Arthritis tips wanted

[regentrude]

Lifestyle, diet, supplement recommendations to ease symptoms and slow progression? Thanks.

Eta: Osteoarthritis. Affected joint in finger. Strong family history. 

Already supplementing Vit D.

Edited June 15, 2023 by regentrude

[Laura Corin]

Osteoarthritis or rheumatoid? 

[regentrude]

Just now, Laura Corin said:

Osteoarthritis or rheumatoid? 

Osteo

[Selkie]

Many people (myself included) have experienced a reduction or disappearance of pain after starting a whole food plant based diet. It doesn’t reverse arthritic changes, but it significantly decreases inflammation throughout the body and that can provide a great deal of relief.

[regentrude]

2 minutes ago, Selkie said:

Many people (myself included) have experienced a reduction or disappearance of pain after starting a whole food plant based diet. It doesn’t reverse arthritic changes, but it significantly decreases inflammation throughout the body and that can provide a great deal of relief.

Thank you. Is the main effect due to the *complete* exclusion of any animal products, or due to the large amount of minimally processed plant food?

I am asking because I am already eating mostly plants, prepare everything from scratch, but eat limited dairy, eggs, and very occasionally fish or meat.

[Selkie]

8 minutes ago, regentrude said:

Thank you. Is the main effect due to the *complete* exclusion of any animal products, or due to the large amount of minimally processed plant food?

I am asking because I am already eating mostly plants, prepare everything from scratch, but eat limited dairy, eggs, and very occasionally fish or meat.

It’s both the exclusion of animal products (which are inflammatory) and the consumption of plants (which are anti inflammatory). 

On Dr. Greger’s site, nutritionfacts.org, he has lots of information on studies showing the effects of both animal products and plants on inflammation levels in the body, and how that in turn affects pain levels of various conditions including arthritis.

https://nutritionfacts.org

[wintermom]

Sorry you're suffering with this. My mom has osteoarthritis in many joints. It can be very painful, as you're already experiencing. Mom has an endocrinologist to monitor her thyroid and parathyroid, mainly for her osteoperosis. I don't know if there is a strong link between these two conditions. Mom suffers from both. 

My mom is in her 80s, and has never made any life-style or eating changes in attempts to reduce the effects of the osteoarthritis condition. She mainly treats the pain with OTC pain meds, or additional pain control from her HCP is the pain is particularly bad. 

I've played tennis wih loads of people in their 50s and 60s with osteoarthritis, and they often access steroid injections to manage their pain and allow them to continue their active lifestyle. They never stop playing tennis! 

ETA: I see that you've upped your Vit D intake. It may be useful to find out if there are other vitamines and minerals that may help keep the "osteo" part of the condition strong. That's where the endocrinologist may be useful. The body's ability to balance calcium and phosphorous levels are key to bone health. OTC calcium supplements may not be enough. Increasing calcium through diet is recommended, but if your phosphorous levels are off, then it's like trying to fill a bucket with a hole. The calcium just won't stick around to manintain strong bones.

Edited June 15, 2023 by wintermom

[Pawz4me]

Diet seems to have no effect at all on my RA or osteo. But for decades I've eaten very similarly to what you describe. I have no idea what would happen if I ate a more processed, more typical SAD. For two/three months at a time I've tried things like WFPB and low carb with no noticeable changes, but I'm certainly not going to experiment with a more crappy diet. 😉  My rheumy says my consistently very low inflammation markers are almost certainly attributable to my diet (my CRP and ESR have always been in the low normal range, even when I have multiple visibly swollen joints).

My rheumy thinks that curcumin/turmeric supplementation is worth trying for anyone with any type of arthritis. It didn't help me, but it's definitely something that won't hurt to try. He also recommends bracing, at least at night, for hand osteo. Beyond that you start getting into steroid injections, which so far I have declined.

I've found that Tylenol arthritis does help a bit. It at least alleviates some of the worst of the pain and stiffness. I was somewhat surprised to find that it works better for me than ibuprofen, but of course that can vary between people. You might also try some of the pain relieving topical creams and ointments. BioFreeze and Voltaren help me a little. My rheumy says the topical stuff can help with the smaller joints, but not for the larger, deeper ones.

