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How to Ease Arthritis -- and Stay Active

Dr. Vijay Vad shares tips on exercise, diet and attitude in advance of his new PBS special, 'Active With Arthitis'

By Vijay Vad, M.D. | May 23, 2013
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Vijay Vad, M.D., is a sports medicine specialist at the Hospital for Special Surgery and faculty member at Weill Cornell Medical College in New York City. He is the author of Arthritis Rx: A Cutting-Edge Program for a Pain-Free Life and has hosted two PBS specials.

As a sports medicine specialist, one of the words my boomer patients most fear that I'll utter is "the A word" – arthritis. When these individuals, who for the most part enjoy very active lives, begin to feel pain in their knees, hips, back or big toe, they come in for an exam, hoping that the cause of their pain will be just the temporary result of playing the weekend warrior: too much golf, tennis or running, without stretching or other conditioning.
 
So I ask them:
  • Truthfully, have you had persistent pain in this joint before coming in now?
  • Do you feel some stiffness in the morning?
  • Are you experiencing a loss of normal function, like difficulty with stairs, getting in and out of chairs or tying shoelaces?
  • Are you aware of "crepitus," which is just what it sounds like: a grinding creakiness in your joint? Does it feel like your joint needs a big shot of WD-40?
  • Have you experienced loss of motion, like difficulty putting on socks or undoing your bra or any of those types of things?
  • Have you noticed that your joint has become swollen or does it look like the bones around your joint have become sort of knobby?
 
Most of the time, they answer "yes" to a few of these questions, which are the international guidelines for diagnosing arthritis. And yes, they groan when they hear the verdict. But I am quick to tell them this: Life is a full-contact sport! What you are experiencing is actually normal wear-and-tear. And we are going to work together to achieve the gold standard of arthritis care: Remedies without harm and mobility without pain.
 
(MORE: How Do You Know It's Time for Joint Replacement?)

It's true: With corrections in diet, exercise, supplements and mindset, it's possible to live a full and active life with arthritis. It's possible to manage arthritis without harmful painkillers. I have patients in their 80s who are still running marathons. As my patients' adviser – and now yours, as well – I have developed a three-step regimen to empower you to remain active with arthritis. It takes some discipline, but the payoff is worth it.
 
1. Eat Right What you put in your mouth definitely affects your joints. Obesity is the handmaiden of arthritis. When you take a step – any step – four times your body weight presses down on your hips, knees, back and feet. If you weigh 200 pounds, that's 800 pounds of pressure per inch with every step.
 
So being overweight is a tremendous burden on your joints. But here's some of the best news I can give you – a guaranteed return on investment – for every pound you lose, you've relieved your back of four pounds. If you lose just five pounds, you've taken 20 pounds of pressure off those joints. And a 25-pound-weight loss translates into a 100-pound loss of pressure on the joints that are giving you trouble.

The best way to lose weight is to eat smarter. Your goal is to reduce inflammation and insulin resistance (also known as metabolic syndrome). Even if you increase your caloric intake to 2,000 calories a day, but eat smarter and focus on an anti-inflammatory diet (such foods as blueberries, avocados, fish, whole grains and beans) you'll most likely lose weight. But you must also reduce fatty meats, fried foods and processed sugars as much as possible. You can still indulge, a little – a steak once a week, instead of three, or ice cream once a week instead of every night.
 
(MORE: Your No. 1 Health Enemy May Be Chronic Inflammation)

A diet change can make a huge difference: A patient of mine tried this out, lost 10 pounds in 12 weeks and instantly felt less pain in his joints.
 
2. Keep Moving It may seem counterintuitive to move your joints when they're a source of pain, but that's just what you must do.
 
Here's a fact: As you age, you lose approximately 1 percent of your muscle mass a year. The more you lose, the more strain you put on your joints, because muscles are the joints' primary shock absorbers. But you can slow that muscle loss with simple strength exercises. For example, try 50 single side kicks each day: Stand straight, ideally without holding onto anything. Then, gently, kick your right leg out to the side, your toes pointing straight ahead and your leg a little more than six inches above the ground, and repeat the motion with your left leg
 
The single best exercise you can do, of course, is walking: 30 minutes a day truly keeps the doctor away. Regular walking is an important goal because it actually encourages joint fluid to circulate, delivering nutrients that keep cartilage healthy and vital.
 
(MORE: Fiftysomething Diet: 5 Nutrients You Need Right Now)

If walking is painful, try a stationary bike or aqua-therapy to build strength and endurance. Arthritis Foundation Aquatic Program classes can be found all over the country, including many YMCAs. (Learn more, and find a class in your area, here.) It's extremely effective — and you don't need to know how to swim to take part.
 
3. Supplement Your Diet The third step of my program is taking appropriate doses of clinically proven, properly manufactured supplements. A lot of clinical research has shown their effectiveness, but always check with your personal physician before adding any supplement to your daily regimen. Make sure the products you purchase are from reputable manufacturers who have the Good Manufacturing Practices seal on their labels.

The supplements I recommend to my arthritis patients include:
  • Curcumin I call this 4,000-year-old remedy a super-molecule. It's also the chemical that gives the spice turmeric its yellow color. A daily dose of 1500 mg has been shown to decrease inflammation and insulin resistance. In a clinical trial on knee arthritis, it delivered similar pain relief to ibuprofen. Curcumin is tough to absorb, but now there are lots of highly absorbable forms available. I've found it very useful in treating arthritis of the knees and hips and especially effective for arthritis of the hands and big toes.
  • Boswellia Derived from the boswellia serrata tree. In clinical trials, 1200 mg daily of boswellia has been shown to be superior to a placebo for treating knee arthritis.
  • Vitamin D Vitamin D deficiency is a major epidemic in the Western world. Taking 1000 IU (international units) daily can decrease inflammation. This vital vitamin is also critical in supporting calcium absorption and keeping the bone underneath your cartilage strong and healthy.
  • EFAC This topical cream made of essential fatty-acid complex has a significant anti-inflammatory effect and is able to penetrate the skin's surface to reduce joint pain.
 
Finally, never underestimate the power of your mind on your journey to conquer arthritis. If you make a conscious effort to become an educated patient, and commit to this plan, you will not only be able to remain active with arthritis but will also stay fit and healthy for a lifetime.

Dr. Vijay Vad's new PBS special, Active With Arthritis, will appear on PBS stations nationwide starting on June 1, 2013. Please check local listings for air times in your area.