Nutritional & Other Self Care Basics for Pain in the Joints
By Dr. Sarah Myhill, MD* •
February 9, 2011
The onset of joint pain may or may not lead to serious structural changes and disability that can be addressed by surgical treatment, or, in the case of Rheumatoid Arthritis, yield to emerging pharmaceutical trials hoping to derail autoimmune destruction. But regardless, a supportive plan that includes these basics will help joints be the best they can be.
"Arthritis" simply means pain in the joints. It names a symptom and is not a diagnosis; it therefore begs the question: What is causing it?
Arthritis has been classified into two types:**
• Inflammatory [rheumatoid arthritis, caused by a malfunctioning autoimmune system that often leads to destruction of joints], and
• Degenerative [osteoarthritis, the consequence of the gradual wearing out of the cartilage that covers the ends of the bones, causing damage and inflammation].
But most sufferers usually have a bit of both, so regardless of the type of arthritis one has, my treatment is the same.
Be Careful with Pain-Killers
Arthritis usually presents with pain. Pain is Nature's way of making you rest. Taking pain-killers such as Paracetamol (acetaminophen in the US) and Co-proxamol (Darvon), and anti-inflammatory drugs such as aspirin, ibuprofen, indomethacin, etc., is likely to make you use a joint which should be rested and will damage the joint and accelerate the rate of deterioration. "Indocid hip" is a well-recognized syndrome (an accelerated arthritis caused by taking pain killers inappropriately, requiring early hip replacement).
That might be acceptable for someone on the waiting list for a hip replacement but not for those who want their joints to last as long as possible! I think it is reasonable to take pain-killers to help sleep, but not if the joint is to be used.
Nutritional Treatment of Arthritis (Basic)
As I get older, my treatments seem to me to be more obviously logical! Whoever comes into my surgery, for whatever reason, gets the standard package of treatments that we should all be undergoing in order to optimize our current health and prevent future complications. This package of treatments (the general approach to maintaining and restoring good health) is as follows:
• Stone Age Diet (meats, seafood, eggs, greens and veggies, nuts & seeds, fruits such as berries) - It is remarkable how many cases of joint-pain resolve on a stoneage diet! For me, avoiding dairy products is crucial, and I can now see how a long family-history of hip-pain could have been avoided. Do not skip the diet! It may be the hardest thing to do initially, but is more than probably the most important.
• Nutritional Supplements - Include a multivitamin, a multimineral, essential fatty acids, and vitamins C and D. Vitamin D is essential to prevent osteoporosis; so get plenty of sunshine or take a vitamin D supplement in the form of cholecalciferol (vitamin D3) 2,000iu daily. See “Vitamin D - most of us do not get enough.”
• Sleep - Get a good night's sleep on a regular basis. See "Sleep is vital for good health."
• Fitness and Posture - Human beings never evolved to walk upright, and our bodies only work if they are kept in the correct position and muscles kept strong. My view is that unless you are conscientious about posture and do daily exercises (such as Pilates, yoga), then you will get joint and/or muscle problems at some stage. Joints are intrinsically unstable and all joints benefit from strong muscles supporting them, so keep yourself fit generally.
This is not as hard to achieve as you may think. 12 minutes a week is all that is required! See "Exercise – if you don’t use it you lose it” and “Exercise - the right sort.”
The ‘Bolt-On Extras’ for Joint or Muscle Pain & Osteoporosis
For a great many people the above interventions, done properly, are all that is required to cure their muscle pain and arthritis. Most people like to skim through this handout and cherry-pick the things they can do most easily, often missing the most important things like diet and exercise!
However, if the above has been done properly, and further improvement is sought, then the extra interventions are as follows:
1. Physical Interventions
With any case of arthritis, an opinion from a good physiotherapist, osteopath or chiropractor is always helpful, since much joint-pain is caused by poor posture and poor musculature. The human skeleton evolved for a creature which was meant to walk around on all-fours, and by adopting the upright position we have put great stresses on it.
2. More Nutritional Supplements
• Other nutritional supplements which are extremely helpful and of proven benefit in all types of arthritis - These include: Devil's Claw (anti-inflammatory), glucosamine (raw material for connective tissue), strontium (for strong bone), boron (necessary for calcium and magnesium metabolism), vitamin D3 (for absorption of calcium and magnesium in bone), and organic silica (considered a serious rival to NSAIDS). These can be purchased separately, but a mix [available in the UK] is good for all connective tissue, including muscle, tendon, bone and gut, and highly protective against osteoporosis. See “Action Against Arthritis – AAA” for detail.
• High dose vitamin B3 (niacinamide, the activated form of niacin) - Dr. William Kaufman, a physician working in America (recognized for his groundbreaking work in arthritis therapy), has shown how high dose B3 as niacinamide (not niacin) works extremely well for all sorts of arthritis.
The best results are achieved by taking regular low doses, such as 100-500mgs, six times daily. Dr. Kaufmann was very particular about this - he insisted on small regular doses. Start with this and if you get benefit, try slow release niacinamide 1,500mgs daily, perhaps increasing to 2-3 daily. Results can be outstanding with less pain and marked improvement in joint mobility. Indeed, Kaufman documented this carefully by measuring the range of joint movement of several joints before and after therapy in 1,386 patients with predictably good results. He suggested that niacinamide worked by accelerating the rate at which joints healed so arresting the degenerative process because it was effective regardless of the cause of the arthritis.
My guess is that niacinamide is an essential part of energy delivery at the cellular level. Because joints are deprived of a good blood supply (they are white if you cut them open) niacinamide effectively improves energy delivery and so healing.
