The three best berries to help alleviate join pain and arthritis symptoms

From express.co.uk

ARTHRITIS has no cure, but pain and symptoms of the condition can be alleviated by including certain foods in your diet that contain anti-inflammatory and antioxidant properties. Three berries have particularly high levels of these qualities.

Arthritis is a common condition causing pain, stiffness and inflammation of the joints. There is currently no cure for arthritis, meaning it is generally regarded as a long-term condition. However, symptoms can be improved by making certain dietary changes, such as eating foods with anti-inflammatory and antioxidant properties. Including these three tasty berries in your diet could help to relieve pain and inflammation associated with arthritis:

Red raspberries
Red raspberries are very high in a flavonoid called anthocyanin.
Flavonoids are plant metabolites that can promote healthy blood vessels and have antioxidant and anti-inflammatory effects.
Red raspberries are also rich in vitamin C, which has been shower to lower the risk of gout, high blood pressure and cholesterol.
Studies in animals have shown extracts from red raspberries reduce inflammation and osteoarthritis symptoms.
“Other research shows the fruit’s bioactive compounds lower system-wide inflammation and, when a regular part of the diet, help prevent a number of chronic conditions, such as heart disease, stroke and type 2 diabetes,” said the Arthritis Foundation.

                      Raspberries and strawberries are high in vitamin C (Image: Getty Images)

                                        

Strawberries

Strawberries are naturally low in sugar and, perhaps surprisingly, have more vitamin C per serving than an orange.
According to the Arthritis Foundation, a study of women who ate 16 or more strawberries a week had lower C-reactive protein.
C-reactive protein is a protein found in blood plasma, whose levels rise in response to inflammation.
Strawberries also contain anthocyanin, providing anti-inflammatory and antioxidant benefits.

Tart cherries
Tart cherries contain anthocyanin, which gives the fruit its rich red colour. Sweet cherries, in contrast, are typically a darker purple colour.
According to the Arthritis Foundation, some researchers have compared the effects of tart cherries to non-steroidal anti-inflammatory drugs.
“Studies, which often use the concentrated juice of Montmorency cherries, have found tart cherries may relieve joint pain in people with osteoarthritis and lower the risk of flares in those with gout,” said the Arthritis Foundation.
“Many berries are loaded with antioxidants, ascorbic acid (a form of vitamin C) and anthocyanins and carotenoids, which give soft berries their deep colours.“
“These compounds help rid the body of free radicals that promote inflammation.”

                                     Tart cherries contain anthocyanin (Image: Getty Images)

https://www.express.co.uk/life-style/health/1106065/arthritis-rheumatoid-arthritis-pain-symptoms-knee-berries

Arthritis sufferer Tom could hardly walk for the bus - now he's running a marathon

From thisiswiltshire.co.uk/news

TOM Jones used to struggle to walk to the bus stop due to his rheumatoid arthritis, but now he plans to run the London marathon.
Tom from Blunsdon was diagnosed with the condition aged just 21 and said it badly affected his usually active life. “I’ve always been into sports, I have a black belt and enjoy playing tennis, but about three and a half years ago I started having aches and pains in my fingers and toes.
“It was really bad acute pain, especially in the morning when it was cold. So I ended up going to my GP and they thought it was gout. But it took about six months before a diagnosis was made and within that time, the pain I was feeling was getting worse and worse.

He added: “At the time I was living closer to work so I was getting the bus everyday and the fifteen minute walk to the bus stop was excruciating. I was in quite a lot of pain so it was a sense of relief that we finally knew what it was and that it is a recognised condition. It is incredibly unusual for a young person to get it, so it was quite a shock at 21 years old to be told you have arthritis. “Before this all happened I was running twice a week, playing sports and keeping active but after that it all kind of disappeared, I didn’t imagine I’d be able to do any of that anymore. It took about a year for the medication to start working and subdue the pain enough for me to go sit on a bike in the gym for 20 minutes.
It affected him mentally: “The most noticeable thing for me was my confidence, it was like taking away a part of my identity, I felt like I couldn’t talk about sport or exercise with my friends and colleagues at work. It was a huge knock for me to be diagnosed because I was so active and I felt my body was giving up on me. I got really down about it."

But now Tom is training for next month's marathon. “It happened over a few months. The drugs were working better and I was only experiencing the pain in the mornings or if I’d had a few drinks the night before. So I decided to get out there and started doing some park runs. Obviously I was no where near as fast as I was but it was fun.

“Mentally it was really hard because over time this constant pain really gets to you, I did struggle in the morning to get up and train. But I really wanted to set myself a goal to prove to myself that I can actually commit to the training and get my body back into shape while also doing it for my mental wellbeing as well.
“If this was ten years ago I’d probably be sitting at home on the dole because of the pain, it is only really now that there has been an advancement in medication to help treat people with the condition. That is why I’m running for Versus Arthritis because they are leading in funding the research.”

https://www.thisiswiltshire.co.uk/news/17524361.arthritis-sufferer-tom-could-hardly-walk-for-the-bus-now-hes-running-a-marathon/

How to Deal With Arthritis in the Hands

From usnews.com

Arthritis in the hands has many potential causes and levels of severity. But the outcome is often the same, no matter what the trigger or stage of your life. “People of all ages with hand arthritis have difficulty with daily activities like opening doors, shaking hands, typing or writing. It limits what they can do day to day,” says Dr. Jonathan Samuels, a rheumatologist with NYU Langone Health and associate professor at the New York University School of Medicine.

Osteoarthritis

Osteoarthritis typically strikes with age and is by far the most common type of hand arthritis. Research suggests that about 40 percent of adults in the U.S. will have osteoarthritis in at least one hand by age 85. Samuels says it’s also common for signs of arthritis in the hands to appear as early as your 40s.

Osteoarthritis involves a gradual wearing away of cartilage in the joints. With cartilage damaged, the bones in the joints may rub against each other, causing various symptoms of arthritis in the hands such as:

• Pain.
• Swelling.
• Stiffness.
• Deformities and angling of some joints.
• Trouble gripping objects.
• Clicking, popping or grinding sounds when you move the joint.

