September is Arthritis Awareness Month

September is Arthritis Awareness Month.

Join me in the first part of our discussion as we dissect the intricacies of arthritis, focusing primarily on osteoarthritis. We'll travel through the landscape of this disease, exploring its potential causes and how it plays out in our bodies.   We'll also touch on the widely unspoken connection between osteoarthritis and cardiovascular health. This is more than a medical discussion; it's a personal journey into a condition that affects millions, including myself.

As we pivot to the second part of our chat, we'll illuminate the path to managing osteoarthritis. Harness the power of diet and exercise in your journey with joint health, discovering the profound benefits of simple things like fatty fish and healthy movement. We'll discuss how your nutrition can help you heal the inflammation of arthritis.

We'll discuss the recommendations I share with my patients to add healthy movement to help heal arthritis and prevent loss of functioning.

Medications are an important aspect of managing arthritis.  In addition to medications, I review some of my common recommendations for osteoarthritis.

Take advantage of savings by shopping my dispensary at Fullscripts.
It's free to register at Fullscripts, and by setting up your account you can have access to my Joint Pain and Arthritis protocols. 

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Transcript

Speaker 1: 0:53

Hello listeners and welcome back to the Art of Healing podcast. This is Charlize, and for this episode we are going to talk about arthritis, because it turns out September is Arthritis Awareness Month, and arthritis is probably the most common discussion that I have when I'm working with my patients and as well as my clients. And then, on a selfish note, I've recently found out I've got a bit of arthritis myself. So let's talk about arthritis. So, in particular, there are actually several types of arthritis. So there are arthritis that is from the immune system or from mechanical wear and tear. It's such a big topic that, even though this is Arthritis Awareness Month, I did want to focus on osteoarthritis, because that's the type of arthritis that, as I'm researching and I've even felt myself, can potentially affect all of us. So let's get into it. So, when we are talking about osteoarthritis, this is different than many other types of arthritis, so I probably should just cover the types of arthritis briefly, just to make sure we're on the same page. So arthritis the term really means joint inflammation. So when you say arthritis, you could really mean a number of things. Some arthritis comes from a problem with your immune system, where possibly, the immune system has attacked the connective tissue of your joint or maybe your immune system has attacked the lining of your joint, so that is something more like a rheumatoid arthritis or a lupus arthritis. There are types of arthritis that you can get. If you were real sick, if you were sick recently and you had kind of a bad diarrhea, it can actually lead to an arthritis because your immune system did get upset and was looking for a target. So that's sometimes called post-infectious arthritis and we can even see something like that when we are getting sick, you know, in the early stages when you have the. You know the aches and the joint pain in early flu or early COVID. So those are distinct types of arthritis, but for this episode I did want to focus on osteoarthritis.

Speaker 1: 3:28

So osteoarthritis is best defined as a combination of things that go wrong in a joint. So it's mechanical wear and tear, it's injury, it's possibly trauma. There is level of engagement of the immune system where the body attempts to do some repair work doesn't go so well. The repair work makes waste products that end up causing some problems of sales, and then along with that there are issues around the joint that may develop as a result, where the joint being inflamed itself causes damage to the muscles or a change in how you walk. The end result is that you maybe have one or more joints that has a combination of pain, trouble with range of motion, which is stiffness, swelling, being tender to touch and just overall an achy joint just kind of sucks. So Osteoarthritis can show up in really any joint. Unfortunately, any of our joints can develop osteoarthritis.

Speaker 1: 4:45

Osteoarthritis of the knees fairly common, so that can cause pain anywhere in the knee. But most commonly I believe from my research most individuals will notice pain in the medial knee, that's the inside of the knee, a part of the knee that's closest to the midline. But you can have the arthritic changes occur beneath the patella or the kneecap and you can have arthritis changes within the entire knee. The end result, of course, is pain, stiffness, various loss of function. For individuals with arthritis of the knee, the most debilitating is losing the ability to walk certain distances and it turns out that developing osteoarthritis of the knee is not good for the cardiovascular health because as you don't walk as much and you're not as active, you lose your aerobic exercise and that can set you up for issues with your heart such as coronary artery disease. You can have osteoarthritis in pretty much any joint.

Speaker 1: 5:55

One common osteoarthritis entity that doesn't get talked about a lot it actually occurs pretty frequently is when women develop pain and swelling in their hands. That is commonly osteoarthritis. And the research I had to do and I had seen patients with this every day but I've got a research, just like you all have to, and I wasn't quite for sure. I thought well, let me look up osteoarthritis of the hand in women and see what the data is saying. And it does appear that osteoarthritis in women is possibly a standalone rheumatologic disease. That's just not well understood. It doesn't really occur as commonly in men, but it's the pain, the stiffness and the joints and then the joints begin to look different. They become enlarged and they stay enlarged and things like getting rings on and off becomes more difficult.

