What Is The Best Arthritis Treatment? – Part 1: The Basics
What Is The Best Arthritis Treatment? – Part 1: The BasicsMay 28th, 2019 by Cindy Perlin, LCSW
Approximately 350 million people worldwide have arthritis. Nearly 40 million persons in the United States are affected by arthritis, including over a quarter million children. More than 21 million Americans have osteoarthritis. Approximately 2.1 million Americans suffer from rheumatoid arthritis. Many of these patients are in a lot of pain and asking, “What is the best arthritis treatment?”.
Why medications are not the best answer to “What is the best arthritis treatment?”
Let me start by confessing my bias. I don’t believe that the best treatment for most illnesses, including arthritis, is a pharmaceutical. The best treatment for arthritis or any disorder is the one that:
- Has the most positive benefits
- Has the least negative side effects
- Addresses the root causes of the problem
Medications, by these standards, are not the best arthritis treatment because, while they may temporarily reduce pain levels, all have negative, even potentially lethal, side effects.
Nonsteroidal Anti-inflammatory drugs (NSAIDs) are the most common drugs prescribed. These include aspirin, ibuprofen, naproxen and prescription drugs like Celebrex (Celecoxib). These drugs can cause gastrointestinal irritation and sometimes fatal bleeding. Three thousand people a year die from GI bleeds caused by aspirin alone. And all the NSAIDs except for aspirin increase the chances of heart attacks and strokes that can occur with no warning and can result in death.
Corticosteroids, another class of drugs commonly used for arthritis, come with their own set of serious side effects, especially with long term use. These include osteoporosis, high blood pressure, diabetes, weight gain, increased vulnerability to infection, cataracts and glaucoma, bruising easily and muscle weakness.
Arthritis is much more common among people who have other chronic conditions. 49 percent of adults with heart disease have arthritis. 47 percent of adults with diabetes have arthritis. 31 percent of adults who are obese have arthritis. Taking a drug that runs the risk of causing these conditions or making these conditions worse is not the right approach.
Medications also do not usually get to the root of the problem. They suppress symptoms rather than address the reasons why they are there. So, if you have inflammation, rather than artificially suppress it, treat the cause. Many of the other conditions that commonly occur with arthritis, such as obesity and heart disease have the same root causes, such as poor diet and a sedentary lifestyle.
So, if you ask me, “what is the best arthritis treatment?”, I’m not going to answer with the name of a pharmaceutical.
There are different kinds of arthritis – They have similar answers to “What is the best arthritis treatment?”
According to the Arthritis Foundation, there are more than 100 kinds of arthritis and related conditions. Arthritis “is an informal way of referring to joint pain or joint disease”. Common symptoms include joint swelling, pain, stiffness and decreased range of motion. Symptoms may come and go, stay the same or get worse over time. Utilizing the best arthritis treatments can significantly improve the course of the disease or even eliminate it.
The most common type of arthritis is degenerative arthritis, also known as osteoarthritis (OA). In OA, the cartilage, which is the cushioning surface of the ends of bone, wears away and, bone rubs against bone, causing pain, swelling and stiffness.
Inflammatory arthritis, including rheumatoid and psoriatic arthritis, is where the immune system attacks the joints with uncontrolled inflammation. Internal organs and eyes may also be affected.
Infectious arthritis occurs when a bacterium, virus or fungus enters the joint and triggers inflammation. Eliminating the infection quickly is most important, but sometimes the joint pain becomes chronic.
Despite these different types of arthritis, the answer to the question, “what is the best arthritis treatment” has some surprisingly similar answers. Where they are different will be noted below.
There is no one answer to “What is the best arthritis treatment?”
Arthritis is a complex disease that has many contributing causes. The progression of arthritis is affected by many different variables, including nutrition, exercise and stress. There are also many therapies that can reduce stress on joints and promote tissue repair. Part 1 of this series will address lifestyle issues.
The basics: Self care strategies are some of the best arthritis treatments
Self-care Strategies that help arthritis include:
- Stress Management
If you are not including attention to these strategies in your treatment, you will not be getting to the root of your problem and your arthritis will most likely continue to progress.
Joint swelling/inflammation is common to all forms of arthritis. Your diet can either promote or reduce inflammation, depending on what food you choose to consume.
A diet high in fruits and vegetables, fatty fish (herring, mackerel, trout, salmon and tuna) and olive oil reduces inflammation. Extra-virgin olive oil may reduce inflammation in the same way that a nonsteroidal anti-inflammatory drug (NSAID) such as ibuprofen or aspirin can – it contains a compound called oleocanthal that blocks the enzymes that cause inflammation.
