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Battling Rheumatoid Arthritis

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Rheumatoid arthritis triggers: they’re all around you

What triggers that arthritis attack that leaves you pain and immobile? It may be the air you breathe, the food you ate or the lipstick you just applied.

Rheumatoid arthritis is an autoimmune disease and these conditions and their causes are poorly understood. The genetic factors involved are pretty strong but other triggers are difficult to pinpoint. Researchers have been trying to identify the environmental factors that trigger these diseases. Scientists at Tel Aviv University report that

• People living close to airports have a higher likelihood of developing rheumatoid arthritis and lupus.
• Certain food additives can also trigger autoimmune diseases.
• Even chemicals in our body care products such as hairspray and lipstick or ingredients in our medications may serve as triggers.

According to rheumatologist Prof. Michael Ehrenfeld of Tel Aviv University’s Sackler School of Medicine:

“The onset of autoimmune diseases is a mixture of genetics, which you can’t change, and environmental factors, which in some cases you can, there are some environmental factors harder to avoid. For example, reactive arthritis is caused by a severe gastro-intestinal, urinary or sexual infection in some people.”

Other factors that can trigger rheumatoid arthritis are

• Extreme stress
• Environmental and industrial pollutants
• Second-hand smoke
• Food additives
• UV radiation exposure

The high level of jet fuel fumes in airports predisposes nearby residents to autoimmune diseases.

Rheumatoid arthritis is a chronic inflammatory autoimmune disease afflicting more than 2 million Americans. Women are 3 times more susceptible than men. The disease occurs when the body’s own immune system to attack the joints, leading to pain, deformities and disability. Unlike osteoarthritis which is age-related, rheumatoid arthritis affects people of all ages.

Prof. Ehrenfeld explains:

“Most people think arthritis has to do with old age. This is false. There is only one major type of arthritis in older people: osteoarthritis, which is brought on by degenerative changes in the body. What you see in older adults is usually a non-inflammatory and non-autoimmune type of arthritis.

Most of the other kinds of arthritis we see in the clinic, the debilitating and inflammatory types, usually occur in young women between the ages of 20 and 40. We hope that our research will lessen the occurrence and onset of these painful disorders.”
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Smoking and rheumatoid arthritis

That arthritis pain is killing you? Well, it might be the pack you smoked today that caused it.

Recent research evidence indicates that smoking cigarettes can increase your chances of getting rheumatoid arthritis, an autoimmune form of the disease that has nothing to do with age. The study looked at 860 people and 605 of these had rheumatoid arthritis and 255 didn’t. Analysis of the data showed that heavy long-term smokers (e.g. those who smoke a apack a day for 10 years) are the most likely to develop the disease. According to study author Ted Mikuls of the University of Nebraska Medical Center:

“This is yet another thing for people to think about when they are picking up their cigarettes – they may be increasing their risk for arthritis.”

Smoking cigarettes is linked to many chronic diseases, including cancer, heart disease and stroke. Now we can add rheumatoid arthritis to this list.

So next time you feel that pain on your joints, check your lifestyle and check your health habits. What have you done today?

About rheumatoid arthritis:

Rheumatoid arthritis (RA) is a form of arthritis that causes pain, swelling, stiffness and loss of function in your joints. It can affect any joint but is common in the wrist and fingers. More women than men get rheumatoid arthritis. It often starts between ages 25 and 55. You might have the disease for only a short time, or symptoms might come and go. The severe form can last a lifetime.

Rheumatoid arthritis is different from osteoarthritis, the common arthritis that often comes with older age. RA can affect body parts besides joints, such as your eyes, mouth and lungs. RA is an autoimmune disease, which means the arthritis results from your immune system attacking your body’s own tissues.

No one knows what causes rheumatoid arthritis. Genes, environment and hormones might contribute. Treatments include medicine, lifestyle changes and surgery. These can slow or stop joint damage and reduce pain and swelling.
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Have heart disease and arthritis? No reason to stop moving!

What a bummer! You need to exercise to keep your heart fit but arthritis keeps you from moving. This is especially tough because arthritis seems to be quite common among those with heart disease. A whopping 14.1 million American adults suffer from some form of heart disease. Another couple of millions have arthritis. Many suffer from both.

 Physical activity is on top of the list of recommendations for people with heart disease because exercise brings lots of health benefits including “improved physical function and lowered blood pressure and blood cholesterol levels.”

And though it may not seem so, those with arthritis also benefit from regular exercise because it reduces arthritis pain and improve functioning of the joints.

But then check out the following statistics:

• 57 percent of adults with heart disease have arthritis.
• 29 percent of adults with arthritis and heart disease were inactive, compared to 21 percent of people with heart disease alone, 18 percent of those with arthritis, and 11 percent of adults with neither condition.

It seems that heart disease and arthritis co-occurring together make the perfect combination to make a patient sedentary. Data from the Behavioral Risk Factor Surveillance System show that lack of physical exercise is common among those with both heart disease and arthritis which unfortunately makes these diseases even worse. Much more, many of these people are not aware of the adverse effects of being sedentary and may even think that exercise would exacerbate rather that help with their conditions.

So what are these people supposed to do?

According to Dr.  Janet Collins, director of CDC′s National Center for Chronic Disease Prevention and Health Promotion:

“These fears are readily addressed by good information, consultation with their doctor, evidence-based programs, and strong social support.”

