Painful joints afflict around 13 million people in the UK, according to the Arthritis Research Council. In fact, so common is the condition, that many people think joint problems are inevitable.

Arthritis is neither an inherited condition nor inevitable with age. In fact, joint health is more to do with our diet (nurture) than our genes (nature). Arthritis is an inflammatory condition linked to toxic free radicals and although conventional treatments, such as non-steroidal anti-inflammatory drugs (NSAIDs), bring symptomatic relief, they do not reverse arthritic pathology and are common causes of stomach irritation and bleeding. For healthy joints we need to eat the right foods and to exercise regularly to conserve mobility¹.

DIET

Shown below are the five elements of a healthy diet. Two of these are particularly important to reduce the body’s inflammatory tendency and prevent age-related joint problems:

1. Antioxidants (from fruit and vegetables) to neutralise free radicals. Fruit and vegetables provide us with vitamin C plus a whole armoury of other antioxidants, such as the carotenoids and flavonoids, which work together as a network to tackle toxic free radicals.
2. Balance of the omega 6:3 ratio of essential fatty acids. The importance of the omega 3 fatty acids in heart, brain and joint health cannot be overstated, so I will be brief. If the intake of the seed oils, rich in omega 6 fatty acids is high compared with that of omega 3, then inflammation often results. Oils rich in omega 6 fatty acids include sunflower, corn (maize), grape seed and safflower. Choose instead oils that are rich in monounsaturated fats, such as olive oil, rapeseed, avocado, almond, and most nut oils. These are low in omega 6 essential fatty acids and are therefore recommended to replace the omega 6-rich oils.

The five elements of a healthy diet:

1. 5 portions of fruit and vegetables per day.
2. 3 portions of whole-grain products per day.
3. 3 portions of dairy products per day.
4. A balance of essential oils; two-three portions of oily fish per week, olive oil and olive oil products instead of sunflower oil and products derived from it.
5. Plenty of fluid.

SUPPLEMENTS:

OMEGA 3 AND ANTIOXIDANTS

Even if you regularly eat oily fish, taking a supplement of omega 3 fish oil is recommended if you are concerned about joint health. Vegetarians can take flaxseed oil, from which the body synthesises EPA (one of two omega 3 fatty acids required by it) and they can now get DHA supplements (the other omega 3 fatty acid required) which is extracted from algae. People with arthritis or joint problems who do not eat enough fruit and vegetables should also take extra vitamin C.

GLUCOSAMINE

These days, it is rare to find any practitioner – orthodox or holistic – who does not recommend glucosamine to a patient with arthritis, because the evidence for its effectiveness is overwhelming². Glucosamine is a metabolite, made in the body, but as we get older, less is produced and as a result, joint health suffers. As scientific evidence from recent clinical trials also supports supplementary chondroitin for joint health, there is an added benefit from taking a supplement of glucosamine plus chondroitin.

HERBAL STRATEGIES

Bromelain comes from the stem of the pineapple plant and contains enzymes with anti-inflammatory effects, which are absorbed into the bloodstream.

A few years ago, along with colleagues at the University of Reading, I conducted a clinical trial to investigate the effects of bromelain on acute knee pain³. We recruited 80 subjects who had had knee pain for less than three months. We divided them randomly into two groups to take either one or two tablets of bromelain per day for one month. At the end of that time there was improvement in knee health in both groups, but a stronger effect among those taking two tablets a day. In my opinion, bromelain should be considered as the first-line treatment for acute (sudden) joint pain. It also appears to be very useful for speeding up the healing of muscle damage (tears etc). Turmeric is a strong anti-inflammatory agent and is often included in practitioners’ prescriptions. Ginger may have a role in joint health. Again, it is an anti-inflammatory agent, but, in addition, it improves the circulation – an important consideration in holistic, multi-faceted therapy. Devil’s Claw. This is another anti-inflammatory agent with good research support and it is also a muscle relaxant. It is for this reason that it is often used for back pain, where arthritis can lead to muscle spasm. (Herbal practitioners often use Devil’s Claw in prescriptions for both osteo and rheumatoid arthritis, irrespective of location in the body). While a herbal practitioner would use a mixture of antiinflammatory herbs for treating arthritis⁴, in many cases, preparations of single herbs taken as tablets can be helpful for minor joint problems.

A MULTI-FACETED APPROACH TO REGAINING JOINT HEALTH

From my experience of dealing with patients with osteoarthritis, I can say this – natural medicine works. However, the greater the pathology (ie the worse the condition), the greater the ‘intervention’ needs to be. Arthritis, with sufficient pathology to show up on X-ray, is unlikely to respond to a single supplement. On the contrary, a combination of a change in diet, nutrient supplementation and herbal support is needed. In fact, it never ceases to amaze me what can be achieved through diet and supplementation. A patient came to see me before Christmas with severe debilitating pain in his left hip. An X-ray taken at his local hospital had shown osteoarthritis and he was to be reviewed in five months’ time for hip replacement. He assiduously followed a dietary regime plus multi-nutrient and herbal supplementation and by June reported full hip mobility with only residual pain and indefinite postponement of his hip operation.

¹ Reader’s Digest. (2005) Foods that harm, foods that heal. ISBN 0-276-42673-8.
² Richy F et al. (2003). Arch Intern Med 163,1514.
³ Walker AF et al. (2002). Phytomedicine. 2002, 9:681.
⁴ Mills S, Bone K (2000). Principles and Practice of Phytotherapy: Modern Herbal Medicine. ISBN 0-443-06016-9.

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