ETA: You also want to do enough hand exercises to keep the soft tissues around the affected joint(s) strong. That will help support them and keep the joint as supple as possible. Motion really is lotion. The key of course is figuring out how much is enough and how much is too much and causes increased pain and stiffness. And try not to over stress affected joint(s)--get aides to help with opening jar lids and things like that.

Edited June 15, 2023 by Pawz4me

[Pawz4me]

11 minutes ago, wintermom said:

 Mom has an endocrinologist to monitor her thyroid and parathyroid, mainly for her osteoperosis. I don't know if there is a strong link between these two conditions.

RA is a strong risk factor for osteoporosis. I don't believe osteoarthritis is, but I'm not positive.

[wintermom]

@Pawz4me RE: Tylenol vs Ibuprofin. My mom gets pretty good relief from Tylenol arthritis, too. She takes it every night so she can sleep. Being able to sleep is key to overall happy lifestyle. It's easier on the stomach than ibuprofin, too. Yes, some issues with the liver, but we do what we need to do in order to function, live, sleep and be active while managing pain. 😉 

[regentrude]

25 minutes ago, Pawz4me said:

Diet seems to have no effect at all on my RA or osteo. But for decades I've eaten very similarly to what you describe. I have no idea what would happen if I ate a more processed, more typical SAD. For two/three months at a time I've tried things like WFPB and low carb with no noticeable changes, but I'm certainly not going to experiment with a more crappy diet. 😉  My rheumy says my consistently very low inflammation markers are almost certainly attributable to my diet (my CRP and ESR have always been in the low normal range, even when I have multiple visibly swollen joints).

My rheumy thinks that curcumin/turmeric supplementation is worth trying for anyone with any type of arthritis. It didn't help me, but it's definitely something that won't hurt to try. He also recommends bracing, at least at night, for hand osteo. Beyond that you start getting into steroid injections, which so far I have declined.

I've found that Tylenol arthritis does help a bit. It at least alleviates some of the worst of the pain and stiffness. I was somewhat surprised to find that it works better for me than ibuprofen, but of course that can vary between people. You might also try some of the pain relieving topical creams and ointments. BioFreeze and Voltaren help me a little. My rheumy says the topical stuff can help with the smaller joints, but not for the larger, deeper ones.

ETA: You also want to do enough hand exercises to keep the soft tissues around the affected joint(s) strong. That will help support them and keep the joint as supple as possible. Motion really is lotion. The key of course is figuring out how much is enough and how much is too much and causes increased pain and stiffness. And try not to over stress affected joint(s)--get aides to help with opening jar lids and things like that.

Thanks. Ortho recommend Voltaren which I have already been using. Will try again.

He mentioned no need to limit movement, just pay attention to pain level.( I have already tried to avoid certain motions because I wasn't sure whether anything was broken/torn; relieved to find it isn't. )

I had a steroid injection in my toe once for an issue; it cause tissue atrophy that took almost a year to reverse, so injections won't be an option for me.

Edited June 15, 2023 by regentrude

[regentrude]

29 minutes ago, wintermom said:

Sorry you're suffering with this. My mom has osteoarthritis in many joints. It can be very painful, as you're already experiencing. Mom has an endocrinologist to monitor her thyroid and parathyroid, mainly for her osteoperosis. I don't know if there is a strong link between these two conditions. Mom suffers from both. 

My mom is in her 80s, and has never made any life-style or eating changes in attempts to reduce the effects of the osteoarthritis condition. She mainly treats the pain with OTC pain meds, or additional pain control from her HCP is the pain is particularly bad. 

I've played tennis wih loads of people in their 50s and 60s with osteoarthritis, and they often access steroid injections to manage their pain and allow them to continue their active lifestyle. They never stop playing tennis! 

ETA: I see that you've upped your Vit D intake. It may be useful to find out if there are other vitamines and minerals that may help keep the "osteo" part of the condition strong. That's where the endocrinologist may be useful. The body's ability to balance calcium and phosphorous levels are key to bone health. OTC calcium supplements may not be enough. Increasing calcium through diet is recommended, but if your phosphorous levels are off, then it's like trying to fill a bucket with a hole. The calcium just won't stick around to manintain strong bones.

Thanks. How does one increase calcium through diet while avoiding dairy?