Some of the recommendations they have come up with are:

• Disease self-management classes, including exercise programs that address arthritis-specific barriers.
• Joint-friendly activities, such as walking, swimming, and biking.
• Specially tailored programs such as Chronic Disease Self-Management Program, the Arthritis Foundation′s Exercise Program, and Enhance Fitness.

It is possible to consider alternative physical movement programs such as yoga, tai chi, pilates, etc. These programs are not as physical strenuous as regular exercise but can still be beneficial if done properly and can be tailored to individual needs.

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The health benefits of hiking

If I tell you I did not do a single jogging run last week, you’d think I’m getting slack and lazy, right?

Well, not quite We (I and my family) just got back from a week of autumn holidays in the Swiss Alps where we did lots of walking and hiking. This time we did long (5 to 6 hours) and short hikes (2 to 3 hours), easy (100 to 200 m altitude difference on easy clear pathways) and tough ones (500 m or more altitude difference on difficult terrain). The family consists of middle-aged parents and two seven-year old twin boys. During the week, we did two of our toughest and longest hike yet and I learned a couple of things:

• For my kids, the tough hikes consisting of rock climbing and cliff hugging and crawling on your hands and knees are much more fun and interesting than the easy slopes and incline. We heard nary a complaint during the tough climbs except “Mom, why are you so slow?” During the easy walks however, there are the frequent “Are we there yet?” and “How many more minutes/kilometers?”
• My kids have overtaken me in skills when it comes to climbing mountains, at least when the going gets tough. You see, Mommy is so slow because her knees were trembling as she scrambles and crawls on the rocks. Mind you, I have no fear of heights nor do I suffer from vertigo. But as somebody who was born close to the seacoast of a tropical island, it took me more than 30 years to find my way to the Swiss Alps, much more hike around. But how I got here is another story. This post is about the health benefits of hiking.

According to the American Hiking Society:

• Hiking is an excellent way to lose excess pounds and improve health.
• Hiking can help prevent heart disease, lower cholesterol levels and control hypertension.
• Hiking helps against stress and depression.
• Physical activity such as hiking slows down the aging process.
• Hiking and walking help reverse the negative effects of osteoporosis by increasing the bone density and slowing the rate of calcium.
• Regular exercise, including hiking, can help prevent diabetes and can protect the body from the degenerative effects of diabetes.
• Walking helps strengthen muscles, especially in the legs and thus benefits people with arthritis.
• The disappearance of or enormous decrease in back pain has been identified as the most common, clearly perceived health benefit reported by walkers.

Now, I hope my description of our hikes did not turn you off and made you come to the conclusion that hiking is too challenging or difficult for you. The trick is to start slow and small. I did. My family did. I had to train my body for years, then my kids. The important thing is to start. Now.

Here’s what the American Hiking Society advises:

Beneficial exercise does not need to involve a long, painful and boring workout. A good workout can be a brisk 30-minute hike with the dog, or a slower one-hour hike through a local park. According to the American Heart Association, it’s best to walk vigorously for 30 to 60 minutes three or four times per week.

Here are some tips from Nomad Journal Trips:

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  • “The first is to walk for more than 20 minutes. This consistently keeps your heart rate up and starts to burn calories. 20 minutes, however, isn’t really going to cut it unless you do it every day. To really break a sweat and build stamina, you want to hike at least an hour. If it sounds like a lot, keep in mind you are going 30 minutes in one direction and 30 minutes back.
  • The second method is to go up. By up, I mean to hike a trail with elevation changes. Generally, a trail that goes up at a slight incline for a long time is better than one that goes up. Time is a key factor, so try to find a trail that isn’t going to wipe you out in the first 200 feet.”

Here is what I’ll tell you next: preparing for a mountain hike and taking safety precautions. Stay tuned for my next hiking post. Meanwhile, I am back in the lowlands and have to go for a jogging run.

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Pumpkin – autumn’s healthy superstar

The world is turning orange. Just look at the leaves and the pumpkins.

Pumpkins are the real stars of autumn, not only as decorations but as food for our kitchen. In this group also belong the butternuts and squash.

Over the years, I’ve been told the following:

Pumpkins are more 90% water.

This is correct. But this is true for most vegetables and fruit. That doesn’t mean that they are not nutritious.

Pumpkin dishes are full of calories.

Not necessarily. I definitely try to minimize the fat and calories in my pumpkin dishes. Here is how:

• Use low-fat cream or milk in your pumpkin soup.
• For pumpkin pies, make your own crust with less fat or buy the low-fat ready-made crusts.
• Include the skin to increase fiber content.
• Use low-fat cream and less number of eggs for the filling.
• Or simply boil slices of pumpkin and sprinkle a little bit of salt.

Nutritional value of pumpkins

Like most orange-colored vegetables, pumpkin is rich in beta-carotene as well as vitamin A, C, and potassium.

According to How Stufff Works, a serving of cooked, mashed pumpkin contains:

Calories	24
Fat	0 g
Saturated Fat	0 g
Cholesterol	0 mg
Carbohydrate	6 g
Protein	1 g
Dietary Fiber	1 g
Sodium	1 mg
Vitamin A	6,115 IU
Niacin	1 mg
Vitamin C	6 mg
Calcium	18 mg
Potassium	282 mg
Carotenoids	6,012 micrograms

 

However, pumpkins are not the only health stars of autumn. Do not forget pumpkin seeds!