We don’t know exactly what causes osteoarthritis. “Repetitive use like knitting puts stress across the joint more than you’d expect. So overuse may be one cause. Other risk factors include genetic predisposition, a family history of osteoarthritis and trauma. If you’ve had any prior injury affecting a joint, you’re predisposed to osteoarthritis,” says Dr. Richard Silver, a rheumatologist and distinguished university professor at the Medical University of South Carolina.

Inflammatory Arthritis

Inflammatory arthritis refers to joint inflammation caused by a glitch in the immune system. Immune cells mistakenly attack a particular part of the body, causing damage and other problems beyond the joints.

For example, in rheumatoid arthritis, which affects about 1 percent of the population worldwide (mostly women), the body attacks the lining of the joints, or synovium, and can damage the underlying cartilage and bones.

Other types of inflammatory conditions that can affect the hands include:

• Psoriatic arthritis: an attack on the joints and skin.
• Lupus: an attack on the joints, internal organs and skin.

Like osteoarthritis, inflammatory conditions produce symptoms of arthritis in the hands that include pain, swelling, stiffness and trouble gripping objects.

However, signs of arthritis in the hands from inflammatory conditions are often accompanied by other symptoms, such as:

• Symmetric involvement. Inflammatory diseases such as rheumatoid arthritis typically strike both sides of the body symmetrically – as opposed to osteoarthritis, which may affect just one side – so both hands (and other joints) are affected by arthritis at the same time.
• Extreme fatigue. You may experience a debilitating fatigue that keeps you from your daily activities or work.
• Inflammation in other joints. Rheumatoid arthritis, for example, can also strike the feet, wrists, elbows, knees and ankles.

Because inflammatory conditions can arrive at most any age, people with these diseases may wind up with arthritis in the hands early in life.

Distinguishing the Difference

Doctors can often tell the difference between osteoarthritis and inflammatory arthritis by the pattern of joint involvement. “For example, if you have bony enlargement of the joints, particularly the distal joints (at the end of the fingers) and proximal joints (in the middle of the fingers) but the large knuckles are spared, that would be suggestive of osteoarthritis,” Silver explains. “In rheumatoid arthritis, the big knuckles and the proximal joints are targets. And it’s spongy swelling, not necessarily a bony swelling.”

Other ways doctors discern a difference: the time of day you experience signs of arthritis in the hands. “Pain and stiffness in the hand that lasts in the morning and gets better with use implies an inflammatory process, such as rheumatoid arthritis,” Silver notes. “If there is not a lot of stiffness in the morning but pain gets worse during the day with use, that would imply a mechanical or degenerative process like osteoarthritis.”

Diagnosing Hand Arthritis

Both Samuels and Silver suggest seeking a medical evaluation when symptoms of arthritis in the hands start to interfere with your day-to-day life.

At the doctor’s office, expect a physical exam and lots of questions about your family history, overall health and any signs of arthritis in the hands that you’ve noticed, as well as questions about the effects that your hand symptoms may be having on your activities of daily living. It is also important to rule out non-articular causes of hand pain, like carpal tunnel syndrome.

Your doctor may also order certain medical tests. “We have helpful blood tests that can often help confirm a diagnosis, and we also rely on different types of imaging,” Samuels says. “Sometimes we have to use ultrasound or an MRI to see inflammation that might not show up on an X-ray.”

Treatment for Arthritis in Hands

Treating an underlying inflammatory condition will go a long way toward reducing symptoms of inflammatory arthritis.

For example, the first line of defence for rheumatoid arthritis is a group of medications called disease-modifying antirheumatic drugs (DMARDs) like methotrexate (Trexall) and leflunomide (Arava). They are used in combination with nonsteroidal anti-inflammatory drugs (NSAIDs such as ibuprofen) and low-dose steroids to reduce inflammation and swelling.

For people whose arthritis does not respond to DMARDs, there are biologic medications such as adalimumab (Humira), etanercept (Enbrel) or abatacept (Orencia). These powerful drugs suppress the immune system. “They are life-changing,” Samuels says. “We see their hands go from claws where they can’t make a fist or open their fingers to playing piano, playing sports and shaking hands without pain. When patients start the medications early, we can prevent damage, and they’re often able to lead fully functional lives.”

Treating Osteoarthritis

There’s little doctors can do for non-inflammatory arthritis in the hands. “Unfortunately, we don’t have a drug that will stop the condition or put it into remission,” Silver says. “Treatment is over-the-counter acetaminophen (Tylenol) or an NSAID, and sometimes a short course of steroid medication.”

However, NSAIDs (both over the counter and prescription strength) are associated with ulcers, stomach bleeding, heart attacks, stroke and kidney failure. Some risks, such as heart attacks, are associated with NSAID use even in the short term. For this reason, doctors recommend infrequent use of the medications. “If they’re going to play golf and know it will exacerbate hand pain, they may be able to take an NSAID in addition to acetaminophen. But you shouldn’t take it every day,” Silver warns.

There has been increasing use of prescription topical NSAIDs in treatment of hand osteoarthritis. But your doctor should supervise use of the medication.

Home Remedies for Arthritis in Hands

The best pill-free treatment for arthritis in hands depends on your symptoms. If you have pain or stiffness, you may benefit from heat therapy (to relax muscles and tendons) such as:

• A paraffin wax bath for the hands.
• Heating pads.
• Therapeutic gloves that promote warmth.

For inflammation, cold therapy (using ice packs) is more appropriate.

Hand exercises for arthritis may help to strengthen the muscles (and your grip) and improve your range of motion. An occupational therapist can help with that and also give you shortcuts to modify activities (such as opening a jar) so you can get through your day.

There’s no conclusive evidence that taking dietary supplements such as chondroitin and glucosamine will help treat osteoarthritis. But doctors say it won’t hurt to give them a try.