[prairiewindmomma]

28 minutes ago, Pawz4me said:

Diet seems to have no effect at all on my RA or osteo. But for decades I've eaten very similarly to what you describe. I have no idea what would happen if I ate a more processed, more typical SAD. For two/three months at a time I've tried things like WFPB and low carb with no noticeable changes, but I'm certainly not going to experiment with a more crappy diet. 😉  My rheumy says my consistently very low inflammation markers are almost certainly attributable to my diet (my CRP and ESR have always been in the low normal range, even when I have multiple visibly swollen joints).

My rheumy thinks that curcumin/turmeric supplementation is worth trying for anyone with any type of arthritis. It didn't help me, but it's definitely something that won't hurt to try. He also recommends bracing, at least at night, for hand osteo. Beyond that you start getting into steroid injections, which so far I have declined.

I've found that Tylenol arthritis does help a bit. It at least alleviates some of the worst of the pain and stiffness. I was somewhat surprised to find that it works better for me than ibuprofen, but of course that can vary between people. You might also try some of the pain relieving topical creams and ointments. BioFreeze and Voltaren help me a little. My rheumy says the topical stuff can help with the smaller joints, but not for the larger, deeper ones.

ETA: You also want to do enough hand exercises to keep the soft tissues around the affected joint(s) strong. That will help support them and keep the joint as supple as possible. Motion really is lotion. The key of course is figuring out how much is enough and how much is too much and causes increased pain and stiffness. And try not to over stress affected joint(s)--get aides to help with opening jar lids and things like that.

This is pretty much me also.

IME, which joint it is also matters as well…managing a DIP or a PIP joint in a finger is a lot easier than managing a MCP. If it’s osteo, it’s usually a DIP, and there are cute ring like braces you can wear as well that may help if it has progressed a bit to help stabilize.

I use voltaren, it’s ok, but not great. I get more benefit from doing hand stretches and adaptation…the wider I can grip something, the better. Bending the joint into a tight angle when doing fine handwork makes me hurt more.

[Pawz4me]

4 minutes ago, regentrude said:

 

I had a steroid injection in my toe once for an issue; it cause tissue atrophy that took almost a year to reverse, so injections won't be an option for me.

That's the main reason I've refused them so far. It seems to me there are more people who say they either don't work/only work for a few days or that they cause more problems than there are people who say they give long(ish) term relief.

 

[regentrude]

1 minute ago, prairiewindmomma said:

managing a DIP or a PIP joint in a finger is a lot easier than managing a MCP. 

What do these abbreviations mean?

[prairiewindmomma]

Distal interphelangeal joint (DIP) is the joint where the tip segment of your finger meets the next segment. PIP or proximal interphelangeal joint is the next joint closest to your hand. The MCP or metacarpophelangeal joint is what you think of as your knuckle.

 

[prairiewindmomma]

I am not sure if I spelled those correctly, but it should be close.

[prairiewindmomma]

Did the doctor stage your arthritis? I think that also matters. I will have joint replacement before I hit fusion or severe deformity because I want to maintain motion in my hands.

[kathyl]

My dh has a lot of pain in his thumb joints.  I ordered a couple things off amazon that he says help.

Compression gloves - wears at night or whenever he's sitting

ELEKHEAL Heating Pad for Hand Carpal Tunnel Wrist Brace for Arthritis Pain Relief, Auto Off Heating Wrap with 6 Heating Settings for Carpal Tunnel Relief, Tendonitis(Large) - there are many to choose from on amazon

 

A doctor told him to use the topical voltaren, and he said it helped.  But he would have to use it a LOT so I'm not sure how that works.  I know he kind of quit after a while.

He also said eating meat regularly makes it worse.  He doesn't eat much dairy or eggs, but he does love meat.

 

 

[prairiewindmomma]

https://www.mayoclinic.org/diseases-conditions/arthritis/multimedia/arthritis/sls-20076952?s=1
 

I tracked down slides for the basic hand stretches I do. If these look dumb and super easy, put them aside for later. As your OA progresses, the tendons become more affected, and these will be handy then.

[gardenmom5]

Anti inflammatory diet.

Yoga.