Do you know for example that

• pumpkin seeds benefit prostate health and help prevent prostate cancer?
• pumpkin seeds are a good source of the vitamins and minerals, including the element Zinc which is important for bone health?
• pumpkin seeds can help lower cholesterol?
• pumpkin seeds may benefit bladder health?
• pumpkin seeds can potentially help prevent arthritis?

For more details about the health benefits of pumpkin seeds, check out www.whfoods.com

My family love pumpkin seeds as:

• extra flavoring for bread and bread rolls
• toppings to green and mixed salad
• snack on the go that fit in a small plastic bag or box that can then be carried in a pocket. Pumpkin seeds are a great alternative to roasted peanuts.

When buying roasted pumpkin kids, make sure to buy the non-salted ones!

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Vitamin D and rheumatoid arthritis

Vitamin D deficiency has been linked to a wide range on health conditions, including rheumatic diseases. Three European studies looked into the relationship between rheumatism and vitamin D levels as well as the effect of vitamin D supplementation.

Study  1:

An Italian study followed up 1191 patients with rheumatoid arthritis. The results showed that vitamin D levels in the blood were lower in these patients compared to the normal levels of at least 50 nmol/L . Furthermore,  supplementation does not always help. Only 40% of these patients who are take vitamin D daily supplementation of 800IU or more reach the normal values. The vitamin D levels in the blood in 60% of patients are still below normal. Measures of disease activity using questionnaires show that low vitamin D levels are correlated to increased disability, decreased  mobility, and more swollen joints.

According to  Dr. L. Idolazzi of the Rheumatology Unit, University of Verona, Italy:

“We have seen in studies that vitamin D deficiency is common in patients with a range of rheumatic diseases, and our results have confirmed this using several clinically accepted measures of disease activity. What we need to see now is a range of long term studies, which examine the clinical response of patients to vitamin D supplementation.”

Study 2:

In another Italian study, the effect of vitamin D supplementation on inflammatory autoimmune diseases was investigated. In this group of 43 patients, only 29% achieved normal vitamin D levels following supplementation.

Study 3:

A third study conducted in the UK involved 90 patients with rheumatoid arthritis, osteoporosis or unexplained muscle pain. These patients, too, had below than normal levels of vitamin D.

About vitamin D:

Vitamin D is also called the sunshine vitamin as it can only be synthesized by the body when exposed to sunlight. Unfortunately, vitamin D is not available in sufficient amounts in the food that we eat. Although vitamin D is available through sun exposure, the risk for skin cancer than the sun rays bring has led many health experts to discourage this practice.

In recent years, there has been a big debate about the necessity of vitamin D supplementation. In many countries, including the US, milk is supplemented with vitamin D. In addition, doctors often recommend vitamin D supplementation to their patients, especially little babies who are being breastfed. The American Academy of Pediatrics recommends routine vitamin D supplementation for children and updated its guidelines on Vitamin D intake last 2008. The new guidelines increased the recommended dose from 200 IU to 400 IU per day.

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Is there such a thing a “too much exercise?”

With the increasing problems of obesity and cardiovascular diseases attributed to sedentary lifestyle, physical exercise has touted as the solution to lots of health problems. But can physical exercise also have some adverse effects on health? German and American researchers presented results at Radiological Society of North America (RSNA) in Chicago last year that indicated that high levels of physical activity can cause cartilage damage and lead to osteoarthritis.

According to Dr. Christoph Stehling, a researcher in the US and in Germany:

“Our data suggest that people with higher physical activity levels may be at greater risk for developing knee abnormalities and, thus, at higher risk for developing osteoarthritis.”

Osteoarthritis is the most common form of arthritis, affecting about 27 million people in the US. It is a degenerative joint disease that causes pain, swelling and stiffness.

The researchers looked at 236 study participants (100 men and 136 women) with ages ranging from 45 to 55. The participants were asked to complete the Physical Activity Scale for the Elderly (PASE) questionnaire and based on their PASE scores, were classified as low, middle-, and high-activity groups. A person of high activity level would typically engage in several hours of walking, sports or other types of exercise per week, as well as yard work and other household chores. The participants were then subjected to magnetic resonance imaging (MRI) that looked at musculoskeletal structures of the knee.

The study results revealed the following knee abnromalities in some of the participants:

• meniscal lesions
• cartilage lesions
• bone marrow edema
• ligament lesions

The frequency and degree of knee damage seems to be associated with the level of physical activity based on PASE scores.

Dr. Stehling continues to say

“The prevalence of the knee abnormalities increased with the level of physical activity… In addition, cartilage defects diagnosed in active people were more severe.”

In addition, certain activities, especially weight bearing activities such as walking or running cause more damage than other activities. The researchers do not necessarily advocate a sedentary lifestyle, which can be also detrimental to musculoskeletal health. Instead, they recommend non-weight bearing activities such as swimming and cycling. These activities are beneficial to cardiovascular health without causing cartilage damage.

The study authors concluded:

•High levels of physical activity may result in knee damage and eventually arthritis for middle-aged men and women.

•MRI showed evidence of knee abnormalities, including cartilage damage and ligament lesions, in active adults with no pain or other symptoms

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Rheumatoid arthritis need not stop you from typing

People with arthritis may have problems with performing simple daily tasks. But how does rheumatoid arthritis affect a person’s capability to use a keyboard and therefore their performance at work? This is the question that researchers from the University of Pitt decided to address.