And one of the best approaches is getting medical advice as soon as you realize that symptoms are becoming a problem. “Don’t wait,” Samuels advises. “Get help earlier, before damage is done."

https://health.usnews.com/conditions/arthritis/managing-arthritis-in-hands

5 Cutting-Edge Arthritis Treatments All Runners Should Know About

From runnersworld.com

When nothing else works, one of these up-and-coming therapies could.

Running doesn’t cause arthritis. Really: A study published just last year in the Journal of Bone and Joint Surgery found that veteran marathoners had about half as much arthritis as their non-running counterparts.

But the population is far from immune from the condition that’s marked by joint pain, inflammation, and a gradual wearing down of cartilage (the smooth connective tissue that protects your joints). “Runners get up to five times their body weight of force through their joints with each step,” says Florida podiatrist and podiatric surgeon Adam Perler, D.P.M. “This adds up to over two tons of accumulative pressure each day exerted on normal functioning joints.” And that’s just part of the reason we pavement pounders can wind up with an arthritis diagnosis—injury, genetics (some people are simply born with more durable cartilage), and alignment issues can also play a role in arthritis.

If you already suffer from arthritis, then you know the symptoms all too well: swollen, stiff, or painful joints first thing in the morning or after a run, limited range of motion, or even ‘locking’ or ‘catching’ in the joint. It’s only natural to look for a sustainable solution, but too often, they’re hard to come by. “Cartilage is produced by cells called chondrocytes but is not easily replaced once it is damaged,” says Perler.

Appropriately strength training the muscles around your joints, having the right shoes, and being properly aligned (if your pelvis isn’t level when you walk, or you tip during a single-leg squat, you could be overloading one side of your body putting unnecessary stress on a joint) are all good first-line defence mechanisms.

You also don’t necessarily have to give up running. Jordan Metzl, M.D., sports medicine physician at Hospital for Special Surgery, finds that many of his patients who suffer from arthritis (everything from arthritic ankles to spines) but also find a healthy way to maintain daily exercise including running, have an easier time managing the painful symptoms of arthritis. “There’s evidence that running is anti-inflammatory on the cellular level: It reduces the symptoms of osteoarthritis, aids with joint mobility, and also helps activate the muscles around joints,” he says. “All things considered, for most patients with osteoarthritis, running, in combination with a smart program that includes a gradual build in conjunction with strength training, does not have to be off-limits, and it may even help reduce symptoms.”

From there, doctors generally turn toward cortisone injections (which decrease inflammation), hydraulic acid injections (which lubricate the joint), or a procedure called microfracture, where an orthopaedic surgeon creates holes through damaged cartilage so your body can bleed into the area and patch the cartilage with scar tissue (which isn’t nearly as effective as the real stuff).

None are perfect, all are Band-Aid-like treatments that address the symptoms but not the root cause, which is why docs today are also turning patients toward some of the therapies below, hoping further science and research can bring a new wave of healing and even regeneration to runners in pain. Here are five of the latest, cutting-edge arthritis treatments.

A Portable Neuromuscular Stimulator

What it is: A souped-up knee wrap that links to an app, available at the Apple Store or Google Play.

How it works: Put the garment on and use it while doing your strength training or off-the-road gym workouts.

What it looks like now: “There’s good research that demonstrates quadricep strength can decrease pain related to knee osteoarthritis,” says Dominic King, D.O., a sports medicine and interventional orthopaedic physician at the Cleveland Clinic’s Sports Health Centre. “This neuromuscular stimulator can not only strengthen the quadriceps muscle, but it also records your range of motion and has a mobile phone application that can help you track your progress to ensure you’re getting the maximum benefit.”

Where it might go in the future: Sports-specific gear and apps. In the future, you might be able to change the neuromuscular stim or specifications based on your sport. There could be a runner’s app, for example, that’s programmed for your particular form of movement and potential issues, says King.

Regenerative Injectables

What they are: Three main forms of injectables aimed at helping the body self-repair — platelet-rich plasma (PRP) products (blood spun down to platelets and growth factor, important for healing); stem cell therapy (basic cells that can become almost any type of cell); and amniotic-derived tissue (from places such as amniotic fluid or umbilical cords). All can be harvested and injected into an afflicted area.

How they work: They’re aimed at helping the body self-repair. (Stem cells can mature into almost any type of specialty cells, such as those that make up bone, ligament, or cartilage.) So, the hope is that these injectables stimulate cellular healing. “I would always recommend starting with one injection. Typically, if there is no benefit in the short term, there is no need to repeat it,” says Perler. If you do notice a benefit, consider a follow-up injection a few months later, he says.

What they look like now: All therapies are experimental, typically not covered by insurance, and none are FDA-approved for arthritis, says Jonathan Finnoff, D.O., a physiatrist and sports medicine specialist at The Mayo Clinic. In theory, these therapies work—these cells do have healing properties in the body. But the research isn’t there yet (and it’s hard to know what you’re really getting in an injection). There are many unscrupulous characters out there making big claims about success rates, which is actually illegal, says Finnoff. Many stem cell injections might not even have live stem cells in them, he adds.

In a position statement, The American Academy of Orthopaedic Surgeons (AAOS) also says “treatments may lack the demonstrated safety and efficacy of many traditional orthopedic therapeutics.”

The product with the most research behind it is PRP, Finnoff says. “In the majority of people, it reduces symptoms of arthritis and, in general, symptoms improve for about a year then symptoms start to come back,” he says. “Studies that do follow up MRIs haven’t shown any significant change in the volume of cartilage, though, even though we hope it’s been regenerating.” It’s important to do your research on the product being used on you and make sure you go to a reputable physician, says Perler.

Where they might go in the future: More research is needed to reveal if and how these biological tools might work, potentially revealing options where it might be possible to better isolate specific healing molecules or remove some of the factors that may inhibit tissue regeneration.

Cartilage Replacement

What it is: Bio-engineered cartilage.

