Ten of the best foods to fight your arthritis

Living with the swelling and stiffness of rheumatoid arthritis is a very difficult and painful thing to deal with on a day to day basis. This pain is caused by the inflammation of the joints which can occur throughout the body. Foods such as red meat, fried food and alcohol have been linked to increasing inflammation in the body and are not recommended to people who have arthritis. Being careful about what you eat is never easy but the good news is that there are certain types of food that can actually help with arthritis.

Below is an infographic provided by www.homeremediesforlife.com that shows foods that are not only good for you but could help to breakdown inflammatory problems associated with rheumatoid arthritis.

10-best-foods-fight-arthritis

 

Living with arthritis

Rheumatoid arthritis

Living with arthritis isn’t easy and carrying out simple, everyday tasks can often be painful and difficult.

However, there are many things you can do to make sure you live a healthy lifestyle. A range of services and benefits are also available.

Work

Many people with arthritis want to continue working for many reasons, including better financial security and higher self-esteem.

Improved treatment approaches have helped ensure that many people who are diagnosed with arthritis can return to work. This is particularly the case if arthritis is diagnosed and treated at an early stage.

You may find work challenging, but your employer should help you with the training and support you need.

Help is also available if your arthritis is so severe that you’re unable to work. Find out more about the Personal Independence Payment(formerly known as the Disability Living Allowance).

Arthritis Care has more useful information about working with arthritis.

Healthy eating

It’s very important to eat a healthy, balanced diet if you have arthritis. Eating healthily will give you all the nutrients you need and help you maintain a healthy weight.

Your diet should consist of a variety of foods from all five food groups. These are:

fruit and vegetables

starchy foods – such as bread, rice, potatoes and pasta

meatfisheggs and beans

milk and dairy foods

foods containing fat and sugar

Read more about how to have a healthy, balanced diet.

If you’re overweight, losing weight can really help you cope with arthritis. Too much weight places excess pressure on the joints in your hips, knees, ankles and feet, leading to increased pain and mobility problems.

Read more about how you can lose weight using the weight loss guide.

Exercise

If your arthritis is painful, you may not feel like exercising. However, being active can help reduce and prevent pain. Regular exercise can also:

improve your range of movement and joint mobility

increase muscle strength

reduce stiffness

boost your energy

As long as you do the right type and level of exercise for your condition, your arthritis won’t get any worse. Combined with a healthy, balanced diet (see above), regular exercise will help you lose weight and place less strain on your joints.

Your GP can advise about the type and level of exercise that’s right for you. You can also download useful free booklets from Arthritis Careand Arthritis Research UK, including:

Exercise and arthritis

Pain and arthritis

Joint care

If you have arthritis, it’s important to look after your joints so there’s no further damage. For example, try to reduce the stress on your joints while carrying out everyday tasks like moving and lifting.

Some tips for protecting your joints, particularly if you have arthritis, include:

use larger, stronger joints as levers – for example, take the pressure of opening a heavy door on your shoulder rather than on your hand

use several joints to spread the weight of an object – for example, use both hands to carry your shopping or distribute the weight evenly in a shoulder bag or rucksack

don’t grip too tightly – grip as loosely as possible or use a padded handle to widen your grip

The Arthritis Care website has more information and advice about taking care of your joints.

It’s also important to avoid sitting in the same position for long periods of time and to take regular breaks so you can move around.

Read more about good posture and how to sit correctly.

At home

If you have arthritis, carrying out tasks around the home can be a challenge. However, making some practical changes to your home and changing the way you work should make things easier.

Practical tips that could help include:

keeping things in easy reach

using a hand rail to help you get up and down the stairs

using long-handled tools to pick things up or to clean

fitting levers to taps to make them easier to turn

using electric kitchen equipment, such as tin openers, when preparing food

You can find more useful information and advice about living independently at home on Arthritis Care.

Occupational therapy

An occupational therapist can help if you have severe arthritis that’s affecting your ability to move around your home and carry out everyday tasks, such as cooking and cleaning.

They can advise about equipment you may need to help you live independently.

Depending on the exact nature of your condition, your GP may be able to refer you to an NHS occupational therapist. However, you may need to access this type of therapy through your local council.

Find your local council on GOV.UK.

Read more about occupational therapy.

Does acupuncture help?

Some people with osteoarthritis say that acupuncture has helped relieve their symptoms.