The researchers followed up 45 patients listed in the University of Pittsburgh Medical Center (UPMC) Arthritis Network Registry. The participants were most women with an average age of 55, and had been suffering from rheumatoid arthritis for about 17 years. Half of participants are employed full or part-time, and everybody in the group of working participants used computers in their jobs.

The researchers evaluated the hand function of the participants using the Keitel Hand Function Index (KHFI) and the Arthritis Hand Function Test (AHFT) and the abilities to use a standard keyboard and mouse using the Assessment of Computer Task Performance (ACTP).

The KHFI included 11 performance test items to measure active ROM of the thumb, fingers, writs, forearms and elbows. The AHFT consisted of 10 test items to evaluate pure and applied strength and dexterity in a variety of hand tasks.

The results of the study are quite encouraging:

• 73% of participants have been trained in touch typing and used the computer an average of 18 hours per week
• Participants with rheumatoid arthritis have comparable skills to non-impaired individuals in terms of keyboarding speed.
• Participants who were trained in touch typing had faster typing speeds than those using a visually-guided (“hunt and peck”) method, with or without rheumatoid arthritis.
• The ability of using a mouse is slightly impaired in workers with RA and the impact of this impairment on job productivity still needs to be evaluated.

These results are indeed good news for those with rheumatoid arthritis. Previous studies have reported that rheumatoid arthritis can impair people’s abilities to perform their jobs so that those suffering from this condition have higher rates of work disability, premature work cessation, and reduced hours on the job.

However, this study indicates that computer work is not greatly affected by rheumatoid arthritis According to figures from the U.S. Census Bureau, the number of workers using computers increased from 46% in 1993 to 56% in 2003 with figures expected to continue climbing higher.

Thus people with rheumatoid arthritis skilled in computer work especially touch typing need actually not fear for significant impairment that may cost their jobs.

According to lead author Dr. Nancy Baker:

“With more arthritic workers using computers, understanding the associations between hand function impairment and peripheral device (keyboard and mouse) limitations is essential and the focus of our current study.”

Photo credit: stock.xchng

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Nutritional supplements for osteoarthritis evaluated

The 2009 Annual Scientific Meeting of the American College of Rheumatology (ACR) was held in Philadelphia in October. One of the main subjects of the research studies presented during the conference was advances in the management of osteoarthritis as featured in this Medscape report.

Osteoarthritis is the most common form of arthritis characterized by the breakdown of cartilage around the joints. Some of the symptoms are pain, swelling, stiffness, and impairment of motion and function. It affects the joints of the hands, knees, hips or spine. Although the causes of osteoarthritis are poorly understood, studies have identified the risk factors as:

• old age
• female sex,
• high BMI or obesity
• previous trauma
• malalignment
• genetic factors and
• biochemical changes in aging joint tissues

During the ACR meeting, several investigations of nutritional interventions for osteoarthritis were presented. Some of the nutritional therapies are summarized below.

Glucosamine for Knee Osteoarthritis

Glucosamine is a common nutritional supplement used for the management of degenerative joint disease. It is available over the counter. At the ACR meeting, the results of the Joints on Glucosamine (JOG) trial that evaluated the effect of glucosamine on knee osteoarthritis were presented, with disappointing results.

“…no differences were observed in the progression of cartilage lesions between the treatment and placebo arms over the 24-week study. Moreover, glucosamine did not reduce levels of urinary type II collagen fragments, a biomarker for cartilage turnover. Taken together, these data suggest that glucosamine does not inhibit structural progression in knee OA, although this study is limited by its relatively small sample size and short follow-up, especially in light of the fact that OA lesions develop and progress over several years. “

Avocado-soybean unsaponifiables (ASU) for Hip Osteoarthritis

The nutraceutical made from Avocado-soybean unsaponifiables (ASU) is a popular osteoarthritis pain remedy especially in Europe. It is made from extracts of avocado and soybeans.  Results of a 3-year trial that investigated the efficacy of ASU to prevent progression of hip osteoarthritis indicated a weak benefit that needs to be confirmed by more studies.

“At 3 years, no differences were observed between the placebo and ASU-treated groups in the primary outcome, which was change in joint space width. However, a statistically significant 20% reduction in progression, defined as > 0.5 mm reduction in joint space width, was observed in the treatment arm. No effects were observed on patients’ symptoms and ASU was generally well tolerated. Interpretation of the findings from this study is limited by the high patient dropout rate from the study of 41% and a failure to observe a significant difference in the primary outcome. Additional studies are needed to conclusively determine whether ASU has structure-modifying benefits in hip OA and could delay the need for joint replacement procedures.”

Antioxidants

Antioxidants are very popular supplements against cardiovascular diseases. But do they have beneficial effects in inflammatory diseases such as osteoarthritis? Unfortunately, years of study haven’t answered this question. One study reported at ACR meeting

“Higher intake of the antioxidants beta-carotene, vitamins E and C, and selenium were not associated with a reduction in the incidence of severe OA. Surprisingly, an association between high selenium intake and knee and hip OA was observed. This intriguing observation, which could influence how one counsels patients on the use of antioxidant supplements, needs to be confirmed with additional studies.”