[Laura Corin]

2 hours ago, regentrude said:

Thank you. Is the main effect due to the *complete* exclusion of any animal products, or due to the large amount of minimally processed plant food?

I am asking because I am already eating mostly plants, prepare everything from scratch, but eat limited dairy, eggs, and very occasionally fish or meat.

I eat similarly to you.

I no longer have pain from my knee that has osteo.  What made the difference for me was working seriously on strengthening the muscles that surround the knee in order to support it.  Walking did not do that in itself.  I use yoga, but any exercises that develop the muscles around the joint might help.  These are some examples for knee support - did you say which joints it was?  I missed that.

https://roh.nhs.uk/index.php?option=com_content&view=article&id=325&catid=66

Edited June 15, 2023 by Laura Corin

[prairiewindmomma]

Example of a finger splint ring: https://www.etsy.com/listing/713079528/evaswan-adjustable-splint-ring-wire?external=1&ref=cl_listing_page_recs_listings-0-listing-1&page_type=cl_listing_page&external_collection=MTA4OTU4NjE4fDQ4MTcyNzc4&dataset=cs

ETA: this splint is more for stage 3 arthritis.
 

Stage 3 is the cartilage is mostly gone, bone ends are reshaping and restructuring, there is frequent pain and you are starting to see joint swelling and thickening regularly. The ring helps keep the joint in alignment because structurally the body can no longer do it.

Swan neck splints, a different kind of ring, allow full natural motion of the joint but not hyper extension (which becomes an issue as the joint dissolves). 

Edited June 15, 2023 by prairiewindmomma

[regentrude]

9 minutes ago, Laura Corin said:

I eat similarly to you.

I no longer have pain from my knee that has osteo.  What made the difference for me was working seriously on strengthening the muscles that surround the knee in order to support it.  Walking did not do that in itself.  I use yoga, but any exercises that develop the muscles around the joint might help.  These are some examples for knee support - did you say which joints it was?  

It's the finger. Top joint of right index currently,  but I did have symptoms in all fingers a couple years back. 

[regentrude]

9 minutes ago, prairiewindmomma said:

Example of a finger splint ring: https://www.etsy.com/listing/713079528/evaswan-adjustable-splint-ring-wire?external=1&ref=cl_listing_page_recs_listings-0-listing-1&page_type=cl_listing_page&external_collection=MTA4OTU4NjE4fDQ4MTcyNzc4&dataset=cs

Interesting.  Those help? I thought motion was better than immobilizing the joint?

[Michelle in MD]

I know they go back and forth on fish oil and its benefits or lack thereof, but I use Nordic Naturals EPA XTRA with good results. I'm petite and only take a half dose. If not fish oil, then olive oil - work up to three tablespoons a day in divided doses. 

You probably already know all this but other foods rich in Omega-3s are avocados, nuts, tuna, salmon, and flaxseeds. For non-dairy calcium, consider chia seeds, tofu, almonds, and lots of leafy greens.

At the end of every shower and sometimes for the entire shower if it's summer, I rinse with very cold water for at least 2 minutes. This really seems to help my joints esp after exercising.

 

[prairiewindmomma]

5 minutes ago, regentrude said:

Interesting.  Those help? I thought motion was better than immobilizing the joint?

My internet connection is being weird this morning. Somehow my answer is up above in an edited form rather than in a new post. I think my forum connection must have reset as an edit rather than the new post I thought I was making. Stabilization > immobilization.

[prairiewindmomma]

As joint deterioration continues, your joints start to sublux/partially dislocate. The splints allow you to maintain motion while trying to prevent deformity. You don’t want your joints to swan neck or deform or otherwise progress from stage 3 to stage 4 where you have to have surgery. Sometimes you can control that process of progression, sometimes you can’t, but usually there is a lot of pain relief when you are at the point you are ready for splints.

[prairiewindmomma]

I get the sense from the comments most people are posting from a place of early stage 2 osteo. I am way further down the road than that, so my comments may not be as helpful to you right now. 

[wintermom]

1 hour ago, regentrude said:

Thanks. How does one increase calcium through diet while avoiding dairy?

Great question! Are you also vegan or vegetarian? Maybe look into foods with bone, such as fish with edible bone (e.g., sardines). What about non-cow dairy, such as water buffalo or goat. Are any of these options for you?