However, if you wish to try it, bear in mind that any benefits of acupuncture are likely to be the result of expectation or the placebo effect.

Read more about the placebo effect.

The lack of evidence for the effectiveness of acupuncture is why the National Institute for Health and Care Excellence (NICE) doesn’t recommend it for treating osteoarthritis.

Arthritis and driving

You only need to inform the DVLA if you have arthritis and use special controls for driving.

GOV.UK has more information and advice about telling the DVLA about a medical condition or disability.

Arthritis: herbs don’t help – says research

Arthritis: herbs don't help

Arthritis: herbs don’t help

“Many herbal medicines and other complementary therapies do nothing to help people with rheumatoid arthritis” The Guardian has reported. The news comes from a report by the Arthritis Research Campaign (ARC) that ranked the alternative and complementary therapies on their safety and effectiveness at treating arthritic conditions.

The report summarises the body of scientific evidence on 40 alternative treatments and scores their effectiveness and safety. One Chinese herbal medicine called “thunder god vine” was found to have serious side effects including nausea and hair loss, while nine treatments were reported to regularly cause side effects. Many treatments were also found to be ineffective or to have little evidence backing their anecdotal benefits.

According to the ARC almost half of arthritis sufferers turn to complementary medicines, spending more than £450m annually. Members of the public may be spending their money on ineffective treatments, and there remains a greater concern that they could be harming themselves or forgoing conventional treatments in the process. While herbal and complementary treatments may be derived from nature, the public should be aware that they still have the potential to cause harm.

Where did the story come from?

The report was commissioned by the ARC, a UK charity supporting research into arthritis and musculoskeletal conditions. The corresponding author was Professor Gary J Macfarlane from the University of Aberdeen School of Medicine and Dentistry. The study was published on the ARC website, and it is unclear whether the report has been peer reviewed.

What kind of scientific study was this?

This evidence-based review summarises evidence on the effectiveness and safety of several herbal and complementary medicines commonly used to treat arthritic conditions. These summaries were compiled into a single 80-page report, which features safety and effectiveness ratings for each treatment.

There are lots of compounds that have been proposed as treatments for rheumatoid arthritis, osteoarthritis and fibromyalgia, and the authors of the report aimed to identify all of those where there has been some claim supported by research evidence.

Specifically, the researchers were interested in compounds that were taken by mouth or applied to the skin. They excluded therapies such as acupuncture, chiropractic, massage and several other hands-on therapies that have been commonly used for arthritis and musculoskeletal conditions. The report covers forty complementary and alternative medicines including deer antler velvet, vitamins and willow bark.

These summaries were compiled by systematically searching medical and scientific literature on these popular alternative treatments. The study’s authors used experts in the field to search for and evaluate the evidence. As the report was aimed at the general public, it also included input from a patient representative.

The authors say that in herbalism emphasis is on an individualised approach, with patients receiving a tailored prescription. However, a recent review concluded that there was a scarcity of evidence regarding individualised herbal medicine and no convincing evidence to support its use. The authors did not search for reports of such an approach.

The authors relied heavily on the results of randomised trials and gave preference to this type of evidence  when estimating an effectiveness score. The scoring system assessed the quality of trials, appraised based on a scoring system called the “Jadad scoring scale”. This commonly used scale has levels from 1 (very poor quality) to 5 (very good quality). The researchers collapsed the scale into two categories: good/high quality (Jadad score 3 or above), and low quality (Jadad score below 3).

They took this into account when scoring the compounds’ overall research evidence base, defining the scores as follows:

1 – There is, overall, no evidence to suggest that the compound works or only a little evidence which is outweighed by much stronger evidence that it does not work.

2 – There is only a little evidence to suggest the compound might work. The evidence from studies in this category often came from only a single study which reported positive results. There are, therefore, important doubts about whether or not it works.

3 – There is some promising evidence to suggest that the compound works. The evidence will be from more than one study. However, there may also be some studies showing that it does not work. Therefore, we are still uncertain whether compounds in this category work or not.

4 – There is some consistency to the evidence, which will come from more than one study, to suggest that the compound works. Although there are still doubts from the evidence that it works, on balance, we feel that it is more likely to be effective than not.

5 – There is consistent evidence across several studies to suggest that this compound is effective.

