Learning how to cope with arthritis

By Jay Chung

Arthritis is a common term used to describe a group of conditions that cause joint damage, inflammation, stiffness and pain. There are more than 100 types of arthritis, but the most common types are osteoarthritis, rheumatoid arthritis and gouty arthritis.

What is osteoarthritis?

Osteoarthritis (OA) is commonly known as “wear and tear” arthritis, but osteoarthritis has multiple factors contributing to its development. OA can develop in areas of previous injury and commonly occurs in the big toe, ankles, knees, hips and low back with age. OA slowly develops and symptoms are stiffness when starting an activity, especially after a period of rest, and soreness during and after movement or activity.

Jay Chung

There are many diet and lifestyle changes you can make to help decrease your risk of developing OA or slow the progression of existing OA. Studies have found that individuals who consume more fruits and vegetables, particularly non-citrus fruit and garlic, have a lower risk of developing osteoarthritis. Maintaining a healthy weight is important in reducing your risk of developing OA. For those who have OA, both reduction in body fat and gain in muscle mass may relieve pain and assist with body function. Even modest weight loss in combination with moderate exercise improves body function, increases mobility and decreases pain – more than weight loss alone. Low impact activities, such as swimming, cycling, water aerobics, tai chi and yoga are excellent choices for those with osteoarthritis.

Food choices and OA

There are a variety of fad diets claiming to cure arthritis. Unfortunately, most arthritis specific diets have not been scientifically proven, but there are important changes you can make to your diet. Limit saturated fats, found commonly in meat and dairy products. Choose low-fat products and lean meats, such as chicken or choose fish, instead of beef. Avoid trans-fats commonly found in packaged, processed foods and show up in ingredient lists as partially hydrogenated oils. Although most people think of soy products as a healthy food choice, partially hydrogenated soybean oil is a trans fat. Minimize your intake of the “white stuff” including white rice, white bread and white pasta. Choose whole grain breads, cereals and pastas and add beans, legumes and lentils to your meals. Avoid added sugar, including organic sugars, fruit juice sweeteners, honey and high fructose corn syrup. Lastly and most importantly, eat a wide variety of fresh fruits and vegetables daily. A vitamin supplement will not replace the nutrients found in foods.

What is rheumatoid arthritis?

Rheumatoid arthritis (RA) is an autoimmune disease and typically develops in women in their 50s. RA commonly affects the joints in the hands and feet and characteristics of RA are morning stiffness, swelling and joint pain in both hands or both feet. It’s uncommon to see a single joint affected in RA and there is rarely a sudden onset of RA after injury. Low impact activities, such as water aerobics, swimming, cycling, tai chi and yoga can decrease pain and improve function in those with RA. In addition to general diet guidelines described above, individuals with RA should increase their intake of omega-3 fatty acids. Omega-3 fatty acids are found in fish, specifically herring, salmon, trout and tuna, flaxseed meal, flaxseed oil, walnuts, tofu and canola oil. Fish oil supplementation has been found to decrease the number of painful and tender joints and decrease the duration and intensity of morning stiffness. Before starting fish oil supplementation, talk with your physician. Side effects of fish oil supplementation include increased menstrual time and individuals taking blood thinners may need to be monitored.

Living with gout

Gout is a painful condition caused by high uric acid levels in the blood. A gout attack occurs when excess uric acid forms needle-like crystals which deposit in joints, most commonly the great toe joint, resulting in pain, redness and swelling. Gout attacks usually occur at night, causing the affected individual to wake with excruciating pain and a red, swollen joint. Repeated gout attacks cause damage to the cartilage in the joints resulting in gouty arthritis.

Diet and exercise is extremely important for individuals with gout. Diets which include foods high in purines can increase uric acid levels. A purine is a chemical compound found in certain foods which break down into uric acid in the body. Foods and beverages high in purines include alcoholic beverages, such as beer, wine and spirits and foods such as anchovies, sardines, herring, mussels, codfish, scallops, trout, roe, haddock, bacon, turkey, veal and venison. Foods moderately high in purines include beef, chicken, duck, pork, ham, crab, lobster, oysters and shrimp. People who suffer from gout now have a way to prevent recurrence. Exercise can increase mobility and blood circulation, as well as strengthen joints and regulate the amount of uric acid in the body. Since uric acid is the underlying cause of gout, exercising for the prevention of the buildup can alleviate pain and suffering.

Most purines are made by the body, but some purines come from diet. Avoiding high purine foods can help to reduce the incidence of gout attacks. If you have gout, important steps you can take include losing weight, drinking plenty of fluids (except alcohol), eating a variety of fresh fruits and vegetables, adding low-fat dairy, such as milk or yogurt, to your diet and minimizing the intake of foods high or moderately high in purines.

Jay Chung is a physician for Barton Internal Medicine and the area’s only rheumatologist. He specializes in rheumatoid arthritis, osteoarthritis, fibromyalgia, osteoporosis, vasculitis, gout and systemic lupus erthematosis. For more information, call (775) 589.8900 or (530) 543.5685.