Speaker 1: 6:49

We can also get arthritis, osteoarthritis after an injury. So one common injury that can lead to that is ankle trauma. That can cause osteoarthritis of the ankle. Same symptoms of pain, swelling, stiffness, tenderness, trouble with walking. We can also get osteoarthritis in the spine, in the lower back or the lumbar spine, very commonly the neck, the cervical spine.

Speaker 1: 7:21

I've had to take a personal interest in osteoarthritis myself because I've recently been diagnosed with osteoarthritis in my shoulder, which is odd, and I'm still trying to figure out how did that happen? I have definitely seen patients that had it, but I was shocked to hear myself that I had it. And it's the same disease process of mechanical overuse, damage within the joint that leads to recruitment of the immune system to try to heal that toxic metabolites that form within the joint and the end result is a joint that has symptoms on a fairly constant basis. But yes, so it can occur in pretty much any joint and it turns out, unfortunately, that just being human, just living in gravity, just walking, puts all of us at risk just a little bit. Some studies have shown that up to one in four adults develop osteoarthritis of a hip by the time they're 85 years old. So that's what I was saying, that almost all of us might be involved. And there are quite a few studies that show that when a joint's immobilized for some reason it doesn't develop arthritis, and I think that was found in like laboratory subjects. So we can't avoid it too much. So we should learn to live with it, we should learn to heal it, maybe Just being in touch with our joints so we can get ourselves ready for it. So when should you suspect?

Speaker 1: 8:52

If you have osteoarthritis Pretty much like with any condition you gotta get expert help. So you have to be evaluated by a healthcare professional physician preferably. But if you've got a joint that's been hurting for over a week or two it's really worth looking into it is a possible osteoarthritis. To diagnose osteoarthritis it doesn't take a lot of complicated diagnostics, simply the history and physical, especially with a skilled physician, preferably an orthopedic surgeon, can probably diagnose if it sounds like osteoarthritis. But things like x-rays are very helpful, especially in particular joints. Also, more advanced imaging such as an MRI can be helpful in finalizing that diagnosis being osteoarthritis.

Speaker 1: 9:40

One question that comes up for quite a few of my patients is if they need lab work to diagnose osteoarthritis. Honestly, I think that is a great question. It really is a very good question. Right now, best of my knowledge and I believe, best of medical science, that we really don't have a lab that directly diagnosis osteoarthritis. There are some laboratory markers that may be elevated as a result of osteoarthritis, so those would be inflammatory markers such as an ESR or a CRP, but beyond that we don't have a direct laboratory diagnostic test to tell us is it osteoarthritis, whereas we do have ways to test for other types of arthritis, and even then, by the way, it's not black and white.

Speaker 1: 10:30

So gouty arthritis or gout. We've got two or three men labs that we can check, including a uric acid level. An ESR can be helpful, possibly a CRP and related labs such as kidney function and liver Rheumatoid arthritis. We have labs that can help to point us in the right direction. You can actually test for what's called rheumatoid antigen or you can test for an ESR as well. But, interestingly enough, when I've been working with patients and I'm convinced that they've got a rheumatoid arthritis so I'm sure that this is a gouty arthritis by the time we finish our work up, and maybe they've proceeded to more advanced treatments, possibly surgery, where the joint was visualized by an orthopedic surgeon that the pathology was not one of those autoimmune entities, it was actually osteoarthritis. So even if you are dealing with another type of arthritis, you can develop osteoarthritis in combination with that.

Speaker 1: 11:42

So, understanding that osteoarthritis the most common type of arthritis is something we'll all be dealing with. It's good for all of us to have a general tool kit with how to take care of our joints. It's something we only, but definitely if you've been diagnosed with osteoarthritis, there's some steps that you can take right away to keep your joints moving well, make yourself stronger, even if you need to be considering surgery. Some important steps you could take to be optimized before that. When I'm working with my patients, the first place I actually start when they're having osteoarthritis especially if they're having osteoarthritis of multiple joints is starting with a good anti-inflammatory diet.