The safety categories are based on a scheme developed by the authors:

Green “traffic light” was awarded to compounds with reported adverse effects which were mainly minor symptoms and infrequent. A classification of green does not mean that the compound has no reported adverse effects and patients should check in the product information leaflet what these are.

Amber “traffic light” was awarded to compounds with adverse effects reported as common (even if they were mainly minor symptoms) or with more serious adverse effects.

Red “traffic light” was awarded to compounds where serious adverse effects were reported. Patients should carefully consider these before deciding whether to take these medicines

What were the results of the study?

The ARC awarded just one point to 13 of the 21 complementary medicines for rheumatoid arthritis, suggesting that these compounds were not effective treatments. The ARC scored fish oils extracted from oily fish such as sardines, salmon and mackerel a maximum 5 points, suggesting they offer benefits. Fish oils also received a green light for safety.

For osteoarthritis three of 28 natural remedies were found to be supported by strong or moderate evidence. The most effective, capsaicin gel, (a therapy based on chilli peppers) has been shown to reduce pain among osteoarthritis patients. A herbal mixture called phytodolor and the nutritional supplement S-adenosyl-L-methionine (SAMe), both received 4 points for effectiveness.

Glucosamine, one of the most widely taken products, has featured in many trials. It was reported to be effective in some trials but not in others. The researchers found that the evidence was stronger for glucosamine sulphate (which scored 3) compared with glucosamine hydrochloride (which scored 1).

For fibromyalgia the researchers report that of the four products assessed, none was highly effective, with three medicines scoring 2 points out of 5, and the fourth considered ineffective, scoring just 1 point.

What interpretations did the researchers draw from these results?

The researchers say that more information on the research studies is available in their full report. In terms of safety, the authors conclude that there is much less information available on complementary medicines than on conventional pharmaceutical medicines.

The researchers gave nine of the compounds an amber safety classification, indicating there were important side effects which had been reported, or that there was insufficient evidence to make a judgement. The “red” safety classification was only issued against the traditional Chinese herbal extract “thunder god vine”.

What does the NHS Knowledge Service make of this study?

This review of the evidence regarding complementary and alternative medicines will undoubtedly be of interest to many people living with painful or debilitating arthritic conditions. The full report clearly presents the results for each compound in a structured way, allowing the public to understand the scientific basis (or lack of one) behind a range of alternative treatments.

The authors acknowledge limitations, in terms of not being able to include emerging evidence and scientific studies published since their search. They say that research that could not be appraised in time for publication will be addressed in future updates.

Given the nature of chronic conditions such as arthritis, people may attempt to manage their symptoms or pain by regularly using complementary treatments. This review highlights the fact that many complementary medicines may not have been subjected to the rigorous safety and effectiveness tests that pharmaceutical products must undergo.

In turn this illustrates that many people may be purchasing treatments that have little or no proven benefit. While this can be financially costly, there is the greater hazard that people may be harming themselves by using untested substances. In fact, one-quarter of treatments tested were found to have common or serious side effects.

While members of the public may continue to choose to use complimentary medicines, they should be aware that there are potential dangers, that conventional treatments available through a GP may be free and that these treatments will have been tested for both their safety and effectiveness.

Hydrangeas and MS (and some types of arthritis)

Hydrangeas and Multiple Sclerosis

Hydrangeas and Multiple Sclerosis

Researchers say a drug made from the roots of the hydrangea could treat several common diseases, the Daily Mail reported. It said experiments showed that the medicine, halofuginone, may be used to treat diseases of the immune system, including multiple sclerosis (MS) and some types of arthritis. It said existing treatments are expensive and the more powerful drugs suppress the whole immune system and can leave patients at risk of infection and other side effects.

This story is based on experiments in mice, which found that the drug blocked the formation of a type of white blood cell (TH17) involved in autoimmune disease. The small-molecule drug eased symptoms in the mice and did not seem to affect other types of cells vital to the body’s defences, which means it may not otherwise inhibit the beneficial parts of the immune system. Mice with a multiple sclerosis-like disease were far less severely affected when given low doses of the drug. More research is needed to fully evaluate the potential of this drug and, as the Daily Mail said, before it is given the green light to treat autoimmune diseases.

Where did the story come from?