How it works: Either your own or someone else’s cartilage is implanted into the injured site.

What it looks like now: FDA-approved surgical procedures such as Matrix ACI (MACI) for cartilage defects, which surgically implants your own cartilage (grown in a lab) into the afflicted joint. Other procedures such as De Novo NT implant fresh cartilage pieces from young organ donors, which tend to be more proliferative than adult cartilage into your body. Another promising alternative is ProChondrix CR, says Perler. Harvested cartilage is specially prepared and shaped into round patches, which can then be implanted into an area where damaged cartilage has been surgically removed, he explains. “These patches have been shown to be able to further stimulate the repair and regrowth of new and viable cartilage.”

“The hope and the hype are certainly high,” says King. But there are logistical problems. “The problem is the integration of the new cartilage graft into the underlying bone. It is like a gardener importing delicate and expensive plants, which are doomed to fail unless you’re also able to import the proper soil with key nutritional ingredients that the plant can not only anchor to but thrive in,” says Perler.

“Surgeries, while promising, are also very dependent on the surgeon,” adds King. Make sure to ask questions about how many procedures they have done and what his or her background is.

Where it might go in the future: How do you get cartilage back into the body so that it adheres to the bone? That’s just one of the questions researchers will study more moving forward to hopefully increase the efficacy of these procedures.

Synthetic Implants

What they are: Eraser-like implants designed to separate the bones of the joint so that surfaces don’t rub together.

How it works: Like a replacement for joint cartilage.

What they look like now: Cartiva, artificial cartilage made of materials similar to that used in contact lenses is inserted into the big toe joint to reduce pain and maintain joint motion (it’s one alternative to a fusion).

Where it might go in the future: Perhaps to more joints. Cartiva, for one, is already approved for use in the knee in Europe and The Calypso Knee System, a small device made of cobalt and chromium that can be implanted alongside your knee joint to take pressure off, is being studied at The Ohio State University Wexner Medical Centre. A clinical trial is studying the device’s ability to extend the life of the knee joint potentially delaying or even eliminating the need for knee replacement.

A Disease-Modifying Injection

What it is: A shot in the knee that stops arthritis in its tracks, halting cartilage destruction.

How it works: Someday, you might be able to get the injection (dosing TBD) and stop the disease.

What it looks like now: Researchers in Toronto have honed in on a molecule called microRNA-181a-5p that’s thought to cause the inflammation and cartilage deterioration associated with osteoarthritis—and have tested a blocker that appears to stop the destruction and protect the cartilage (in pre-clinical models of osteoarthritis).

Where it might go in the future: “We have drugs that stop the pain process but no drugs that can stop the disease,” explains Mohit Kapoor, Ph.D., senior author of the study and the Director of Arthritis Research Program at the University Health Network in Toronto. “The way we envision this is if it shows further promise in terms of its ability to stop cartilage degradation and is safe, it’d be a local injection which would be given to patients with knee osteoarthritis.” Researchers are currently working on testing the safety and efficacy of a drug as well as determining the adequate dose and frequency of injections.

https://www.runnersworld.com/health-injuries/a26652330/new-arthritis-treatments/

Avocado seed extract can be the answer to chronic inflammation conditions like cancer, heart disease, arthritis

From economictimes.indiatimes.com

The extract's vibrant colour plays any role in production of pro-inflammatory mediators.

NEW YORK: Researchers have identified that an extract from avocado seeds exhibited anti-inflammatory properties in a laboratory study.

The team, including Joshua Lambert from Penn State, said that it represents a potential source for novel anti-inflammatory compounds that could be developed as a functional food ingredient or pharmaceuticals.

The researchers developed the extract over the last decade as a food colourant and it is not known whether the compounds responsible for the extract's vibrant orange colour play any role in its ability to inhibit the production of pro-inflammatory mediators, said Lambert.

To determine the anti-inflammatory properties of the avocado seed extract, the researchers used cell culture models and enzymes that are important in immune response and inflammatory diseases.

A class of immune cells called macrophages were grown in petri dishes and activated with a pro-inflammatory stimuli in the presence or absence of the avocado seed extract. 

                                                                         Getty Images

The researchers measured the production of important pro-inflammatory mediators and signalling pathways in the cells after treatment with the extract. 

"The next step, before we can draw further conclusions about the anti-inflammatory activity of this avocado seed extract, will be to design animal model studies," Lambert explained.

"The level of activity that we see from the extract is very good. We saw inhibitory activity at concentrations in the low microgram-per-millilitre range, which is an acceptable amount of activity to justify further studies," Lambert added.

The discovery could be important because cancer, cardiovascular diseases, arthritis, colitis and many more serious conditions are associated with chronic inflammation, suggests the study published in the journal Advances in Food Technology and Nutritional Sciences.

https://economictimes.indiatimes.com/magazines/panache/avocado-seed-extract-can-be-the-answer-to-chronic-inflammation-conditions-like-cancer-heart-disease-arthritis/articleshow/68437651.cms

Best supplements for arthritis: The natural compound proven to help stiff joints

From express.co.uk

BEST supplements for arthritis: Painful and inflamed joints can be debilitating and can make carrying out simple, everyday tasks difficult. But keeping your levels topped up of a certain natural compound could help relieve these symptoms.

Arthritis is a common condition which affects more than 10 million people in the UK, according to the NHS. It can affect people of all ages, causing symptoms such as joint pain, tenderness and stiffness, inflammation in and around the joints, restricted movement of the joints, warm, red skin over the affected joint, and weakness and muscle wasting. There’s currently no cure for the condition, but doctors usually recommend medication, physiotherapy and surgery to reduce pain and inflammation. However some experts say keeping your levels topped up with a certain natural compound can offer relief.