Otherwise, do some research as I don't know. When I worked with an endocrinologist, the go-to recommendations were milk, yogurt and cheese. But these products from other  non-cow dairy sources would also be good. 

 

[Selkie]

1 hour ago, regentrude said:

Thanks. How does one increase calcium through diet while avoiding dairy?

You will get plenty of calcium by eating plants such as dark leafy greens, soy foods (edamame, tofu, tempeh), beans, lentils, peas, nuts (almonds, Brazil nuts, macadamias, and pistachios are especially rich in calcium), seeds (chia, flax, sesame seeds & tahini), seaweed, and fortified plant milks.

Here's an article that explains how it is not only possible, but actually beneficial, to get the calcium you need from plants rather than animal foods:

https://www.forksoverknives.com/wellness/milk-myth-why-you-dont-need-dairy-for-calcium/

Getting Clarity About Calcium

The subject of calcium is a hotly debated one. One of the biggest controversies is whether or not we can really get enough calcium following a whole-food, plant-based diet that excludes dairy. 

Here are some of the more common questions:

How much calcium do I really need?

Can I really get enough calcium eating just plants?

What is calcium absorption, and why is it important?

What factors (or foods) make me lose calcium?

Can’t I just fix everything by taking calcium supplements?

To help clarify this important topic, let’s tackle each of these calcium questions one at a time:

HOW MUCH CALCIUM DO I REALLY NEED?

The current daily recommended allowance for calcium for most adults is 1,000 to 1,200 milligrams. However, plant-based health experts believe these requirements are high for a simple reason: a diet high in animal protein has a high excretion rate, which means you are forced to consume more calcium to make up for the inherent calcium excretion. When following a whole-food, plant-based diet (that is also low in sodium and caffeine), calcium excretion rates are much lower, which logically means that a plant-based eater’s calcium intake can also be much lower.

How much lower? A study published by the American Journal of Clinical Nutritionshowed that “individuals with low, but nutritionally adequate, intakes of sodium and protein may have calcium requirements as low as 500–741mg/day.”

CAN I REALLY GET ENOUGH CALCIUM EATING JUST PLANTS?

Like iron, magnesium, and copper, calcium is a mineral. It is found in the soil, where it is absorbed into the roots of plants. Animals get their calcium by consuming these calcium-rich plants. So even though we are all conditioned to believe that calcium comes from milk and dairy products, the real source of calcium richness is the earth. No wonder that a whole-food, plant-based diet has plenty of calcium.

A varied diet of starches, vegetables, and fruits (without dairy) has sufficient calcium to meet our needs. If you eat a relatively low-calcium diet, your body will adjust. Studies show that when fed a relatively low-calcium diet (415 mg/day), our intestines become more efficient at absorbing calcium, and our kidneys conserve it better. Equally, when overfed with calcium (1,740 mg/day) our bodies adjust as well: our intestines block the calcium absorption, while our kidneys eliminate more. This is an example of how our bodies protect us: if not eliminated, the excess calcium would get deposited in our soft tissues (heart, kidneys, muscles, and skin), making us vulnerable to illness and even death … a true testament to how smart our bodies really are!

So your needs are met. Always. 

At the end of the day, the “disease” of calcium deficiency from a calorically sufficient natural whole-food plant-based diet is nonexistent.

HOW MUCH OF THE CALCIUM I EAT IS ACTUALLY ABSORBED?

The amount of calcium we ingest may be less important than how much we actually absorb. For example, 1 cup of milk contains about 300 mg of calcium. But only about 30% of it (90 mg) is actually absorbable, and thus bioavailable (available to our bodies).

Let’s compare the calcium content and absorption rate of cow’s milk versus some plant-based alternatives:

The calcium in firm tofu has about the same absorption rate as dairy products, hovering around 31%. And while ½ cup of tofu yields the same amount of calcium as 1 cup of milk (300 mg), it contains more protein, far less saturated fat, and about a tenth of the sodium.

Calcium-intense vegetables like Chinese mustard greens enjoy absorption rates of around 40%. In terms of calcium content, 1/2 cup of these cooked greens will give you as much calcium as one glass of milk.