Rarely there can be upsets in liver function but this is accompanied by nausea. So if you feel a bit sick, get liver function tests checked.
• Antioxidants - In inflammation, the white cells are overactive and reacting against things that they really shouldn't. The process of white cells being overactive results in the release of superoxides. If you think of your immune system as a little army, then superoxides are the bullets that they fire in order to kill bacteria and viruses. However, if these are aimed at one's own joints, then essentially one's joints become damaged by friendly fire.
Trying to identify the cause of excessive white cell activity, such as allergy, will obviously be very helpful. However, one can also tackle this by using antioxidants. Antioxidants are the molecules which mop up these superoxides (free radicals) and limit the damage that they may cause. So attention to antioxidant status is going to be very helpful. See Antioxidants - Crucial 'A-Team' in the Fight Against Aging and "Antioxidants and Free Radicals – What They Are and What They Do."
• Vitamin B-12 - Vitamin B-12 is extremely useful because it effectively gives instant antioxidant cover whilst one is correcting levels of the above. I find vitamin B-12 very useful in many cases of what I call useless inflammation (such as multiple sclerosis and rheumatoid arthritis) because I suspect it is acting as a damage limitation molecule. B-12 is often helpful in bursitis (tennis elbow, golfer's elbow, Jeep bottom, housemaid's knee, etc.).
• Chinese remedy - An old Chinese remedy for arthritis is twice boiled chicken bones. This makes great sense because all the raw materials for making new bone and cartilage are to be found in stock from boiled bones. So do buy and boil up bones for stock for soups and stews. I do! [ProHealth Note: In this regard, read about the recent development of “Undenatured Type II Collagen – Chicken Soup for Your Joints.”]
Keep Your Joints Warm
Joints have a very poor blood-supply. If a joint is cut open, it appears white because it has no direct blood-supply. The oxygen has to diffuse a long way from the blood vessels before it gets into the joint. I suspect that the reason why cold weather affects joints badly is because the blood-supply is reduced and so the oxygen supply to the joints is cut off. This causes a build-up of free-radicals and therefore pain.
It is vital to keep all joints warm! People often feel better in a hot climate, partly because their joints are warm, partly because of the sunshine making vitamin D, and partly because diets in hot climates are usually closer to the "Stone Age" diet.
Keep Muscles Moving
Muscles are dynamic structures that hate stillness and welcome movement. This is because the circulation of blood to, and the venous and lymphatic drainage of, muscles is partly dependent on their rhythmical contraction and relaxation, which pumps nutrients in and waste products out. This is why massage is so good for almost any muscle problem. A build-up of waste-products such as lactic acid causes pain. See “Muscle Stiffness” and “Fibromyalgia.”
"Inflammatory" Arthritis, e.g., Rheumatoid, Ankylosing Spondylitis, Reiter's
Some people with arthritis are reacting allergically to their own gut flora and there has been interesting work that links Rheumatoid Arthritis with allergy to Proteus mirabilis, and Ankylosing spondylitis (arthritis that primarily affects the spine) to allergy to Klebsiella. See “Ankylosing spondylitis.” In these cases, taking high dose probiotics may also be helpful. See “Probiotics.”
Also see “Autoimmune Diseases – The environmental approach to treating” for further ideas for reducing inflammation.
Many of these are of proven benefit, but I would not suggest them until all of the above have been well tried. This is because the above remedies are addressing the root causes of problems, which to me seems the logical way to proceed. I do not know how many of the herbal remedies work; I just know they do! Because Devil's Claw is so good, I put this in my “Action Against Arthritis” supplement mix.
Surgery or Not?
Ultimately everybody has to work out their own package which helps them. The key obviously is to try to find the cause of the arthritic pain. And if the above package is not giving worthwhile improvements, then diagnostic X-rays and MRI scans can be extremely useful to look for structural changes that may need operative treatment.
But do not consider surgery until all the above interventions have been properly tried and given a chance to work!
Also see "Osteoporosis – Practical Nutritional Considerations.” Many late cases of arthritis have periarticular osteoporosis (when bone building is not keeping up with bone reabsorption, but bone mass reduction is less severe than in osteoporosis), so these two subjects should be addressed together.
* Dr. Sarah Myhill, MD, is a UK-based fatigue specialist with a focus on preventive care, nutrition, and patient education. This material is reproduced here with kind permission of the author, from her website (DrMyhill.co.uk) ® Sarah Myhill Limited, Registered in England and Wales: Reg. No. 4545198.
** ProHealth Note: Rheumatologists at Yale have estimated that 60% of people with undiagnosed Lyme disease eventually develop Lyme arthritis (an inflammation of the lining of one or more joints caused by the Lyme spirochete), and in recent reports suggest Lyme should be considered in the evaluation of patients with just one or a few affected joints, in Lyme endemic areas. The treatment in case of Lyme arthritis being a course of antibiotic therapy.]
Note: This information has not been evaluated by the FDA and is not meant to prevent, diagnose, treat, or cure any illness, condition, or disease. It is essential that you make no additions to or changes in your health support plan or regimen without first researching and discussing it in collaboration with your professional healthcare team.
ProHealth offers a wide range of nutritional supplements for optimal health.*
*These products are not intended to diagnose, treat, cure, or prevent any disease.
| (1 existing comment)
Sarah is our heroine
|Posted by: 4j2nq2
Feb 9, 2011
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It is so good to read her advice again. I miss hearing her voice on this site so I was delighted to read something again since I got onto ProHealth.
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