A 2015 Cochrane review, which looked at 43 studies involving 9,110 people, found chondroitin could help improve quality of life for people with arthritis.
This included helping with joint stiffness and a slight improvement on the narrowing of joint space that is associated with the condition.
Furthermore, a 2015 study in Scientific Reports found glucosamine (another natural compound found in cartilage) and chondroitin together were more effective at relieving symptoms for people with knee arthritis than taking chondroitin on its own.
Holland & Barrett explains what it is: “Chondroitin is one of the building blocks of cartilage - the tough tissue that acts as a shock absorber around the joints in humans and animals.
“It’s chondroitin’s job to help your cartilage hang on to water - increasing its elasticity.
Chondroitin is also found in tendons, ligaments, bone and skin.”

                                                                    (Image: GETTY)

Chondroitin is available in tablets, capsules and patches, and is often combined with glucosamine.
The National Institute for Care and Excellence (NIC) doesn’t currently recommend chondroitin for the treatment of osteoarthritis.
But if you decide to take it, the high street health store advises: “Recent trials have seen adults take doses of 800-1200mg of chondroitin sulphate per day, often divided into smaller doses.
“But be on the safe side, always follow the recommendations on your product label, and speak to your GP before you start taking chondroitin if you have any questions.”

Another supplement recommended to help relieve painful symptoms of arthritis is turmeric.
Known for its anti-inflammatory properties, taking the orange-coloured spice could be the answer to your painful joint problems.
Arthritis Foundation explains: “Curcumin is the chemical in turmeric that can reduce joint pain and swelling by blocking inflammatory cytokines and enzymes.
“A 2010 clinical trial using a turmeric supplement showed long-term improvement in pain and function in patients with knee osteoarthritis.
“A small 2012 study using a curcmin product, BCM-95, showed more reduced joint pain and swelling in patients with active rheumatoid arthritis when compared to diclofenac sodium.”

https://www.express.co.uk/life-style/health/1100524/best-supplements-arthritis-pain-symptoms-chondroitin-glucosamine

5 Tips for Dealing with Insomnia Caused by Juvenile Arthritis

From juvenilearthritisnews.com

It can be hard to sleep when something is disturbing you. Room temperature, too much light, and sound are all simple things that can make it difficult to sleep. So, it’s no wonder that many people with chronic pain and fatigue suffer from insomnia, affectionately known as “painsomnia.” Kids with juvenile arthritis may find that pain keeps them up at night.
Unfortunately, there’s no cure for insomnia caused by pain. But there are ways to help manage it without having to turn to sleep medicine. Simple things can go a long way to help kids with JA get a good night’s sleep.

Keep a routine

My mum always said children benefit from being kept on a routine. For kids with JA, a consistent bedtime routine can help a lot. Going to bed and waking up at the same time help your child develop a natural sleep cycle. A warm shower, dim lights, and a cuddle can help calm your child, may dull the pain, and will let their body know it’s time to sleep.

Warm up

Many kids with JA benefit from heat therapy, which can be soothing and relieve pain. Warming up their bed with a hot water bottle 10 minutes before bedtime can do wonders for joints (make sure they do not sleep with it). The warmth may help them from becoming too stiff and tempted to get up to stretch. Heated blankets on a timer can also help when it’s time to get up in the morning.

Use weighted or heavy blankets

Weighted blankets are getting a lot of attention lately and for good reason. These comforting blankets help many people get a better night's sleep by providing gentle pressure that helps reduce anxiety and prepare the body to sleep. Some people in the chronic pain community swear by weighted blankets. In my experience, even using a heavy blanket can be helpful.
While it’s not a good option for all, especially those who have joints that are aggravated by touch, some kids may benefit from weighted blankets in a few ways. First, the calming effect helps them relax and feel tired. And second, the pressure can also feel good on tired joints, similar to how compression socks or gloves may relieve pain. I personally get much better sleep when using heavy (not weighted) blankets. And third, they may not experience as much fatigue during the day due to a more peaceful sleep. If you think a weighted blanket may be a good option for your child, talk to their rheumatologist or physical therapist.

Gear up

I swear by compression gloves and socks. Juvenile psoriatic arthritis always caused me a lot of enthesis pain, especially at night. Wearing compression garments helped me cope with the pain, calmed me, and helped swelling stay under control while I slept.
If your child benefits from braces, compression, or other gear during the day, ask their doctor whether it would be OK to use at night. Sleeping in something that helps control the pain will naturally make night-time easier. If it’s not possible, try to find alternatives. For example, a hard brace worn during the day could be swapped for a sleeve at night.

Distraction therapy

Since I was a teenager, I need to listen to boring podcasts or videos to fall asleep during flares. Thinking about the story or topic helps to take my mind off of the pain, and helps me relax. Distraction therapy goes a long way: Listening to an audiobook (preferably not an exciting one), gentle music, or a podcast is an excellent way to help take your mind off the pain as you fall asleep.

Sleepless nights happen

Sometimes you’ll do everything possible but your child still won’t fall asleep. It’s natural and OK. Sometimes fatigue can make you feel a little overtired and make it hard to sleep. Or it hurts too much to fall asleep. Whatever the reason, sleepless nights happen. Try to be patient. It takes a lot of trial and error to find things that work, and what works may depend on whether or not your child is flaring. But focusing on a calming routine and certain tools can make a difference for kids with JA.

https://juvenilearthritisnews.com/2019/03/14/5-tips-insomnia-sleep-disturbances-juvenile-arthritis-heat-therapy/

Hip exercises may improve walking, pain with knee arthritis

From reuters.com

(Reuters Health) - Patients with arthritic knees can add hip-strengthening exercises to their workout to improve the ability to walk and maybe reduce pain, according to a research review.
Based on pooled data from eight clinical trials with a total of 340 patients, the study team concludes in the British Journal of Sports Medicine that hip strengthening exercises involving weights or elastic bands would help the most.

“Despite knowing that exercise is beneficial, what type of exercise should be included in a thorough exercise program remains largely unknown,” said lead author Andrew Hislop of the University of Queensland in Brisbane, Australia.