A diet high in omega-6 fatty acids, which are found in corn, sunflower, safflower and soybean oils, and many snack and fried foods raises your risk of joint inflammation and obesity. Eating grilled meats, red meat and sugar can also increase inflammation. Many people with RA also find that eliminating gluten, found in many grains including wheat, can significantly reduce inflammation and pain.
The Mediterranean diet is an excellent diet for people with arthritis. It emphasizes locally grown fruits and vegetables, healthy fats like olive oil and nuts, whole grains and some fish, yogurt and red wine. Some arthritis patients have noted changes in their pain levels and been able to reduce their medications in as little as a week after starting the diet.
Many people who switch to a Mediterranean diet also experience weight loss. Every pound of weight loss relieves four pounds of pressure on joints.
Many nutritionists and physicians will tell you that the best way to get the nutrients you need is food. This is correct in the sense that healthy foods contain a variety of nutrients that complement each other and work together for optimal health. However, in reality, it is very difficult to get all the nutrition you need from foods. Because of modern agricultural methods used in factory farms, the soil our food is grown in is often depleted of vital nutrients so the food is not as nutritious as it has been in the past. We’re also less active and don’t consume the quantity of food our ancestors did.
In addition, many of the medications used by patients with arthritis can deplete vital nutrients, making nutritional deficiencies more likely. Taking the right supplements can make a real difference in your arthritis pain and progression.
Nutrients that may need supplementation include omega 3 fatty acids, selenium, folic acid, Vitamins C, D, B6, B12 and E, calcium, magnesium and zinc.
To summarize, changing your diet and adding supplements is a big part of the answer to the question, “What is the best arthritis treatment?”
It can be very difficult to put together an appropriate supplementation program on your own. If you don’t have access to a knowledgeable healthcare provider, the ID Life company has an excellent alternative. You can fill out a free, very detailed questionnaire that asks about medical conditions, diet, stress and other lifestyle issues, medications, etc. and they will instantly generate a recommended supplement regimen for you. They explain, based on your answers to the questionnaire, why they are recommending each supplement and even break supplement recommendations down into three levels of importance. Then, if you like, you can order the supplements from them in conveniently packaged 2x daily supplement packs.
Having trouble getting enough fruits and vegetables into your diet? This supplement can help: Juice Plus
Exercise is critical for people with arthritis. It strengthens the muscles around the joints and increases flexibility to reduce stress on the joints. It also helps to maintain healthy bones, improves balance, helps with weight control, increases energy levels and helps with mood and sleep.
Many people in pain, including people with arthritis, are afraid to move due to fear of reinjury. This fear is so common there is a medical term for it: kinesiophobia. Getting professional guidance from a physical therapist, movement therapist or chiropractor about what type of exercise to do and how to gradually build up endurance can be extremely helpful and can reduce kinesiophobia.
There are several types of exercise that can help reduce joint pain. Incorporate all of them to get the best pain reduction:
Range of motion exercises involve movements to relieve muscle stiffness and increase your ability to move your joints through their full range of motion. These exercises can be done daily.
These are exercises such as weight training that help you strengthen the muscles that help support and protect your joints. Strength training should be done no more than every other day at first to allow your muscles to rest and rebuild.
Low impact aerobic exercises such as walking, bicycling and swimming improve your overall fitness level. They help improve heart health, weight control, mood and energy levels.
Exercising in water is particularly helpful for people with arthritis because the water supports body weight, reducing stress on joints, while the resistance created by the water helps strengthen muscles.
Try to gradually build up your aerobic exercise in time, frequency and intensity until you have achieved a moderate intensity of exercise most days of the week for a total of 150 minutes per week.
Other types of exercise
Gentle forms of yoga and tai chi can also be very helpful. They improve flexibility, balance, posture and coordination as well as promote relaxation. Be sure to find an instructor who is knowledgeable about your condition and who promotes body awareness in the practice of the exercises.
Any movement, including performing household chores and walking the dog, is better than no movement at all.
To ease into your exercise program and to prevent exacerbating pain, do all exercises slowly and gently with body awareness. Applying heat before exercise and ice afterwards can help. If you haven’t been exercising at all, you may find that you have some muscle soreness after exercise at first.
Local chapters of the Arthritis Foundation have specially tailored exercise programs in many parts of the US. You may also find exercise programs tailored for people with arthritis at your local YMCA.
Stress Management — Another good answer to the questions: “What is the best arthritis treatment?
The connection between stress and illness is well documented in the scientific literature. The more stress a person has and the more trauma they have experienced, the more likely they are to develop a chronic mental or physical illness. A history of chronic childhood trauma (mental, physical or sexual abuse, witnessing domestic violence, living with a parent with a substance abuse problem or mental illness) is particularly harmful.
