Arthritis: when your joints are inflamed

Osteoarthritis strikes nearly 10 per cent of men and 20 per cent of women above the age of 60. For many sufferers, pain is a daily companion that keeps them from living full, active lives.

Approximately 80 per cent of sufferers have limitations in movement, and 25 per cent cannot perform activities of daily living.

Osteoarthritis, or degenerative joint disease, is characterised by the gradual wearing away of cartilage that cushions joints throughout the body. This causes bones to rub against each other, leading to pain, swelling and stiffness of the joints.

This devastating condition is often associated with ageing, injury and obesity. It usually affects the joints that have been continually stressed throughout the years including the hand, wrist, neck, back, knee and hip. Osteoarthritis sufferers often experience pain and stiffness in the morning, but it improves as the day progresses.

Osteoarthritis is already one of the 10 most disabling diseases in the country. Its prevalence is increasing with extended life expectancy, with the greatest disease burden being in places where access to therapies is not readily available.

To address this growing burden, the Osteoarthritis Research Society International recently published new guidelines in the journal, Osteoarthritis and Cartilage. The guidelines highlight the non-surgical management of knee osteoarthritis and the importance of biomechanical interventions, exercise and weight management strategies.

Depending on the severity of the condition, common treatment approaches usually involve over-the-counter and prescription medications. However, these approaches can have side effects that can range from a nuisance to life threatening.

According to the Arthritis Foundation, “Staying physically active and maintaining a healthy weight are key to living well with osteoarthritis. Too little movement can lead to stiffness and weak joints. Losing one pound can take four pounds of pressure off your knee joints.”

Locally, inactivity levels are high, with more than half of adults being insufficiently active. Urbanisation and rapidly growing cities have resulted in increasingly popular sedentary pastimes such as watching television.

Some people with osteoarthritis tend to avoid exercise when they are in pain, or out of fear of worsening the cartilage loss. But research shows that exercise is an integral part of the prevention, maintenance and treatment of osteoarthritis.

The World Health Organisation (WHO) recommends that adults of 65 and above do at least 150 minutes of moderate-intensity aerobic physical activity or do at least 75 minutes of vigorous-intensity aerobic physical activity or an equivalent combination of moderate- and vigorous-intensity activity throughout the week.

Exercise is also an effective weight control mechanism, which can help prevent osteoarthritis.

Strengthening exercises help reduce stress and pain by building muscles and keeping joints flexible and mobile.

Combining regular exercise with a healthy diet can assist weight loss, reduce joint stress, and provide the body with required nutrients for health and healing. Researchers have found vitamins A, C and E to have antioxidant properties that have potential benefits to osteoarthritis sufferers.

According to WHO, there is a threefold increase in risk of progression of osteoarthritis for people in the lower decile of vitamin C and D blood levels.

Citrus fruits are excellent sources of vitamin C but there are many non-citrus sources as well. Examples include papaya, strawberries, pineapple, kiwifruit, cantaloupe, raspberries, blueberries and watermelon.

To get enough vitamin D, it is important to get frequent, short exposure to direct sunlight. Regular short exposure has been found to be much more effective and safer than intermittent longer ones.

As a general rule, older people need more vitamin D than younger people, larger people need more than smaller people, and dark-skinned people need more than fair skinned people.

Dr Cory Couillard is an international health columnist who works in collaboration with the World Health Organisation’s goals of disease prevention