Arthritis

Consequences of Arthritis

Osteoarthritis initially affects the smooth cartilage lining of a joint. Once the cartilage lining starts to roughen and thin out, the tendons and ligaments have to work harder. This can cause swelling, and the formation of bony spurs called osteophytes. Severe loss of cartilage can lead to bone rubbing on bone, altering the shape of the joint and forcing the bones out of their normal position. This may lead to deformity and compression on the nerve roots of the spine, causing neuralgia (e.g. Sciatica). Not only is the swelling, pain and stiffness associated with arthritis troublesome, but, by restricting an individual’s ability to move freely, it can also exacerbate other conditions including obesity, heart disease, diabetes and cancer. Restricted mobility can also have a profound effect on mood,  lead to depression, and increase the incidence of hot flushes and other menopausal symptoms.

Who gets osteoarthritis?

Osteoarthritis typically develops in adults who are in their late 40s or older. It’s also more common among women and people with a family history of the condition. Joint discomfort usually begins soon after cancer treatment, affecting people regardless of age and for a longer period of their life. Over 55% of people experience symptoms consistent with early-stage arthritis after cancer treatments such as surgery, chemotherapy, and ongoing hormone or biological treatments like Herceptin [Pegram].

Treatments

Analgesia: Simple analgesics include paracetamol, non-steroidal anti-inflammatory agents and, if severe, stronger painkillers such as opioids. Although helpful, they have significant long-term cardiovascular and gastrointestinal risks and several unwelcome side-effects.

Invasive procedures: Surgical interventions such as joint fusion and replacement prosthesis remain effective but intrusive [Reddy]. Steroid injections can provide initial relief, but cannot be repeated often.

Integrative therapies (Non-nutritional): In addition to improving exercise levels,  Yoga and Pilates have demonstrated some effectiveness in helping relieve joint pain and improving mobility [Haslock]. Weight reduction, if overweight, does have benefits by reducing the load on weight-bearing joints, even if joint pains have already started [Felson]. Physical complementary interventions such as acupuncture, reflexology, chiropractic, osteopathy and massage offer emotional support, and there are some reports of improved relief from pain and stiffness [Thomas].

Exercise strategies: click here

Nutritional strategies: click here

Topical chilli pepper extract (Capsaicin): Three randomised trials, involving over 400 participants, have investigated the effectiveness of topical application of capsaicin gel in treating arthralgia. Doses varying between 0.025 – 0.075% were applied four times a day for a treatment period ranging between 4 and 12 weeks [Altman, Mcleane, Kosuwon], and a placebo gel was used as a control. In all three trials, summarised in a systemic review, capsaicin was found to be about four times more effective than the placebo gel at improving pain, stiffness, joint tenderness and function in participants [Mason]. Significantly more participants using capsaicin cream reported a reduction in pain, joint tenderness and use of self-medicated and prescribed analgesics.