The reasons for this are well known. When a person’s life experience has caused them to always feel unsafe or they are always worrying, their bodies are constantly in the stress response, also known as fight or flight. The fight or flight response is a survival mechanism that helps us to fight or run when presented with physical danger and involves physiological changes in the body that maximize our ability to do this in the moment.
Changes in the body during the stress response include increases in muscle tension, heart rate, blood pressure and respiration rate and decreases in blood flow to extremities, immune system response, digestion and tissue repair. These changes, when prolonged by chronic stress, can cause illness and impede recovery.
Another effect of chronic stress is cortisol dysfunction. Cortisol is a powerful anti-inflammatory hormone that the body releases during the stress response to mobilize energy and reduce inflammation. Prolonged stress depletes cortisol levels and may also interfere with the ability of cortisol to bind with cell receptors. The result may be out of control inflammation that contributes to both osteoarthritis and rheumatoid arthritis, among other illnesses.
So, another part of the answer to the question, “What is the best treatment for arthritis” is managing stress.
Treatments that help manage stress
Cognitive Behavioral Therapy (CBT)
Thoughts that we are in danger trigger the fight or flight response. Any kind of fear, such as fear of loss of a relationship, fears about finances, fears about pain, will trigger a fight for flight response. CBT is a psychological therapy that teaches patients to examine their thoughts and replace them with more realistic, calming or helpful thoughts. This allows the body to spend less time in fight or flight, which lessens pain and promotes healing.
Meditation and other relaxation techniques
Meditation is about redirecting attention away from worry thoughts and focusing on a repetitive word or the breath. A special kind of meditation that is very popular is mindfulness meditation, which trains participants to focus on their breath while witnessing their thoughts, noticing them without reacting to them. Other types of relaxation techniques involve breathing techniques, repeating calming phrases or visualizing peaceful scenes. The purpose of all of these techniques is to quiet the mind so that the body is no longer in fight or flight and in a calm state that is more conducive to health and healing.
Biofeedback is a treatment that uses sensitive electronic instruments to measure a patient’s physiology and then feeds that information back to the patient so that control of physiology can be learned.
There are two major types of biofeedback, peripheral biofeedback and neurofeedback. Peripheral biofeedback includes measurements of hand temperature, muscle tension, skin moisture, heart rate and respiration rate, which are all measures that change with stress. Neurofeedback involves measuring the electrical activity of the brain in order to normalize it.
Peripheral biofeedback is usually combined with relaxation techniques. By measuring the physiological changes that accompany stress and relaxation it becomes much easier for the patient to measure progress and see what works. This makes learning how to relax much easier and quicker. It also helps with motivation, as patients can see that they are having a positive effect on their bodies.
Neurofeedback uses audio and visual feedback to reward the brain for making positive changes. With pain, that usually involves calming overactive areas of the brain that are associated with pain signaling. When someone is in pain for an extended period of time, the brain becomes chronically over-sensitized to stimuli. The brain constantly generates pain signals even when tissue healing is complete. Neurofeedback can calm the brain enough to eliminate this excessive pain signaling.
Trauma resolution techniques
An unresolved trauma is a dangerous event experienced in the past that continues to be relived in the present. The traumatized person may continue to be preoccupied with the event even though it happened long ago, or the memory of the event still has a strong negative emotional charge. The traumatized individual may have flashbacks of the trauma, which means they re-experience it in their mind as if it is still happening now. They may avoid any reminders of the trauma or overreact to anything that resembles the original trauma in any way. Unresolved trauma keeps the body chronically in the stress response because the body stays constantly on the alert for danger as if it is still happening in the present.
Resolving the trauma, i.e. putting it in the past, leaves the body in a calmer state where healing is more likely. Talk therapy is usually not very effective for resolving trauma because of the way that the brain stores traumatic memories. However, there are psychotherapy techniques that have been developed that do help to rapidly resolve trauma.
One very powerful trauma resolution technique is energy psychology. There are many variations of this technique. The most popular one is the Emotional Freedom Technique (EFT). Others include Thought Field Therapy (TFT) and the Tapas Acupressure Technique (TAT).
All of the energy psychology techniques have a common premise: when a distressing event is recalled, the emotional energy associated with it creates an energy field around the body that can be accessed to dissipate the energy. This takes the emotional charge out of the memory and allows it to be stored as something that happened in the past. This technique can also be used to focus directly on pain and the fears associated with it. Often there is an immediate and enduring reduction in pain using this type of technique.
There is so much more to answering the question, “What is the best arthritis treatment?”
Other “best treatments” include massage, physical therapy, anti-inflammatory supplements, acupuncture, low level laser therapy, pulsed electromagnetic therapy (PEMF) and more. All of these treatments are safe and effective for inflammatory joint diseases. Stay tuned for Part 2 and Part 3 of “What is the best arthritis treatment?”
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