When patients find out they have arthritis, they frequently ask me what causes it and if there are any treatments that do not involve surgery or prescription medicines. First, as far as what causes arthritis, there is no one answer. Wear-and-tear arthritis, or osteoarthritis, is caused by a combination of things, including nutrition, trauma, genetics and endocrine abnormalities.
As far as what treatment works, it varies from individual to individual. Because there are many causes, treatment that works in one individual patient may not be as successful for others.
Arthritis is a progressive disease, meaning the disease itself has the tendency to worsen over time. But that rate of progression varies greatly among individuals. What is sometimes frustrating to a patient is that there is no miracle cure. Treatment options affect each individual differently, and sometimes trial-and-error is the best way to find manageable relief.
In medicine, in order for physicians to feel that a treatment works, we like to have a well-done double-blind study. In order for researchers to conclusively find a treatment that works, double blind studies must be conducted. These are scientific studies in which at least two separate groups are given an experimental treatment or procedure at different times, with neither group aware of when that treatment or procedure was given. Ideally, we’d like to have the study repeated by another group of researchers just to make sure there is no possible bias.
In a double-blind study, one group receives a drug and the other a placebo (sugar pill), with neither the subjects nor researchers knowing who is receiving which. It is sometimes difficult to recruit patients for a study such as this since they know there is only a 50 percent chance of receiving the actual drug. But only when we have that control group can we safely and competently report that a drug is working, versus the possibility that the symptoms have diminished or decreased temporarily.
When these double-blind studies are performed and show a difference in outcome between treatment with the drugs versus the placebo, we can confidently tell patients whether a procedure or particular drug works to decrease the symptoms associated with arthritis. Without this type of study, we wouldn’t know whether a treatment is actually successful in decreasing pain of arthritis or if it is the disease waxing or waning that causes relief. It could also be the placebo effect, which can occur with any type of treatment.
Unfortunately, in the arthritis field, there are many claims of successful treatments with various nutritional supplements, over-the-counter medications and/or magnets, crystals, etc., but most of these have never undergone the rigid examination that a double-blind study requires. It is not to say these forms of treatment do not work, but there is no way we can know conclusively whether this is successful or not unless studies are done. Unfortunately, to carry out these studies is both time consuming and expensive. Thus, claims are made for many arthritis treatments without studies being done.
As far as dietary or nutritional supplements go, the only ones that have been proven successful are glucosamine and chondroiten. It has been shown in well-performed double-blind studies that they can definitely decrease the symptoms of osteoarthritis. Approximately 50 percent of patients taking these supplements feel they are worthwhile and decrease pain significantly more than patients taking an unknown control or sugar pill. They are definitely successful in many, but not all, patients who have arthritis.
Activity Modification and Weight Loss
There are things patients can do themselves to help alleviate the discomfort of arthritis. One is activity modification. High-impact sports, such as jogging, basketball or some types of aerobics, have a tendency to put pressure on the joints and hasten the progression of the disease. Engaging in lower-impact activities, such as walking, working with light weights or swimming, strengthen the area without adding stress to the joints. Exercise helps stimulate functioning cartilage cells, which can decrease pain. In addition, the natural lubricating fluid in your joints nourish the cartilage, a process encouraged by exercise.
Last, but not least, maintaining a normal weight is another way to help ward off pain. The heavier you are, the more weight your joints have to bear, and the less mobility you will have as a result. Following a healthy eating plan and exercising regularly will not only help you shed pounds, but will also help to alleviate joint pressure and pain.
Changes in diet and exercise can be safely tried by patients on their own to see if they can decrease the symptoms associated with arthritis. In many patients, especially early on, these changes may be successful in returning you to pain-free activity and getting you back to the life you love. However, some patients, even with these activity modifications, exercise programs and dietary plans, will still have pain that slows down their return to functioning normally. If these initial measures do not give you the relief you need, your orthopedist or healthcare provider will be able to advise you on other things to try. TPW