One cup of bok choy, 1½ cups of kale, or 2 cups of broccoli contain the same amount of calcium as a glass of milk, due to their much better calcium absorption rate (in the 50–60% range! )

WHAT FACTORS (OR FOODS) MAKE ME LOSE CALCIUM? 

Many factors contribute to calcium loss, from age (older people lose more calcium) to vitamin D status (people who test low for vitamin D3 tend to lose more calcium) to the concurrent contents of your intestines. Sodium, protein, and caffeine play primary roles in calcium loss.

Sodium: Sodium is our biggest enemy when it comes to calcium loss. For each 1000 mg of sodium (2,500 mg of table salt) excreted by the kidneys, about 40–60 mg of calcium goes with it.

Protein: As the intake of dietary protein increases, so does the urinary elimination of calcium. So when you double your protein, your calcium loss through urination increases by 50%.

The propensity of protein to cause calcium loss is particularly interesting when it comes to dairy products, which have always been considered as one of the best calcium sources. You lose 1/3 of the calcium you get from milk and over 2/3 of the calcium you get from cheeses.

Caffeine: Caffeine also seriously affects the body’s ability to retain calcium, as it acts as a diuretic and pulls calcium out from the body.

In stark contrast, many leafy green vegetables provide lots of easily absorbed calcium without causing calcium loss!

CAN’T I JUST FIX EVERYTHING BY TAKING CALCIUM SUPPLEMENTS?

Even though studies show that supplementing with calcium can reduce the risk of fractures by 10% (hip fractures excluded), doing so can also increase our chances of cardiovascular disease and strokes, cause kidney stones, and induce gastrointestinal distress.

According to the results of a recent randomized, double-blind, placebo-controlled study of over 36,000 post-menopausal women, “Calcium supplements with or without vitamin D are associated with an increased risk for MI (myocardial infarction) and stroke, and this risk appears to apply across subgroups defined by important baseline characteristics. These findings suggest that targeted prescription of calcium supplements to specific population subgroups, such as younger people and those with low dietary calcium intake, should not be endorsed.”

BUT IF WE DON’T DRINK MILK OR TAKE CALCIUM SUPPLEMENTS—WHAT HAPPENS TO OUR BONES? 

A recent study addressed this very important question, comparing the bone mineral density of long-term vegans versus omnivores. The results were astounding; even though the vegans have vastly lower dietary calcium and protein intakes, they enjoyed the exact same bone density as their meat-eating counterparts.

In conclusion, you don’t need dairy or supplements to get enough calcium (in fact they may be a hindrance rather than a help). As long as you eat a calorically sufficient whole-food, plant-based diet that drastically reduces or completely eliminates added sodium, you’ll get all the calcium you need.

Sources

Heaney, R. (1993). Protein intake and the calcium economy. Journal of the American Dietetic Association, 1259-1260.

Ho-Pham, L., Nguyen, P., Le, T., Doan, T., Tran, N., Le, T., & Nguyen, T. (2009). Veganism, bone mineral density, and body composition: A study in Buddhist nuns. Osteoporosis International, 2087-2093.

Oliveira, Rosane. Everything you ever needed to know about calcium. Retrieved here.

Radford, L., Bolland, M., Gamble, G., Grey, A., & Reid, I. (2013). Subgroup analysis for the risk of cardiovascular disease with calcium supplements. BoneKEy Reports, the Journal of the International Bone and Mineral Society. 

Hunt, Curtis, Johnson, LuAnn K. (2007). Calcium requirements: new estimations for men and women by cross-sectional statistical analyses of calcium balance data from metabolic studies. American Society for Clinical Nutrition.

Walsh, S. (2002). Diet and Bone Health. Retrieved here.

[regentrude]

1 hour ago, wintermom said:

Great question! Are you also vegan or vegetarian? Maybe look into foods with bone, such as fish with edible bone (e.g., sardines). What about non-cow dairy, such as water buffalo or goat. Are any of these options for you?

Otherwise, do some research as I don't know. When I worked with an endocrinologist, the go-to recommendations were milk, yogurt and cheese. But these products from other  non-cow dairy sources would also be good. 

 

Thanks. No, I am not vegetarian,  but it has been suggested that a vegan diet would be beneficial. Not sure I am willing to go all the way though.