Joint health: Know more about arthritis and gout

Arthritis and gout are diseases that adversely affect the quality of life of many South Africans.

03 September 2004
by Warren Kings

How long has it been since you touched your toes with ease, did the limbo or tried the splits? Chances are, you were a child. It seems that as we grow up, our flexibility becomes more limited, our muscles and joints more set.

For many people, taking up a flexibility-building activity such as yoga can restore some of that lost flexibility. But for others who suffer from conditions that attack the joints, such as arthritis or gout, good nutrition, supplements, exercise and possibly medication all have a part to play.

Arthritis

There are more than 100 types of arthritis, the most common of these being osteoarthritis and rheumatoid arthritis.

Osteoarthritis

Cartilage acts as a shock absorber between joints and prevents adjacent bones from rubbing against one another. If this cartilage wears away, as is the case with osteoarthritis, friction between the bones leads to pain and stiffness when moving the joint. Osteoarthritis usually affects weight-bearing joints such as the knee and hip joints. Stiffness also becomes common after long periods of rest. A lack of treatment can lead to a tightening and shortening of the muscles that move the joint, resulting in limited mobility.

Who gets it? Around 90 percent of people over the age of 40 have some degree of osteoarthritis. As with all forms of arthritis, there is a genetic component. Osteoarthritis is more common in women and can be passed from mother to daughter. Obesity is a risk factor, and mechanical injury, hormonal disorders and previous joint damage can lead to acute symptoms.

How do I treat it? There is no cure, but regular exercise and healthy eating habits will help prevent joint deterioration. Exercise builds the muscles around the joints, encourages the production of joint-lubricating fluids, and keeps the joint in motion. Swimming is a popular choice, as the water cushions the body, provides resistance and prevents shock to the joints.

Try to incorporate 30 minutes of activity every day, but listen to your body: don't exercise if you are in pain. Alternate heating and cooling sore joints with compresses to ease discomfort and swelling.

Make sure you get enough essential fatty acids, found in oily fish, nuts, seeds and whole grains, because they help to reduce inflammation.

Glucosamine, a cartilage-building compound, can be taken as a supplement and cayenne cream rubbed into the joint may ease pain.

According to homeopath and acupuncturist Dr Karen Davey: "If people follow a healthy lifestyle, arthritis can be quite well controlled. Acupuncture can play an important role in pain control." She recommends glucosamine chondroiton, which lubricates the joint, protects the cartilage and aids the Body's natural healing, and rhus toxitendron to control pain and reduce stiffness.

Rheumatoid arthritis

This is an auto-immune condition in which the body attacks its own joint linings. The wrists, fingers and toes are usually first to suffer. Early symptoms are very gradual. Generally one joint is affected after the other, and the joints then become tender to touch.

Stiffness after rising is a common symptom. It can also occur after extended periods of inaction. As the disease develops, nausea and fatigue can strike daily. Other symptoms include fever, weight loss, recurrent infections, damage to small blood vessels and leg ulcers

Who gets it? Evidence once again points to a genetic element. It is far more common in women and can start at any age, but usually between the ages of 26 and 50. The exact cause is unknown, but many experts believe there is a link to the same virus that causes glandular fever. Women who have taken the Pill seem less at risk of developing the condition.

How do I treat it? Short periods of rest and a healthy diet are prescribed. Aspirin is a good painkiller and anti-inflammatory, but large doses are needed to alleviate symptoms. Other medications such as Salazopyrian have excellent results, but the side effects can include kidney damage and decreased fertility in men.

Rheumatologist Dr Kathy Spargo of Vincent Palotti hospital in Cape Town says: "Many people allow rheumatoid arthritis to get more serious because they are afraid of the side effects of medications. This is a mistake. The risk of not treating is often far worse." A daily cup of ginger or celery-seed tea is recommended, or adding ginger or celery seeds to meals.

Gout

Gout is a metabolic disorder linked to a build-up of uric acid, which is a byproduct of the body's cleansing process. Gout occurs when too much uric acid is being produced or when an insufficient amount is being excreted. As it builds up, the excess uric acid is converted into sharp, needle-like crystals, which settle around the joints and other tissues. This causes inflammation and no small amount of pain.

Gout can lead to kidney stones and, if cold enough, the crystals can push through the skin. These white, hard protrusions are called gouty tophi and usually pierce the ear. When the liver breaks up chemicals called purines, uric acid results. Foods high in purines include organ meats, legumes, oatmeal, spinach, asparagus, cauliflower and mushrooms.

Who gets it? Gout is more common in men and can be passed from father to son. At least one man in 100 over the age of 40 suffers from gout. It strikes suddenly and without warning and causes swelling at the joints, most commonly the big toe. Precipitating factors include a minor injury or bump, stress, excess alcohol, excessive dieting and even dental operations.

How do I treat it? According to nutritionist and osteopath Dr Peter Dowling, the most important thing is nutrition. "When you correct your eating habits," he says, "you reduce the intake of acid-forming foods, reducing inflammation." Patients of his suffering from gout are put on a strict water-only diet for a short detox. If they can't rest at home during that time, he recommends drinking small amounts of fruit juice.

Ongoing dietary changes should include increasing your intake of oily fish, for the essential fatty acids, and lowering your alcohol intake. Cherries, celery and strawberries contain proanthocyanidins that help reduce joint inflammation, so include them in your diet too. Buchu, nettle and coriander teas may help the kidneys to excrete uric acid and dandelion tea will boost liver function.

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