Speaker 1: 12:28

So whatever gets into your system has an impact on your joints. It's easy to think that most of the time, your diet is only affecting things like your blood sugar or only your weight, but if you're eating foods that are high on the glycemic index meaning you have a lot of sugar and create a lot of oxidant stress on your body, that's going to make your osteoarthritis more painful. In terms of the diet, you'll want to think about things that you want to try to include pretty frequently. So whole foods typically produce, so our whole grains, beans, vegetables and fruit, making sure they're in your diet on a regular basis and preferably spread across every meal. And then something we're probably aware of most of us that consuming the anti-inflammatory fats, which are called the omega-3 fatty acids, having those in your diet on a regular basis is great.

Speaker 1: 13:37

One superfood that is great to include, high in omega-3s and has less impact on the environment, are going to be the smaller, fattier fish, so that turns out to be sardines and anchovies. It's a topic that I introduce to my patients honestly, sometimes for fun, because it's kind of fun to watch them cringe. I live in a landlocked area so we're not close to the ocean so it's not a lot of seafood eaters here. There's some, but I shouldn't say that. But I do like to watch them cringe.

Speaker 1: 14:11

But sardines and anchovies are actually a great addition to your diet. Some consider them to be a superfood, but they're a good way to get an omega-3s and fatty acids which can be getting to those joints to help them heal, getting to your muscles and great for your brain. The other benefit with those is that, since they're not predator fish, they're lower down on the food chain than things like tuna, that they're less likely to contain higher amounts of toxins like heavy metals that we don't necessarily want and I believe our thought to be better for the environment, which is always a good thing. So having those as part of your diet, not to mention that sardines and anchovies are likely great in cost they tend to be pretty inexpensive. So in your diet, having those fatty fish, a good overall general diet that's often recommended by many of us doctors would be the Mediterranean diet. That's a great diet that, if you're thinking quit, go to help your joints. Maybe switching more over to Mediterranean diet to help those joints would be a great idea.

Speaker 1: 15:26

You may be aware of some of your own food intolerances or you may have already had some advanced testing or be aware of certain food allergies. I don't want to forget that for some of us, making some subtraction so that might be removing gluten might help our joints feel better, because in some of us, when we consume that, it makes us produce more pro inflammatory compounds in our diet. So beyond the dinner table, there's other things that we want to do to keep our joints healthy. So exercise would definitely be the next recommendation. My one bit of caution is, if you're working with a painful joint more than one painful joint, that you really have an expert opinion before you get started. If you're dealing with knees that have arthritis or hips that have arthritis, I would recommend you be evaluated by a Northeastern specialist or you be evaluated by a physical therapist so that you know what exercises work best for you.

Speaker 1: 16:27

In general, for most of us, walking will meet our aerobic exercise needs. My general advice I give to my patients is 150 minutes a week of aerobic exercise, which roughly 30 minutes of walking a day, but maybe doing a little bit more than that to keep the cardiovascular health up. And then we know that when we exercise we increase our blood flow so we can get more blood flow to those painful joints as well as improving our circulation and overall lowering our inflammation. If walking or aerobic exercises might be limited again working with a specialist for tailored advice for you but something like a stationary bike might be easier, an elliptical machine may be easier on your joints. And don't forget swimming, if you're okay with the resistance of swimming. So if you don't have an upper extremity arthritis, water aerobics or swimming is a great way to get some resistance in, as well as the aerobics that we're after.

Speaker 1: 17:35

Beyond the aerobics, doing some resistance training is actually good for our joints, good for our muscles, good for building lean muscle, because one of the things that happens in our arthritis is loss of muscle mass around that joint that's affected. So resistance training I typically advise my patients, maybe two to three times a week for shorter sessions, working each bodily group until the point that it hits fatigue and then resting and then doing another rep, and that's typically resistance training. But same deal. Might be better to get some tailored advice. I got tailored advice from my physical therapist as far as my resistance training. I had to make alterations because of my shoulder osteoarthritis. So getting some tailored advice, but doing some resistance training a few times a week. Beyond that, you know other exercises yoga can be good, although I would advise you to work with your yoga instructor on limitations, modification of poses, depending on where your osteoarthritis is. So, for instance, like for me, I've got it in my shoulder, so initially I really couldn't do anything overhead and that limited quite a few of the yoga poses I would normally be doing because I couldn't reach overhead for a brief period of time. Same deal if you have osteoarthritis in a hip or knee. Just being aware of that, I mean again, work with a specialist to find out what your limitations are.

