Topics
Weather
Diet
Exercise
Drugs
Q. "What about diet and arthritis?"
A. "Much has been written about the relationship between
what we eat and rheumatic symptoms. Unfortunately we don't yet know quite
as much about this as we would like. There is some evidence that certain
foodstuffs may have a detrimental effect on the symptoms experienced but
the picture is not clear-cut. Carefully conducted studies have shown that
if an extremely simple diet is consumed, then the inflammation of rheumatoid
arthritis improves. However, the diet in question is not one which would
be practical in the long term so this isn't really helpful.
In the case of
inflammatory arthritis, it has been shown that supplementing the diet with
fish oil or evening primrose oil may help, and there are good scientific
reasons for this. This may be an expensive diet and results are not
obtained straight away. The benefit is not usually on a par with that
achieved with effective drug treatment but the treatment is safe. Diet is
important to those who are overweight as this may have a detrimental effect
on weight-bearing joints. Although there are many books and articles
written about special diets, much of what is written is the opinion of the
author and cannot be substantiated by carefully conducted research.
Plausible though the stories may seem, they just don't stand up to close
scrutiny in the majority of cases. However, don't let that put you off
experimenting if you wish because occasionally individuals seem to derive
benefit from dietary change. The important thing is not to deprive
yourself of important nutrients so take professional advice if you are
concerned about this."
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Q. "Does the weather affect arthritis?"
A. "Some sufferers do complain that in certain weather their symptoms improve or deteriorate. The commonest experience is that pain increases when the climate is damp or cold. Studies have shown that there is a relationship between changes in atmospheric pressure and humidity on the one hand and joint pains on the other. Not all sufferers are affected in the same way though.
Quite often, a holiday abroad seems to improve arthritic symptoms. This may be partly due to the weather but relaxation and a break from the normal routine are perhaps more important. Don't emigrate unless you are very sure that it will help and that the medical services in the other country are as good as where you live now!"
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Q. "If I have arthritis should I exercise or will it be harmful?"
A. "The short answer to this is 'no', it won't be harmful. It depends to some extent on the nature of the condition, the joint(s) affected and the type of exercise you are contemplating. Inflamed joints, as in rheumatoid arthritis will tend to become more inflamed if they are exercised so rest is beneficial, at least in the setting of a flare. Against this must be set the detrimental effects of rest, or lack of exercise. For instance, lack of exercise is not good for the skeleton generally in that osteoporosis is more likely to be a problem in the longer term and this is a condition which is more likely anyway in arthritis sufferers. Therefore, although rest is helpful in the short term if joints are inflamed, exercise is beneficial to preserve general fitness, the range of joint movement and also in preserving muscle tone. Healthy strong muscles are essential to protect joints from damage. Certain types of exercise are preferable to others. For instance, if weight-bearing joints are affected, non-weight-bearing exercise is probably better - swimming and cycling are two examples here."
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Q. "Why does my doctor think that anti-inflammatory drugs are a bad idea?"
A. "Anti-inflammatory drugs (NSAIDs) can cause side-effects in some people. Most of the time the side-effects are mild and not serious but occasionally they may be severe and even life-threatening. The most troublesome side-effect is irritation of the lining of the gut, most often the stomach. NSAIDs often have to be taken with food to reduce the harmful effect on the stomach lining. Even so, problems may arise and bleeding or even perforation of the gut may occur. Fortunately such problems are infrequent but your doctor may consider that you are at increased risk for some reason, or else there may be other reasons to suppose that NSAIDs are inappropriate. For instance, you may have had digestive tract problems in the past or else you may have osteoarthritis, in which anti-inflammatory drugs would be expected to be less helpful than in a condition like rheumatoid arthritis. Your doctor will explain whay there is reluctance to give you these drugs if you ask."
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Copyright © Ray Armstrong 1996