How to beat arthritis

“The pain passes but the beauty remains.” This was how artist Pierre-Auguste Renoir described the crippling arthritis that plagued him from the age of 47. For the rest of his life, the condition kept him wheelchair bound and deformed his hands, even though he continued to paint slowly and in great pain. Had the French Impressionist been diagnosed in the 21st century and not the late 1800s, his outlook would have been more positive. As our knowledge of arthritis management improves, the condition no longer automatically means a life sentence of unending discomfort and disability.

Arthritis is an umbrella term for any number of disorders that cause inflammation of the joints. The condition leads to chronic pain, swelling and stiffness, most commonly in the fingers, toes, wrists, knees, elbows, hips and ankles. Arthritis may prove a small ripple in a person’s life, making it harder to get out of bed, or a major disruption, causing inability to walk or write. According to Arthritis Australia, the disease affects one in six people (or around 3.1 million Australians). More women (roughly 60 per cent) are affected than men.

A disease with many faces

There are more than 100 different forms of arthritis, including lupus (which causes inflamed connective tissue) and gout (which occurs when uric acid accumulates in joints). Most Australians are diagnosed with osteoarthritis (OA), which affects about 75 per cent of arthritis sufferers. OA results when the wear and tear of age erodes the cushion of cartilage that provides a smooth protective covering between the bones in a joint. It usually occurs in people aged 50 and over. Risk factors include a family history, being overweight, getting older, chronic stress across joints (such as the big toe joint in people who wear tight shoes) or joint trauma (for example, sports injuries). The first signs of OA are usually stiffness, pain and tenderness in weight-bearing joints such as the hips, knees, lower spine, feet and hands.

Rheumatoid arthritis (RA), which affects three times as many women as men, can be far more debilitating than OA. It occurs in around 1 per cent of the population, usually between the ages of 25 and 45. RA is caused by an autoimmune disorder. This means the body attacks its own tissues lining the joints, inflaming the synovium, which contains a thick synovial fluid, which looks a little like egg white and lubricates the joint. In RA, the inflammation that occurs around joints causes pain, heat and swelling, sometimes accompanied by weight loss, fever, lethargy and painless, hard, round nodules under the skin.

Joint protection

Exercise is the best way to keep joints nourished. It keeps synovial fluid circulating around the joint and that fluid also supplies nutrients to the cartilage. If you suffer from arthritis and don’t exercise, your muscles weaken to the point where everyday activities become harder because joints stiffen. In the long term, this can speed up the rate of deterioration. However, people without arthritis should also aim to keep joints well lubricated through regular movement throughout their life. Good exercises include swimming (which is also gentle on joints), strengthening with weights, walking, tennis and golf (for muscle strength and improving balance) and tai chi, which improves muscle strength and flexibility as well as balance.

Once arthritis is diagnosed, treatment involves medication to alleviate pain, reduce inflammation and prevent joint damage. Surgery may sometimes be needed to correct joint deformity, reconstruct a diseased joint or completely replace a joint with a prosthesis (such as a new hip). A minor operation called arthroscopy can also provide some relief by smoothing over or removing ragged joint edges, debris and loose material in the joint. Prevention of further damage may involve splinting to stabilise joints (the simplest example is a knee bandage) and orthotics (shoe inserts) to correct weight distribution.

It’s not clear what sets off the inflammation that causes arthritis and no one has yet found a cure for the condition. However, contributing factors may include genetic predisposition, environmental causes such as diet or stress and random triggers such as infection or psychological stress (for example, bereavement). In roughly two-thirds of patients, arthritis will prove temporary and go away permanently. In one-third, the condition is permanent. Some will go in and out of remission. Many natural health practitioners report great improvement with changes in diet such as eliminating dairy and gluten.

Though there is no foolproof way to protect yourself against developing arthritis, you can lessen the risks. A lifestyle that minimises stress and distress appears to reduce internal inflammation. Other important preventive strategies include maintaining a healthy weight, following a healthy diet, taking precautions to reduce repetitive strain injuries at work, warming up before regular exercise and ensuring that all joint injuries are properly and promptly treated.