Speaker 1: 19:09

An ancient practice which is a martial art which is very good for osteoarthritis and a recommendation I make to my patients, especially over the age of 70, is Tai Chi. Tai Chi is a martial art, but of course in the West we use it as a form of exercise. There are numerous studies showing that it can really benefit those large joints. Great benefits for stability, great benefit for breath work. There's a similar practice called Chi Gong which is somewhat similar, which is linking movement to breath, and I am greatly simplifying both of those practices. They are very in-depth and they're very knowledgeable practitioners of both of those. However, they are a great place to get started if you're someone who has multiple joints involved and maybe doing the walking or elliptical is going to be too much.

Speaker 1: 20:08

Medications play a role in the management of osteoarthritis. The challenge with many of our prescription medications is that the duration they can be used for is limited. The most common that's prescribed are insteds or non-steroidal anti-inflammatories, which are great for joint pain. You get them in your body and they're going to stop the pain fairly soon, but they can damage the stomach. When the stomach is exposed to nostril loyalties for too long, the lining gets thin and you can easily get ulcers. A lot of people complain of other symptoms with nostril loyalties, like lower intestinal symptoms, which probably the lining is getting thin there. We just don't know it.

Speaker 1: 20:55

Frequent use of nostril loyalties can lead to high blood pressure when they have to be used. Well for one. If you're using a rostroroda, at that point a physician needs to be involved, because things like your blood pressure need to be monitored. We need to make sure your kidneys aren't being affected by the nostril loyalties. So when you need them they are great, but they can't be used forever and they really can't be used every day. When we do that we're going to run into some kind of side effect. That's a rough discussion to have with my patients. We often have to come up in a system so that if we we know we've got someone with osteoarthritis but for some reason is not able to get a surgery that's going to be curative, then we've got to find a way that they can use nostril loyalties, but not too often.

Speaker 1: 21:42

Other recommendations get into the prescription realm, such as prescription pain medicines and then, of course, tylenol or acetaminophen sorry, acetaminophen, which is a pain medication available over the counter, but same thing, it can't be used all the time, every day, because too much acetaminophen can hurt the liver and can interact with prescription medications. So, beyond those recommendations, many people become curious about what supplements they might want to include when they're dealing with osteoarthritis. So using supplements for osteoarthritis can be a great thing. My advice for myself and for my patients is to be wise about it, to be prudent about it and understand that, even though we may be including supplements, that they can have side effects. We have to be aware of how they could be affecting your body or interacting with other medications. But typically there are a few that I'll recommend to most of my patients. Generally they're safe. But things you should be aware of, or you may want to discuss with your physician or naturopath or a healthcare practitioner, is if you're already on medications, because side effects we have to assume could be there and interactions could be there.

Speaker 1: 23:15

The first supplement you might want to consider is glucosamine and conjoitant, which are actually separate but they're often combined together in supplements. That supplement helps to get more fluid into the joint cartilage, creating the extra cushion. So for some of us with osteoarthritis that can bring some relief. And what I will do is in the show notes I will share with you my recommendations with full scripts and you can actually shop my dispenser at full scripts to see which brands of glucosamine and conjoitant I recommend. Another recommendation is for SAME. It's a great supplement, one that I actually pretty frequently recommend in my practice. That can help with joint pain. Overall fairly safe for most of us, but again, you probably want to be working with someone if you're needing individual advice.

Speaker 1: 24:16

Many patients have found that adding curcumin or turmeric helps with their joint pain. Lots of people like to take it by the capsule, but I like to remind my patients that it's actually a spice and sometimes you get the best benefit with spices by simply including them in your food. So when you're cooking and you're focusing on that anti-inflammatory diet, it may be good to add spices like curcumin and turmeric to your foods so you get the benefit without necessarily having to purchase another supplement. In your show notes I will make sure to include all the ways to get to this information and I'll include a link to my full scripts dispensary where you can sign up and start to view the catalog and you'll have access to some of my protocols, because I do have a protocol for osteoarthritis or for arthritis and joint pain that you can have a look at and, in particular, it's a really good idea because you can actually save quite a bit of money using my full scripts dispensary. So when it's open to use and you can shop for some of your other supplements.

Speaker 1: 25:30

But in particular, in the timing of this podcast, when it's coming out, there's actually going to be a pretty good sale coming up. Likely, like most of us, you're buying your supplement, so you'll have a great way to save quite a bit coming up in the next week or so. So I'd recommend having a look in the show notes at my dispensary link also, you can sign up for my newsletter where I will share all the details of this podcast as well as how to get to my full scripts dispensary so that you can have a look at my recommendations for arthritis as well as some of my other protocols. So, as always, thank you so much for joining me. We will be back probably next week and then we'll probably be coming to the end of this season fairly soon. All right, take care, and I will see you next week.