Most international guidelines recommend exercise in the conservative management of knee osteoarthritis, a bone and cartilage disease that affects one in four people over age 55. However, many doctors don’t follow up on this advice with patients or refer them to the proper physiotherapist for an additional appointment, Hislop noted.
“With a growing population and increasing number of lower limb injuries, there is going to be an ever increasing burden on the health system to manage knee osteoarthritis,” he told Reuters Health by email.

Hislop and colleagues conducted a systematic review and meta-analysis of randomized controlled trials that investigated the effect of adding hip-strengthening exercises to a regimen often prescribed to strengthen the quadriceps muscles at the front of the thigh for people with knee arthritis.
The researchers looked at whether aspects of knee and walking function improved, as well as whether pain and quality of life were affected by the added hip-strengthening routine.

They also evaluated three types of hip exercises to see which had the greatest effect: resistance weight-lifting, functional neuromuscular exercises such as single-leg squats or stepping, and so-called multimodal exercise that combined these two.
Overall, adding hip-strengthening significantly improved walking function, though it did not have a statistically meaningful effect on pain, stair function or the ability to stand from a sitting position.

When researchers looked at individual types of hip exercise, however, they found that resistance exercises in particular were more effective than functional neuromuscular exercises for improving pain and functioning. Multimodal exercise had no added effect.
“Strengthening the hip muscles, particularly the hip abductors, might improve pelvic drop and trunk control, lightening the load on the knee,” Hislop said.
“Many health professionals are concerned only with the site affected by the disease, forgetting the regional consequences of the disease” at the hip or beyond, said Dr. Jamil Natour, chief of rheumatology at the Federal University of Sao Paulo in Brazil, who wasn’t involved in the study.
“We should verify that the ‘normal’ hip of a patient with knee osteoarthritis is evaluated and possibly rehabilitated,” he told Reuters Health by email.

Researchers also want to understand exactly how exercise influences knee osteoarthritis pain. The effect be physical, but could also stem from other factors such as a general improvement in wellbeing, attention from a healthcare professional or a placebo effect.

“Over the last decade or so, many researchers have looked for the optimal exercise program, but unfortunately, without luck,” said Marius Henriksen, head of the Physiotherapy and Biomechanics Research unit at Copenhagen University Hospital in Frederiksberg, Denmark, who wasn’t involved with the study.
“To me, that suggests that the exercise that is effective is the exercise that is being done,” he told Reuters Health by email. “Go out there and exercise and be physically active, and do something that you find fun and meaningful.”

https://www.reuters.com/article/us-health-hipexercise-knee-arthritis/hip-exercises-may-improve-walking-pain-with-knee-arthritis-idUSKCN1QP1VW

11 Reasons Behind Your Ankle Pain (and When to Take It Seriously)

From rd.com/health

Ankle pain can be hard to pin down—from fracture to sprain to strain to arthritis, here’s how to tell what’s hobbling you.

Whether you’re participating in a sport or just going about your every day, more likely than not, you’ll be saddled with ankle pain. According to the National Athletic Trainers Association (NATA), there are about 28,000 ankle injuries in the United States each day. Now, not all require doctor care, but if you’re saddled with ankle pain, here’s what you need to know about the various causes and how to get back on your feet.

It’s a sprain
Ankle sprains are the number one sports injury, says the NATA. When a ligament in the ankle tears, that’s a sprain. If it’s a sprain, you may notice bruising and swelling and the spot may be tender to the touch; the sprain can range from mild to significant, describes the American Academy of Orthopaedic Surgeons (AAOS). Treatment involves RICE (rest, ice, compression, elevation), and in more severe cases, physical therapy or a brace. Follow these first aid steps for a sprained ankle.

It’s a strain
Strains and sprains may sound alike, but they’re different injuries. While a sprain may affect the ligament, a strain is when the muscle tears, explains the NATA. (It may also be a stretch in the muscle or tendon, according to AAOS.) Telling a strain apart from a sprain can be tough. Consider what other symptoms you’re feeling. Along with ankle pain, you may also feel muscle spasms, weakness, swelling, and cramping, says the AAOS. Practice RICE at home to treat a strain.

It’s an injury somewhere else

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While it’s common to assume ankle pain means an ankle injury, it may actually be a problem up the chain, says Selene Parekh, MD, MBA, a foot and ankle orthopedic surgeon at Duke Health. For instance, an irritated nerve in your back or knee can show up as pain with numbness and tingling in your ankle, he says. If you’re dealing with back pain, here are 10 surprising reasons it may hurt.

Your foot’s the problem

Because your ankle sits just above your foot, it makes sense that it can also be the source of ankle pain. One example? “Having really high arches can change the mechanics in your foot, leading to changes in the mechanics in the ankle,” says Dr. Parekh. Being extremely flatfooted can do it, too, and in this case, you may also notice swelling on the inside of your ankle, according to the Mayo Clinic. Custom orthotics or a change in footwear may help, he says.

It’s gout

Gout is a form of inflammatory arthritis: A build-up of uric acid in the blood leads to the formation of crystals in your joints. These crystals can bring on painful “attacks” (they often start in the big toe). As gout progresses, you may also suffer from attacks in other joints, including your ankle. Purine-rich foods—alcohol, fish, shellfish, and organ meats—can make gout attacks more likely. “If you notice that you feel this pain every time you eat red meat or drink beer, tell your doctor, as this is important information that can help them decide if you should be evaluated for gout,” says Dr. Parekh. If you’re diagnosed, medications can help treat and prevent flare-ups.

It’s a fracture

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No one wants to get the news that they broke an ankle. But if your pain kicks in after you fall or hit your ankle on something—and you have swelling and discomfort that won’t go away—you could have a break. See your doctor—you may need an x-ray; in some cases, you may have to wear a boot or cast to protect the bones and allow them to heal.

It’s a stress fracture

Many athletes are accustomed to the pain and discomfort of training—but they still need to listen to the body. “They sometimes don’t recognize that they’re in pain,” says Dr. Parekh. It isn’t until they notice swelling that they go get an MRI, only to be diagnosed with a hairline crack in an ankle bone known as a stress fracture. This is different than a regular break: A stress fracture is an overuse injury caused by repetitive movements, rather than an acute injury. If you work with your doctor to cut back on your activity, your bone will have a chance to heal properly.