The research was carried out by Dr Mark S Sundrud from the Harvard Medical School and Immune Disease Institute and colleagues from other institutions. The study was funded by grants from the National Institutes of Health, Juvenile Diabetes Research Foundation, Cancer Research Institute and Portuguese Foundation for Science and Technology. The study was published in the peer-reviewed medical journal Science .

What kind of scientific study was this?

This was an animal study carried out in the laboratory using human tissue and mice. The researchers say that a disadvantage of current immunological therapies for autoimmune diseases (diseases where the immune system attacks the body) is that they are generalised in the way that they prevent inflammation and are not targeted. These powerful drugs are expensive, often have to be injected and, as they suppress the whole immune system, can leave patients at risk of infections.

They say a more selective therapy that targets specific parts of the disease process would be advantageous and possibly produce fewer side effects, such as the risk of infection.

Halofuginone is a small molecule that can be obtained from the hydrangea root. It is used in traditional Chinese medicine and supposedly has antimalarial qualities. It has also been tested in clinical trials for the treatment of scleroderma, a rare autoimmune disease that affects the skin and internal organs. This is also an autoimmune disease and so has similarities to the disease model the researchers were studying.

The researchers aimed to test whether halofuginone could selectively inhibit the white blood cells (TH17 cells) involved in autoimmune disease. These cells are part of the immune system and regulate the immune response. TH17 cells develop from other cells called CD4+ T-cells and then differentiate within the body into cells that produce several different signalling molecules called cytokines. Cytokines are proteins released by cells in response to infection or other stimuli to signal or regulate the immune response. The ‘differentiation’ has been linked to several autoimmune diseases, including multiple sclerosis and arthritis. Existing treatments for severe forms of multiple sclerosis and some forms of arthritis involve antibodies that neutralise some of the cytokines.

In this study, the researchers hoped to find that halofuginone would suppress the differentiation process.

The researchers cultured mouse CD4+ T-cells along with the cytokines that normally trigger the development of TH17 cells. They also cultured human CD4+ T-cells along with the cytokines. To test if halofuginone affected the differentiation of CD4+ T-cells into TH17 cells, they added the drug to the CD4+ T-cells. They then observed whether this reduced the production of IL-17, the principal cytokine made by TH17 cells. They did this for both the cultured mouse and human cells.

The researchers also tested the effect of halofuginone on a clinical scoring of symptoms in two groups of mice that had been artificially given an experimental form of immune brain disease, resembling multiple sclerosis in humans. One group of mice had a large number of TH17 cells, while the other group had few.

What were the results of the study?

When the researchers cultured mouse CD4+ T-cells with the cytokines and the halofuginone, they found that there was a pronounced decrease in the numbers of TH17 cells, the white blood cell involved in autoimmune disease.

A similar experiment with the cultured human CD4+ T-cells showed that halofuginone selectively suppressed the production of IL-17.

The mice with a large amount of TH17 cells in the brain and which had been given halofuginone developed the brain disease more slowly and less severely than the mice with another form of the disease that didn’t involve TH17 cells.

What interpretations did the researchers draw from these results?

The researchers say that, although the exact mechanism controlling TH17 differentiation remains unclear, their results highlight a previously unknown link between the pathway that links T-cell differentiation and immune-pathology. They say their research shows that the pathway identified is a selective one and that it regulates T-cell differentiation in a major way.

What does the NHS Knowledge Service make of this study?

This study will be of interest to researchers as it points towards specific parts of the immune pathway that can be targeted by novel drugs. There are several points to note:

More research is needed before it is known that hydrangea root or halofuginone have the same effects on immunological conditions in humans and are safe to use.

This was a well-conducted study, which presents the beginning of a novel approach to drug development. The researchers themselves are cautious in predicting that this drug will cure MS, diabetes or arthritis, but highlight that the research expands the knowledge about how these cells and cytokines are involved in autoimmune human processes.

Joint pain – signs, symptoms and causes

Joint Pain

Joint Pain

Introduction

Joint pain is a very common problem with many possible causes – but it’s usually a result of injury or arthritis.

In older people, joint pain that gets steadily worse is usually a sign of osteoarthritis. It may affect just one joint, or many. See your GP if you have persistent symptoms of osteoarthritis.

The information and advice on this page shouldn’t be used to self-diagnose your condition, but may give you a better idea of what’s causing your pain.

 

Knee pain

The knee joint is probably the most frequently damaged joint and is particularly vulnerable as it takes the full weight of your body.