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Fish oil to treat rheumatoid arthritis

It is well-known that fish oil is beneficial to cardiovascular health. Fish oils are rich in long-chain omega-3 fatty acids docosahexanoic acid (DHA) and eicosapentaenoic acid (EPA), the so-called “good fats.”

New research evidence suggests that fish oil may also help treat other chronic diseases, especially inflammatory conditions such as rheumatoid arthritis.

According to Medline Plus Encyclopedia,

Rheumatoid arthritis is a form of arthritis that causes pain, inflammation, stiffness and loss of function of the joints. It can affect any joint but is common in the wrist and fingers. More women than men get rheumatoid arthritis. Unlike osteoarthritis, which the common arthritis that comes with old age, rheumatoid arthritis can occur in young adults starting between ages 25 and 55 years. There are different grades of rheumatoid arthritis. It can last only for a short period of time; it can come and go. The severe form can last a lifetime and can lead to disability. Aside from the joints, rheumatoid arthritis can also attack the eyes, mouth, and lungs.

Rheumatoid arthritis is an autoimmune disease, e.g. the body’s immune system attacks its own tissues. I Researchers from the University of London and Harvard Medical School report that consumption of fish oil can reduce inflammation associated with rheumatoid arthritis. Inflammation occurs when the body’s immune system targets healthy tissue by mistake leading to white blood cells sticking to the endothelium (blood vessel lining). The human body converts DHA in the fish oil into Resolvin D2, which has some anti-inflammatory properties. Resolvin D2 causes the endothelial cells to produce small amount of nitric oxide, a chemical signal that discourages the white blood cells from sticking to the endothelium, thus preventing inflammation.

According to study leader Mauro Perretti, Professor of Immunopharmacology at Queen Mary, University of London

“We have known for some time that fish oils can help with conditions like arthritis which are linked to inflammation. What we’ve shown here is how the body processes a particular ingredient of fish oils into the chemical Resolvin D2. This seems to be a very powerful chemical and a small amount can have a large effect.”

The study suggests that fish oil, DHA and Resolvin D2 could form the basis of new treatments, not only for rheumatoid arthritis, but also for other inflammatory diseases. An additional advantage of fish oil is that it is natural, does not come with side effects associated with anti-inflammatory pharmacologic agents such as suppression of the immune system and increased cardiovascular risks.

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Study: magnet therapy does not work for arthritis

Many people wear copper bracelets and magnetic wrist wraps to counteract the pain that comes with arthritis and other musculoskeletal disorders. The practice is called magnet therapy. Magnet therapy come in different forms, e.g. magnetic bracelets and other accessories you can wear on your body but can also include drinking magnetized water. Magnetic therapy is used in a wide range of ailments which include (source: Magnetic Therapy Council UK):

• Arthritis
• Bowel Disorders
• Chronic Fatigue Syndrome
• Diabetes
• Fibromyalgia
• High Blood Pressure
• Insomnia
• Migraine
• Osteoporosis
• Poor Circulation
• Repetitive Strain Injury
• Sciatica
• Spondylosis

Researchers from the University of York finally conducted the first randomised placebo-controlled study on the efficacy of these accessories in the management of pain caused by osteoarthritis.

The researchers looked at 45 people over the age of 50 or more who were diagnosed with osteoarthritis, the most common form of arthritis. Each study participant wore four devices in a random order over a 16-week period – two wrist straps with differing levels of magnetism, a demagnetised wrist strap (placebo) and a copper bracelet. The study found no clinical significant differences between the devices in terms of their effects on pain, stiffness and physical function.

According to study leader Stewart Richmond, a Research Fellow in the Department of Health Sciences at the University of York,

“It appears that any perceived benefit obtained from wearing a magnetic or copper bracelet can be attributed to psychological placebo effects. People tend to buy them when they are in a lot of pain, then when the pain eases off over time they attribute this to the device. However, our findings suggest that such devices have no real advantage over placebo wrist straps that are not magnetic and do not contain copper.”

Previous studies have indicated that the bracelets give some relief for arthritis patients. The results of this study contradict those previous reports. However, this design of this study is more reliable, this being the first randomised placebo-controlled trial for this therapy. However, one of the limitations of the study is the small sample size.

Magnet therapy is one of the leading alternative therapies for arthritis worldwide. It is a rapidly growing business with an estimated worldwide sales of $4 billion US.

According to Stewart

“Although their use is generally harmless, people with osteoarthritis should be especially cautious about spending large sums of money on magnet therapy. Magnets removed from disused speakers are much cheaper, but you would first have to believe that they could work.”

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Cartilage loss: body weight matters

Your knee is a very essential anatomical part in order to be mobile. That is why the bones of the knee are well-protected by the tibio-femoral cartilage. However, the protective cartilage sometimes gets damaged due to a wide range of factors, leading to pain, loss of mobility and even disability. Cartilage damage can lead to osteoarthritis, a progressive and painful disease caused by breakdown of the cartilage. It is the most common form of arthritis, afflicting approximately 27 million Americans.

According to lead researcher Dr. Frank Roemer

“Osteoarthritis is a slowly progressive disorder, but a minority of patients with hardly any osteoarthritis at first diagnosis exhibit fast disease progression. So we set out to identify baseline risk factors that might predict rapid cartilage loss in patients with early knee osteoarthritis or at high risk for the disease.”

