There are many arthritic patients and sufferers in pain that use magnets. Some are very certain that the magnets they are using are a great help.

There are no large controlled clinical trials to evaluate the benefits of magnets on arthritis.

Doctors in general do not think they work to relieve pain in arthritis. There are, however, amazing anecdotal evidence. There are stories that seem too good to be true.

A friend of mind, Steve, has severe back problems. He has a prolapsed intervertebral disc.
He could not stand for long and often made his journey to the toilet on all fours. After a MRI scan and other tests, his orthopaedic Surgeon told him he needed surgery.

A friend introduced him to magnotherapy. He placed a powerful booster magnet directly over the prolapsed disc. Within a week he was up and about. Today he wears a magnetic bracelet and although his disc is still out, he can do most things with care.

Experts think that a magnet placed over an artery will improve the oxygen carrying capacity of blood. This encourages faster healing. This theory is used in horse racing. Injured horses are fitted with magnets to speed up recovery and get them back on the track in the quickest time possible.

The most recent trial results showed that there was no real benefit from using a magnetic bracelets. The only benefits were placebo effect. The proponents argue that the improvements in animals confirm the benefits are not just placebo. They site circumstances where animals have made significant improvements after a magnet was fitted. A dog that needed to be lifted up unto the back of the car was able to leap in after having a magnetic collar, and many more similar stories.

Magnets are safe to use. The drugs that are used to help control pain and stiffness in arthritis come with risks. Often with magnets from a reputable company you get your money back within a specified time. If it does not work send it back.

The new alloy deodymium magnets retain their magnetic properties for 100 years. So one magnet will last a like time as long as you do not lose it.

Trial Results.

Here is a brief summary of a trial result published in the British Medical Journal (BMJ).

Randomized controlled trial of magnetic bracelets for relieving pain in osteoarthritis of the hip and knee.

Tim Harlow, Colin Greaves, Adrian White, Liz Brown, Anna Hart, Edzard Ernst

BMJ 2004;329 (18 December), doi:10.1136/bmj.329.7480.0-b

Abstract

Objective: To determine the effectiveness of commercially available magnetic bracelets for pain control in osteoarthritis of the hip and knee.

Design: Randomized, placebo controlled trial with three parallel groups.

Setting: Five rural general practices.

Participants: 194 men and women aged 45-80 years with osteoarthritis of the hip or knee.

Intervention: Wearing a standard strength static bipolar magnetic bracelet, a weak magnetic bracelet, or a non-magnetic (dummy) bracelet for 12 weeks.

Main outcome measures: Change in the Western Ontario and McMaster Universities osteoarthritis lower limb pain scale  (WOMAC A) after 12 weeks, with the primary comparison between the standard and dummy groups. Secondary outcomes included changes in WOMAC B and C scales and a visual analogue scale for pain.

Results: Mean pain scores were reduced more in the standard magnet group than in the dummy group (mean difference 1.3 points, 95% confidence interval 0.05 to 2.55). Self reported blinding status did not affect the results. The scores for secondary outcome measures were consistent with the WOMAC A scores.

Conclusion Pain from osteoarthritis of the hip and knee decreases when wearing magnetic bracelets. It is uncertain whether this response is due to specific or non-specific (placebo) effects.

Dr. Phil Hariram,

Arthritis Guide.

If you have arthritis and you are looking to control pain without drugs, then the first thing you need to do is to  reduce your weight or maintain a normal weight. If you are overweight, weight loss will be the most important thing you can do to improve the level of pain, stiffness and mobility.

A small amount of weight loss can make a significant difference. The best measure of weight in relation to height and general body health is the Body Mass Index (BMI). The normal range is 20-25 and 26-30 is considered overweight and over 31 obese.

Extra weight puts additional stress on weight bearing joints such as knees and hips, and increases the level of pain. It also increases the risk of arthritis. It is not always easy to lose weight if you have arthritis.

If your weight remains constant on a particular diet plan, then you are consuming just the right amount of calories to provide for the needs of the body. If you are gaining weight, then you are taking more than your body needs and the extra calories are stored as fat.

To lose weight you need to consume less than your body requires. This way the extra calories needed is obtained from the breakdown of fats stored in the body. Exercise will help you burn fats. It is not as effective as a specific diet plan but will help. It should be incorporated into the whole weight loss plan.

The heavier you are, the more calories you will burn during exercise. Exercise will keep the joints supple, reduce stiffness and tone up supporting muscles. It also makes you feel healthier and energised.

When exercising, you are moving synovial fluids around the joint. This is beneficial because it improves nutrition to the joint.

To assess your progress, evaluate the level of pain, stiffness and mobility before your diet and exercise plan, then make assessments at intervals.

Dr. Phil Hariram

Arthritis Guide.

Glucosamine and chondroitin are widely advertised as remedies for osteoarthritis. The benefits, however, are not clear.

A qualitative assessment of various trials were done by T.E. McAlindon et al. to evaluate the benefits of glucosamine and chondroitin products for osteoarthritis of the knee and/or hip.

The studies were randomised, double blind, placebo controlled of four weeks duration. Fifteen studies reached the criteria and were included in the analysis.

Conclusions: Trials of glucosamine and chondroitin products for osteoarthritis of the knee and hip showed moderate to higher effects but there were quality issues and possible bias suggesting that benefits were exaggerated.

They concluded, however, that some degree of benefits appear probable.

A trial by H.Muller-Fassbender et al. in 1994 compared glucosamine sulfate to ibuprofen in osteoarthritis of the knee. The result showed that glucosamine was as effective as ibuprofen but without the potential serious side effects.