It’s arthritis

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If you injure your ankle, you’ll be able to point to the spot that hurts. With chronic conditions like arthritis, the entire joint will be in pain, says Dr. Parekh. Arthritis commonly afflicts foot and ankle joints, says the AAOS, and along with pain, you may also experience stiffness. Watch for the arthritis symptoms that are easy to miss.

It’s osteoarthritis

A form of arthritis, osteoarthritis (OA) means you have damage to the cushiony cartilage in the joint, explains the AAOS. With bone rubbing on bone, the pain can be intense and worsen over time. Lifestyle changes like exercise—it’s true—and losing excess weight can help take stress off of joints, says the Arthritis Foundation.

It’s rheumatoid arthritis

The autoimmune condition often first flares up in the ankle, says the AAOS. Your body’s own immune cells attack parts of the joint, causing inflammation. One reason to suspect rheumatoid arthritis: It will attack both joints at the same time, so your doctor may suspect the condition if you have pain in both ankles. Check out 34 things you should know about arthritis.

It could be an emergency

If your ankle is swollen and you have a fever, it may be an infection, warns FamilyDoctor.org, a website run by the American Academy of Family Physicians. If multiple joints are swollen, doctors may suspect rheumatic fever, a complication from untreated strep throat that can damage your heart, says the Mayo Clinic. Other signs of infection include redness, warmth, and tenderness in the joint; seek help ASAP.

When to call a doc

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Because ankle pain is so common, Dr. Parekh says that doctors don’t see the vast majority of patients; they limp along and treat their pain at home until they feel better. It’s OK to practice RICE and take NSAIDs, he says, but you should see a doc if pain persists. If you have dull, achy pain that lasts for two to four weeks—or a sharp stabbing pain for two to three days—seek medical help. Pain that continues to get worse is another reason to make an appointment.

https://www.rd.com/health/conditions/ankle-pain-reasons/

Should You Try Acupuncture to Treat Arthritis Pain?

From health.usnews.com

About 1 in 4, or more than 54 million, adults in the U.S. have arthritis, according to the Centres for Disease Control and Prevention.

The umbrella term describes various conditions that affect the joints and surrounding tissues. The most common type, osteoarthritis, involves the breakdown of cartilage in joints, such as the hips and knees, and it’s particularly prevalent as people get older.

“Osteoarthritis is a degenerative mechanical condition that causes loss of cartilage resulting often in joint pain and sometimes loss of function,” explains Dr. Charis Meng, a rheumatologist at the Hospital for Special Surgery and Weill Cornell Medicine in New York City. As with many causes of chronic pain, there’s no quick fix.

In some cases, surgery such as knee replacement is recommended to treat advanced osteoarthritis. That’s “probably the closest thing we come to a ‘cure’ quote unquote, because you’re replacing the joint,” Meng says.

Still, she and other experts reiterate that right now there’s no therapy to reverse the cartilage loss that happens inside the knee or another joint with OA. And for many surgery isn’t necessary or recommended, even while joint pain from arthritis may limit function and daily activities and undermine quality of life.

To try to tame that chronic pain and improve function, experts recommend everything from losing weight (to take stress off joints) to exercise to over-the-counter and prescription medication and injections of cortisone in the joints, depending on the individual, to ease discomfort.

In addition, some people turn to acupuncture – a form of traditional Chinese medicine that typically involves practitioners inserting ultra-thin needles into the skin – in an effort to relieve or reduce arthritis pain. “Right now we don’t have a medical cure. So we rely on treatment, and I look at acupuncture as a traditional treatment for osteoarthritis pain,” says Meng, who is certified in acupuncture. “I always make it clear it’s not a cure, because nobody’s replacing the cartilage with acupuncture or anything else for that matter in Western medicine.”

Practitioners say acupuncture may also help to relieve pain from rheumatoid arthritis, in which the body’s immune system “attacks” the joints, causing painful inflammation.

Where many with arthritis use more than one approach to address pain and improve function, Jamie Starkey, manager of the Eastern medicine program and lead acupuncturist at the Cleveland Clinic's Centre for Integrative and Lifestyle Medicine, sees it as complementing other options for treating arthritis. “It really oftentimes does take a multidisciplinary approach to care,” she says.

Acupuncture is a kind of traditional Chinese medicine where practitioners insert ultra-thin needles  into the skin. (Getty Images)

Along those lines, some research provides support for using acupuncture to treat arthritis. In general, the technique has been shown to reduce inflammation, and relieve various forms of chronic pain. Still, there’s also conflicting data, too.

A research review published last year in Evidence-Based Complementary and Alternative Medicine concluded “acupuncture alone or combined with other treatment modalities is beneficial to the clinical conditions of RA (rheumatoid arthritis) without adverse effects reported and can improve function and quality of life and is worth trying.” Another meta-analysis published in The Journal of Pain in 2018 found acupuncture to be effective for treating osteoarthritis pain, among other types of chronic pain, and that the benefits persist over time and pain relief can’t be explained solely by a placebo effect.

But experts reviewing studies on acupuncture to treat arthritis have bemoaned a dearth of high quality research in that area. Further complicating matters is the heterogeneity of acupuncture itself: That is, various practitioners use different techniques, rather than one uniform type of acupuncture being applied.

A 2010 Cochrane review, including studies of people with osteoarthritis in the peripheral joints (knee, hip and hand), found it conferred a small benefit, but owed that was at least partially related to placebo effect. The findings from a 2014 study published in the Journal of the American Medical Association didn’t support the use of acupuncture to relieve moderate or severe knee pain in individuals over 50 (which is typically the result of osteoarthritis). And a 2018 Cochrane review found: “Acupuncture probably has little or no effect in reducing pain or improving function relative to sham acupuncture in people with hip osteoarthritis.”