The researchers looked at 336 people with 347 osteoarthritic knees. The majority of the study participants were women (65.2%), with an average age of 61.2 years and an average body mass index (BMI) of 29.5. The participants were followed up for 30 months. During this period, cartilage loss was monitored using whole organ magnetic resonance imaging. The results showed that

• 20.2% of participants had slow cartilage loss during the follow-up period
• 5.8% experienced a rapid rate of cartilage loss.

The researchers also identified the top risk factors that might influence the rate of cartilage loss, namely:

• preexisting cartilage damage at baseline
• evidence of tear or injury to the meniscus (the cartilage that cushions the knee joint)
• high BMI
• evidence of inflammation in the synovitis which lines the joints.

Of these, the high BMI is the only modifiable factor. Age, sex and ethnicity don’t seem to play a role in cartilage loss.

The rate of cartilage loss increased with increasing BMI. BMI is the ratio of body weight to height and a range of 18.5 to 25 is considered normal. BMI values above this range indicate being overweight or obesity. For every one unit increase in BMI, the likelihood of rapid cartilage loss increased by 11%

Dr. Roemer continues

“As obesity is one of the few established risk factors for osteoarthritis, it is not surprising that obesity may also precede and predict rapid cartilage loss. Weight loss is probably the most important factor to slow disease progression.”

Photo credit: stock.xchng

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Osteoarthritis in canines: biomarker research gives hope to dog owners

It is not only humans who suffer from osteoarthritis. Animals such as horses and dogs can have it as well. Osteoarthritis is a disease characterized by degradation of the articular cartilage, that results in pain, inflammation and loss of motion in the joint.

And like humans, animals also suffer from pain and restricted mobility that the disease brings.

Researchers at the University of Missouri have been searching for a feasible biomarker for risk of developing osteoarthritis and they might just have found one that works for dogs as well. According to James Cook, professor of veterinary medicine and surgery, and the William & Kathryn Allen Distinguished Professor in Orthopedic Surgery

“By developing methods for earlier diagnosis of osteoarthritis, prevention or even curative treatment strategies to manage the disease become more realistic. Biomarkers could detect the disease before pain and swelling occurs, and owners could take preventative measures, such as modifying activities or diet, helping their pets lose weight and strengthen their joints, to reduce the likelihood of their dogs developing osteoarthritis.”

The researchers looked for potential biomarkers in the synovial fluid, the fluid that lubricates the joints. It is believed that the synovial fluid responds rapidly to damage to the joints. The By taking samples from dogs, UM researchers found that the quantity and quality of synovial fluid exhibited some marked changes in canine patients with injured stifle joints. This is the joint in the hind limbs of dogs that is the equivalent joint to the human knee.

“At the MU Comparative Orthopaedic Laboratory, we are particularly interested in identification and validation of biomarkers that can detect early stages of osteoarthritis to provide accurate diagnostic and prognostic information prior to the onset of clinical disease for people and for pets,” Cook said. “Our team, led by Drs. Kuroki, Stoker and Garner, is making tremendous progress in developing simple tests on blood, urine and synovial fluid that show great promise for helping us diagnose impending osteoarthritis before it is too late to help the patient in the most effective manner.”

Like in humans, osteoarthritis in dogs is associated with age. It is estimated that 20% of middle-aged dogs and 90%of older dogs have osteoarthritis in one or more joints. In humans, the incidence is even much higher.

Photo credit: stock.xchng

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A therapy to get osteoarthritis patients moving

Physical exercise is essential in maintaining joint health and in managing symptoms of osteoarthritis. But it doesn’t feel like it, as many arthritis patients would attest, making performance of simple daily activities challenging, much less compliance with prescribed exercise routines.

But a new type of therapy, the so-called activity strategy training might just be the help that patients with osteoarthritis of the hip and knee.

This is based on a study conducted by researchers at the University of Michigan Health System.

Taught by occupational therapists, this structured rehabilitation program is designed to educate patients about joint protection, proper body mechanics, activity pacing, and environmental barriers. For example, patients with joint pain caused by osteoarthritis learn techniques for walking around the house or outdoors, or even getting in and out of a car.

The study compared two strategies: the commonly prescribed regular exercise and health education sessions vs the activity strategy training (AST) plus regular exercise. The outcomes showed that AST was more effective in increasing and maintaining physical activity in osteoarthritis patients. The difference between the two strategies is probably that AST is more customized to the patients’ needs while structured exercise is not. Furthermore, AST addresses barriers to physical activity that may be specific to certain communities or environment, such as those found in senior homes, for example.

Osteoarthritis is “a degenerative disease that causes the breakdown of the cartilage in joints. Activity strategy training, however, is not commonly prescribed to patients with hip or knee osteoarthritis… Most physical activity programs for these patients only offer structured exercise, which has been shown to have short-term positive effects on arthritis pain and physical disability. But these effects usually fade soon after participation in the program ends.”

The researchers went on to urge osteoarthritis patients to take a proactive role in their therapy. According to lead author Susan L. Murphy

“People with osteoarthritis need to be their own agents of change. They can do so much to manage symptoms and stave off functional decline caused by osteoarthritis just by being physically active. The bottom line is to find ways to help people create and maintain these healthy habits.”

