional therapist with twenty-three years experience working with clients in Ireland and the UK as well as being a health consultant on radio in Spain. Although I write a lot of fiction, I actually wrote my first two books on health, the first one, Size Matters, a weight loss programme 20 years ago, based on my own weight loss of 154lbs. My first clinic was in Ireland, the Cronin Diet Advisory Centre and my second book, Just Food for Health was written as my client’s workbook. Since then I have written a men’s health manual, and anti-aging programme, articles for magazines, radio programmes and posts here on Smorgasbord.

If you would like to browse my health books and fiction you can find them here: My books and reviews 2021

 

Thanks for visiting and I am always delighted to receive your feedback.. stay safe Sally.