Eighty percent of North Americans have X-ray evidence of osteoarthritis by age 65, and 60 percent have significant joint pain. Osteoarthritis is the most common type of joint pain and since there is no effective treatment, doctors usually just prescribe medications to reduce the pain. When pain medication is not enough, you may be advised to have the joint replaced. More than 700,000 people in North America have their knees replaced each year, mostly because of osteoarthritis.

Researchers at Surrey University in England reviewed 68 studies on the effects of diet on osteoarthritis and found that osteoarthritis is associated with everything that increases inflammation, and that the joint pain can be reduced by everything associated with the control of inflammation (Rheumatology, May 1, 2018;57(suppl_4):iv61–iv74). Steps recommended to reduce inflammation include:
• A diet high in omega-3 oils (seafood, seeds), leafy green vegetables (kale, spinach, parsley) and other anti-inflammatory foods
• Weight reduction in people who are overweight (but not in skinny people)
• Strengthening and flexibility exercises (Arthritis Care & Research, Dec 5, 2017;69(12)) and aerobic exercise (The Knee, January 18, 2018)
• Avoiding smoke
• Restricting alcohol

What Causes Inflammation?
Inflammation means that your immunity stays on all the time. Your immunity is good for you because it kills germs that try to invade your body, as well as the countless cancer cells that your body makes every day. However, after a germ or defective cell is gone, your immunity is supposed to slow down. If your immunity remains active, it uses the same chemicals and cells that attack germs to attack you, and that includes destroying the cartilage in your joints. Common health problems linked to inflammation and osteoarthritis include obesity, high blood pressure, high cholesterol (Rheumatology, Jan 1, 2016;55(1):16–24), diabetes and metabolic syndrome.

My Recommendations
• If your joints hurt, try to find out the cause of your pain. Check with a doctor to see if you have a hidden infection, gout, psoriasis or some other known cause of joint pain.
• If you have sudden locking of your knee that gets better and then recurs, you may have “joint mice,” loose pieces of cartilage that slip between the cartilage to cause horrible pain. Your doctor can usually cure you by removing these lose pieces by arthroscopy.
• Whatever the cause of your joint pain, try an anti-inflammatory diet that includes lots of vegetables, fruit, whole grains, beans, nuts and other seeds and nuts, and severely restricts red meat, processed meats, foods with added sugar, all sugared drinks including fruit juices, and refined carbohydrates (foods made with flour or white rice).
• Lose weight if overweight. I recommend Intermittent Fasting
• Osteoarthritis always worsens with inactivity, so keep on moving, but be guided by pain and slow down or stop when your pain worsens. You should not do sports that involve impact, because the force of your foot hitting the ground can break off cartilage. Good non-impact sports include cycling and swimming.
• It is acceptable to try to control your pain with non-steroidal anti-inflammatory drugs (NSAIDs). However, they are only pain medications and do nothing to cure the cause of your joint pain. NSAIDs do have side effects, so take the lowest dose that helps relieve pain.
• If the pain becomes so unbearable that it keeps you awake at night, you can consider a knee replacement. However, replacing the joint requires driving a spike into the middle of the bones of your knee and that pushes aside the shock-absorbing marrow and weakens the bone to increase your chances of breaking the bones if you fall. If that happens, the knee cannot be replaced again until the broken bones heal. You may be unable to walk or be bedridden for a very long time.

Checked 7/2/23