 

Photo credit: stock.xchng

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Information On Rheumatoid Arthritis Focuses On Treatment

One of the causes of arthritis is an autoimmune disease that causes the body to go into a self-preservation mode and attack healthy tissues, believing they are a threat to its well-being. While there is no known exact cause of autoimmune deficiencies, information on rheumatoid arthritis points out that some environmental factors may be involved. It is also thought that viruses, bacteria or fungus has some role in its development, information on rheumatoid arthritis targets the treatment more than the cause.

Unlike osteoarthritis, which generally affects older people as a degenerative disease, information on rheumatoid arthritis points out this disease can attack not only the cartilage in the joints, but also the bone structure. When pain usually associated with arthritis is experienced, it is sometimes difficult to pinpoint the exact cause of the pain, but thorough diagnosis by the doctor can determine if is a natural progression of cartilage loss or an internal strike by the body’s immune system that is causing the problem.

The repeated inflammation of bone tissue cause the pain to come and go, making diagnosis difficult. Exploratory x-rays and CAT-scans can help determine the cause. Additionally, information on rheumatoid arthritis suggests that the degeneration it causes is symmetrical, meaning if one hand is affected, the same effect will be experienced in the other hand as well.

No Known Cure For Rheumatoid Arthritis

There is no known treatment to totally stop the progression of this type of infection, but many drug therapies used in the initial stages have been shown to help reduce the frequency of inflammation as well as damage to the joints and other organs. Most of the information on rheumatoid arthritis is aimed at treating the pain and stopping the spread of the inflammation and two different classes of drugs are most often used.

Anti-inflammatory drugs are often used to help reduce the pain in affected joints and to help reduce swelling. Non-steroidal Anti-inflammatory drugs are often used in place of regular aspirin due to the lower dosage requirement to achieve the same effects. Additional information on rheumatoid arthritis accepts the idea that long-term use of long-acting drugs to prevent bone deformity may also be needed.

While the first line drugs work against the inflammation and pain, these second line drugs, which can take months to show signs of working, are the prevent the crippling effects of bone deformity. Newer drug therapies work biologically to halt the progression of inflammation, and are many of the same drugs used to fight the effects of cancer.

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Recognizing Common Arthritis Symptoms

It can be scary going to the doctor, but you can be in and out quicker if you are able to give your doctor accurate descriptions of you problem. Be sure to tell him or her when the problem started and if there are any times the pains seems worse. Also knowing these common arthritis symptoms will make you realize when to make a doctor’s appointment or not. Generally, the earlier your doctor knows about your arthritis symptoms, the earlier you can be accurately diagnosed and get effective treatment.

Joint Pain

Now this is the biggie of arthritis symptoms. Arthritis is an umbrella term for over 100 types of inflammations of the joints. Joints, in this case, do not refer to any herbal smokes, but to the natural hinges of your body. Joints and therefore, joint pain, are in your wrists, ankles, hips, neck, fingers, knees and shoulders. This is usually a pain you’ve never had before while performing tasks that you never before had any problems doing, such as opening a bottle or turning the pages of a book or walking up a flight of stairs.

Joint Stiffness

This is another of the major arthritis symptoms to look out for. Limbs and joints that previously not hurt while moving not only hurt, they refuse to move. This can be varied such as a hand refusing to uncurl from a fist position you made as you slept to not being able to move a leg. You move (or can’t move) more like the Tin Man in The Wizard of Oz before he gets his dose from the oil can. This can get better throughout the day, and often gets worse in the cold.

Physical Joint Changes

These are other common arthritis symptoms, although they do not happen to everyone with the beginnings of arthritis. The painful places of your body become visibly swollen, more red or discolored and very tender, often to the point where the only thing they will tolerate touching them is air.

Other Tips

In order to diagnose you and get you the help you need as quickly as possible, your doctor will also need to know your medical history and the medical histories of your parents and siblings, if possible. If they are willing to talk about it, ask and write down what your parents or sibling remember about when their arthritis started and what type of arthritis it was diagnosed as. Remember to thank them.

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Food For Thought—The Impact Of Your Diet On Arthritis

Everyone knows that a healthy diet is the key to living a healthy life.  However, what many people don’t know is that it can also play a huge role in the risk of developing arthritis.  A person’s diet directly affects their weight and food allergies, both of which are directly related to arthritis.  Eating healthfully is a key way of both preventing and managing arthritis.

Managing Your Weight

One major way that diet is related to arthritis is that it directly affects your body weight.  Body weight is a major risk factor for arthritis.  The risk is quite simple to understand: the more that one weighs, the higher their risk of developing arthritis.  Yet, this phenomenon is not so simple to control in real life.

When someone develops arthritis due to their weight, it puts immense stress on their joints.  This makes it difficult to move and walk, let alone exercise.  Many obese or overweight people who are affected by arthritis often adopt a sedentary lifestyle—and yet, this only makes the problem worse.  The vicious cycle is extremely difficult to deal with.  Osteoarthritis and rheumatoid arthritis patients are commonly affected by this never-ending cycle.

It is more important than ever to monitor your diet if you have arthritis, because having arthritis makes exercise nearly impossible!  You can begin managing your arthritis through a diet by avoiding alcohol, sodium, fat, cholesterol, and sugar.

Allergic Reactions

Another reason to monitor your diet when you have arthritis is because certain foods can trigger arthritis flares.  Certain foods can impact the immune system, and affect the production of anti-inflammatory compounds.  Rashes, hives, and asthma are all allergic reactions that could indicate that you have consumed a food that is also an arthritis flare.