However, knee pain isn’t always a joint problem. Learn about the most common causes of knee pain and what you should do.

The most common and more unusual causes of pain in a single joint are described below.

Inflammation of the joint lining

If you’ve injured the joint recently and it suddenly becomes painful again, the thin layer of tissue lining the joints and tendons may be inflamed – a condition called traumatic synovitis. It usually doesn’t cause any redness or heat.

You should be able to manage injury-related swelling at home with anti-inflammatories, an icepack and rest.

Gout or pseudogout

If the skin over the joint is hot and red, and the pain comes in repeated attacks, the cause is likely to be either gout or pseudogout.

Both conditions are types of arthritis.

Gout usually affects the joint of the big toe first, before affecting other joints. It’s important to correctly diagnose gout, as treatment will prevent future attacks of joint pain and disability.

Pseudogout is a similar condition to gout, but usually affects the knee joint first.

See your GP if you think you have either condition.

Damage to the cartilage at the back of the kneecap

Knee pain that feels worse when going up or down stairs could be a sign of a damaged kneecap – a condition called chondromalacia patellae. This shouldn’t cause any redness or heat around the knee.

The cause isn’t really understood, but it can be linked to overuse of the knee.

You can treat this problem yourself with anti-inflammatories, an icepack and rest.

Bleeding into the joint space

If you’ve recently had an injury to the knee joint, such as a torn ligament or knee fracture, it may cause bleeding into the joint spaces. This is known as haemarthrosis.

This is more likely to happen to people on anticoagulants, such as warfarin.

Signs of haemarthrosis are:

swelling of the knee

warmth

stiffness and bruising, which occur soon after the injury

You should go to hospital immediately for treatment if you have a very swollen knee.

Less common causes

Sudden pain in a joint is less commonly caused by:

a fracture – read about a broken arm or wristbroken legbroken ankle or hip fracture

reactive arthritis – which usually develops after an infection and tends to affect young adults

psoriatic arthritis – a type of arthritis that affects up to one in five people with psoriasis

rheumatoid arthritis – which can start in just one joint, with the pain coming and going

Osgood-Schlatter’s disease – swelling and tenderness over the bony bump just below the kneecap

Rarely, the cause may be:

septic arthritis – a serious condition that causes a painful, hot, swollen joint that you won’t be able to move (sometimes with fever) – see your GP urgently or go to A&E

haemophilia – an inherited condition that affects the blood’s ability to clot

a tropical infection

cancer

crumbling of the bone (avascular necrosis) – caused by a lack of blood supply

repeated dislocation of the joint

Pain in many joints

Rheumatoid arthritis

Rheumatoid arthritis is another type of arthritis that causes pain and swelling in the joints – usually the hands, feet and wrists.

The pain may come and go in the early phases, with long periods between attacks.

It can leave you feeling generally unwell and tired. Read more about the symptoms of rheumatoid arthritis.

Psoriatic arthritis

Psoriatic arthritis affects up to one in five people with psoriasis. This type of arthritis is unpredictable, but flare-ups can usually be managed with treatment.

Like other types of arthritis, it means that one or more of your joints are inflamed and become swollen, stiff, painful and difficult to move.

A viral infection that causes arthritis

Examples of viral infections which can cause pain in the joints and symptoms of a fever include:

viral hepatitis – liver inflammation caused by a virus

rubella – a viral infection that used to be common in children

A disease of the connective tissue

Widespread joint pain is sometimes a sign of a disease that affects almost all the organs of the body, such as:

lupus – where the immune system mistakenly attacks healthy cells, tissue and organs

scleroderma – where the immune system attacks connective tissue underneath the skin, causing hard, thickened areas of skin

Less common causes

Widespread joint pain can less commonly be caused by:

a rarer type of arthritis – such as ankylosing spondylitisjuvenile arthritis or reactive arthritis

Behçet’s syndrome – a rare and poorly understood condition that causes inflammation of the blood vessels

Henoch-Schönlein purpura – a rare condition, usually seen in children, that causes blood vessels to become inflamed

cancer

some treatments – including steroid therapy, isoniazid and hydralazine

hypertrophic pulmonary osteoarthropathy – a rare disorder that causes clubbing of the fingers, seen in people with lung cancer

sarcoidosis – a rare condition that causes small patches of tissue to develop in the organs