Despite mixed research results – which have been disputed by some practitioners – acupuncture is widely used to treat chronic pain, and data strongly supports its safety.

Almost anyone can have it done with little risk or discomfort. “If somebody has very limited mobility and has trouble getting onto the table – I have had this happen – maybe acupuncture is not the best thing for them, because they do have to lie still for about 20, 30 minutes,” Meng says. “And some people, if they just have a lot of disabilities and they have trouble doing that, it won’t be a very comfortable experience for them.” One other instance where caution may be advised: “Some people are on blood thinners like warfarin or other anticoagulants, and you do have to be careful with acupuncture,” Meng says. "Because even though the needles are very, very thin, there’s always an increased risk of bleeding when you’re on those type of blood thinners.”

For those who are interested in trying acupuncture to treat arthritis pain, it’s important to seek out a licensed acupuncturist, who is board certified, says Brian Jackson, an acupuncturist in the orthopaedics department at the University of Maryland School of Medicine. Experts also advise not only considering the professional’s education not only in acupuncture generally, but inquiring about the practitioner’s experience treating arthritis pain and other chronic pain. “The majority of our patients are sort of neck and lower back pain patients; and we have pretty good success rates with treating those patients,” Jackson says.

A physician referral is a good place to start to find an acupuncturist – but often that’s not possible (your physician may not have any suggestions on this).

National Certification Commission for Acupuncture and Oriental Medicine, or the NCCAOM, provides an online directory to find a certified acupuncturist in your area. As the non-profit’s website notes, “NCCAOM is the only national organization that validates entry-level competency in the practice of acupuncture and Oriental medicine (AOM) through professional certification.”

Many states require this certification, which involves taking an exam to demonstrate competency in acupuncture, to get licensed. “If you have an acupuncturist working within a hospital system oftentimes we mandate the NCCAOM certification in order to go through our credentialing process,” Starkey says. “So it’s a sure bet that if they have the certification, they’ve at least met minimum standard requirements as far as education and clinical training.”

Besides evaluating the practitioner, you’ll also want to check on insurance coverage. “Acupuncture’s not covered by Medicare, and it’s covered by some commercial insurances, but certainly not all of them,” Meng notes. Starkey adds that increasingly more private insurers are covering it. “I definitely encourage patients to reach out to their insurance company,” she says.

Besides checking on insurance coverage, you’ll want to talk with the acupuncturist about what to expect from treatments, as well. “I would definitely ask the acupuncturist – whoever you see – what the expectation is for the number of treatments and when you should expect a response. It shouldn’t just be endless treatment with no goal in sight,” Meng says. “I use three for my number of how many I’ll try before saying it’s a negative or positive trial. But depending on the person you see, that may vary.” And if you don’t see results with one acupuncturist or one type of acupuncture, that doesn’t mean you won’t – or can’t – from another, say practitioners; so it’s worth exploring your options.

Ultimately, the point is do your due diligence to address arthritis pain, experts say, so that you’re able to find some relief, whether that ultimately means trying – or sticking with – acupuncture or not.

https://health.usnews.com/health-care/patient-advice/articles/2019-03-05/should-i-try-acupuncture-for-arthritis

Rheumatoid arthritis risk lower among smokers who quit

From reuters.com

(Reuters Health) - Adults who quit smoking decades ago may have a lower risk of rheumatoid arthritis than people who gave up cigarettes more recently, a U.S. study suggests.

Smoking has long been linked to an increased risk of rheumatoid arthritis, and quitting can reduce this risk. But the new study offers fresh evidence that years of cessation can pay off more than just a brief period without cigarettes.
“These results provide evidence for those at increased rheumatoid arthritis risk to quit smoking since this may delay or even prevent the onset of rheumatoid arthritis,” said senior study author Dr. Jeffrey Sparks of Brigham and Women’s Hospital and Harvard Medical School in Boston.
Also, Sparks said by email, while quitting smoking is the best way to reduce rheumatoid arthritis risk, cutting back on smoking “should also help lessen the risk.”
Rheumatoid arthritis is an immune disorder that causes debilitating swelling and pain in the joints. It’s less common than osteoarthritis, which happens when cartilage on the ends of bones wears down over time.
Sparks and colleagues examined up to 38 years of data on more than 230,000 women, including 1,528 who developed rheumatoid arthritis.
Compared to women who never smoked, current smokers were 47 percent more likely to develop rheumatoid arthritis, the researchers report in Arthritis Care and Research.

Current smokers were also 67 percent more likely to develop “seropositive” rheumatoid arthritis —when patients have antibodies in their blood that help identify the disease.
Patients with seropositive rheumatoid arthritis tend to have a more severe disease course with more joint deformities, disability, and inflammation outside of the joints.
Compared to women who quit smoking within the previous five years, women who quit at least three decades ago were 37 percent less likely to develop seropositive rheumatoid arthritis.
The current study wasn’t a controlled experiment designed to prove whether or how smoking might cause rheumatoid arthritis. It also wasn’t designed to show if quitting can directly prevent rheumatoid arthritis.
Women in the study were predominantly white and well-educated, and it’s also possible that results might be different for other groups of people, the study authors note. Smoking was also only assessed every two years, and it’s possible the study missed some changes in smoking habits that occurred between assessments.
But the results should still give smokers yet another reason to quit, said Dr. Kaleb Michaud, a researcher at the University of Nebraska Medical Centre in Omaha who wasn’t involved in the study.

“There’s a clear dose-dependency seen between the cumulative amount of smoking and the risks for future rheumatoid arthritis,” Michaud said by email.

“There’s little evidence that smoking cessation reverses rheumatoid arthritis — it’s still incurable and a chronic source of pain and suffering for many people,” Michaud added. “But current smokers could at least reduce this risk by smoking fewer and fewer cigarettes.”

https://www.reuters.com/article/us-health-smoking-arthritis/rheumatoid-arthritis-risk-lower-among-smokers-who-quit-idUSKCN1QI5H9