There are several other foods that could possibly cause an arthritis flare or worsen arthritis.  These foods include: red meats, chocolate, additives and preservatives, caffeine, salt, and dairy products.

Tips On What To Eat

If you have arthritis and are trying to manage your diet, there are a few tips that could be of help.  First of all, snack on grapes, pineapples, and other fruits.  Many fruits contain the compound resveratrol, which is known for blocking cell inflammation.  Additionally, eating vegetables, especially broccoli, is known to reduce inflammation.  Fish is also a good choice because it is high in omega-3 fatty acids, which can help to decrease inflammation.

Under Control

For people who suffer from arthritis, diet might seem like an unnecessary thing to worry about.  Yet, the relationship between diet and arthritis is quite clear.  Your diet is a modifiable risk factor for arthritis—and it could be something you need to change.

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B Cells Can Act Independent of T Cells In Autoimmune Diseases

In autoimmune diseases, it has long been believed by scientists that B cells (the source of damaging autoantibodies) are activated only by when stimulated by T cells.

Now, new findings by Yale researchers showed that in systemic autoimmune diseases (such as lupus and rheumatoid arthritis), B cells can be activated even in the absence of T cells — thereby leading to suggested news ways of intervention in tackling the process leading to autoimmune diseases.

Recently this same Yale group along with collaborators at Boston University discovered an unexpected role in autoimmunity of Toll-like receptors, previously thought to be stimulated by molecules expressed on microbial pathogens. Shlomchik and his colleagues showed that they can also recognize and react to “self” molecules, in particular mammalian DNA and RNA. When this occurs, these receptors help activate B cells that make the classical autoantibodies of lupus.

The new Yale study now shows that these signals substitute for T cells in starting the autoimmune process in B cells. The researchers propose that once B cells are activated via Toll-like receptors, they can subsequently recruit T cells and that this can lead to a “vicious cycle” of chronic autoimmune disease in which the two types of cell activate each other.

According to Mark Shlomchik, MD, professor of laboratory medicine and immunobiology at the Yale School of Medicine and senior author of the study:

“The findings were surprising because many scientists believed that B cells remain quiet in autoimmune diseases unless they are stimulated first by T cells.

It became a chicken or egg problem. If cooperation between T and B cells is needed to create an autoimmune disease, who falls off the fence first, and why?”

The findings of the said study may explain why treatments that target T cells fared very poorly while the newer treatments targeted at the B cells are working a lot better.

Here’s a brief explanation how B cells work in the immune system:

B cells react against invading bacteria or viruses by making proteins called antibodies. The antibody made is different for each different bug. The antibody locks onto the surface of the invading bacteria or virus. The invader is then marked with the antibody so that the body knows it is dangerous and it can be killed off.

The B cells are part of the memory of the immune system. The next time the same bug tries to invade, the B cells that make the right antibody are ready for it. They are able to make their antibody more quickly than the first time the bug invaded.

What happens here is that, the treatments to work should be able to intervene in the immune system’s attack to the body’s own tissue.

Read more details from Medical News Today.

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Orthokine Therapy: Long-Term Safe and Effective Against Knee Osteoarthritis

Developed by Düsseldorf orthopaedic surgeon Dr. Peter Wehling and molecular biologist Dr. Julio Reinecke – the orthokine therapy is a treatment by which anti-inflammatory proteins from the patient’s own blood are the ones injected into the arthritic joint.

It is based on an understanding of the biological mechanisms that lead to of osteoarthritis and pain. In osteoarthritis, the body produces interleukin-1 (IL-1), a protein that contributes to the breakdown of cartilage.

To slow down or stop this process, the biological adversary of IL-1, the interleukin-1 receptor antagonist (IL-1Ra), is used. IL-1Ra neutralizes the effect of IL 1, and has anti-inflammatory, analgesic and cartilage-protective effects.

In the Orthokine method, various anti-flammatory proteins and growth factors such as IL-1Ra are obtained from the patient’s own blood and injected back into the affected joint.

Now, results of a two-year study which compared treatments of hyaluronic acid, orthokine and placebo in osteoarthritis of the knee, revealed that orthokine treatment is the safest and most effective treatment. This has been the GOAT study (German Osteoarthritis Trial) conducted by researchers at Heinrich Heine University in Düsseldorf.

They compared the effects of injections of Orthokine, hyaluronic acid and placebo in 310 arthritis patients over a two-year period. Hyaluronic acid, a joint lubricant, is widely used to treat arthritis. Saline was used as the placebo.

Two years after the series of injections, patients treated with Orthokine scored substantially better than those treated with hyaluronic acid or placebo on measures of pain and joint function.

Two years after the initial treatment, 188 of the 310 patients were still reporting improvements with respect to pain and joint function, while 122 had sought other treatments in the meantime such as surgery, injections, medication or acupuncture. The number of patients requiring further treatment was smallest in the Orthokine group.

According to Prof. Peter Wehling, chairman of the board of Orthogen AG and the co-developer of the orthokine therapy:

“The two-year results confirm our previous studies: Orthokine therapy provides long-term relief from pain and joint dysfunction in many patients and does so more effectively than comparable treatments”.

Findings appear in the journal Osteoarthritis and Cartilage. Read more details of this study from
The Medical News Today.

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