Dr. Phil Hariram,

Arthritis Guide.

Glucosamine is an amino acid sugar produced by the body and present in cartilage. It has been widely promoted as a treatment for osteoarthritis.

There is no conclusive evidence that this drug is effective. It is up to you to make your own mind up on it. There are individuals who swear by it and others who have no benefit.

Promoters of glucosamine claim it repairs damaged cartilage. It is derived from shells of shellfish. It is classified as dietary supplement just like chondroitin and its manufacture is not subjected to regulation. Make sure you purchase from a reputable company and check the ingredients.

There are no serious side effects with glucosamine. It is extracted from shells of shellfish so if you are allergic to shellfish be aware of this. If you are a diabetic, remember that glucosamine is an amino acid sugar and can impact on your blood sugar level.

Your family doctor is not likely to recommend glucosamine or chondroitin as an arthritis treatment because there is no clear evidence that they confer greater benefits over placebo in arthritis treatment.

It is, however, a safe medication. If you are on this drug or you are considering taking it, use it for three months before making your evaluation. If you are convinced there is improvement, continue using it as a treatment of arthritis.

Dr. Phil Hariram,

Arthritis Guide.

Chondroitin is a carbohydrate compound and is present in cartilage. It gives the cartilage elasticity. Articular surface of joints are protected by cartilage (articular cartilage) and this cartilage is a tough smooth gristle that reduces friction and protects the underlying bone from wear. Damage and wear of the cartilage is seen on an x-ray as loss of joint space. Cartilage contains both glucosamine and chondroitin.

The rationale for the use of chondroitin and glucosamine as treatment of arthritis is that these two drugs, according to some, will improve the health of affected articular cartilage. Both chondroitin and glucosamine are manufactured by the body.

Chondroitin is considered a dietary supplement and as such the manufacture is not regulated. The quality of products available will vary.

It is available as chondriotin sulphate, obtained from cows’ cartilage. Make sure you purchase a recognised brand from a reputable company and check the label for ingredients. If you are not sure, ask, or consult your doctor. Do not discontinue your on going medication.

According to studies, patients with mild to moderate osteoarthritis had relief on par with NSAIDs such as ibuprofen. Trials, however, are inconclusive and a large placebo controlled trial will one day throw light on whether this drug should be an acceptable arthritis treatment.

There are no serious side effects. Reported side effects are increased intestinal gas and loose stools. It should not be given to children or taken by women considering pregnancy or who are pregnant. It may potentiate the effects of anti-coagulants.

If you are taking this drug or considering taking it in future, make your assessment on its effeciacy after three month. If you feel it is doing you some good, continue.

Dr. Phil Hariram,

Arthritis Guide.

Apart from gout, diet does not have a significant direct impact on arthritis. Diets, vitamins and supplements will not cure your arthritis but altering your diet to maintain or attain the right weight is an important step to reduce the burden of arthritis.

For weight loss, dietary change and the amount you consume is important. Your diet must contain basic nutrients such as minerals and vitamins. Poor diet will impact on your general health and subsequently on your arthritis.

To help your arthritis, ensure your diet is balanced and varied and incorporates vitamins, minerals, anti-oxidants and other essential nutrients. Reduce animal fats and eat more fish. Take plenty of fruit and vegetables.

Omega-3 polyunsaturated fats found in fish oil has been shown to be beneficial in inflammatory arthritis. It is also useful in gout but it has high quantity of purines which in broken down in the body to produce urates and therefore should be avoided in gout.

A balanced and varied diet with more fish, fruit and vegetables is beneficial in all forms of arthritis. Nutritional supplements are available over the counter and are usually costly. Most of the ingredients are present in a balanced diet.

Your weight is important. So what should your weight be? You should use the Body Mass Index (BMI) as a guide to assess whether your weight is acceptable or not. To find out your BMI, first measure your height in metres,(i.e. say 2metres) then multiply it by itself (2×2=4). Check your weight in kilograms (say 80Kg). Now divide your weight in Kg by the first figure (80 divided by 4 =20). That is your Body Mass Index (20). Recommended BMI for most people is between 20 and 25. For your arthritis aim to be within this range if you can.

From childhood I have been told that calcium is good for my bones. Lack of calcium may lead to osteoporosis especially in arthritic patients. Vitamin D is also important for bone formation. The commonest source of calcium is in milk. If you are on skimmed milk as part of your low fat and calorie controlled diet be assured that skimmed milk has more calcium in it that full fat milk. Daily recommended intake of calcium in under 60s is 1000mg and over 60s -1500mg.

During the summer your body manufactures vitamin D through the sunlight on your skin and you do not need to worry about Vitamin D intake. You, therefore, need to be more vigilant in winter. Older arthritic patients may need supplements.

In case of gout, you should be careful with certain foods. Foods high in purines such as meat and fish should be consumed with care. Avoid or reduce alcohol.

Fish liver oil contains both omega-3 fatty acids and Vitamin D. it is a useful supplement but care should be taken in women thinking of starting a family or already pregnant. It also contain Vitamin A and is not recommended in pregnancy because of potential harm to the foetus. Avoid fish liver oil or vitamin A supplements. It is better to take pure fish oil (high in omega-3 but has no Vitamin A) rather than fish liver oil.

Dr. Phil Hariram
Arthritis Guide.

Exercise is good for arthritic joints. Exercise keeps the joint flexible and the muscles strong. Inactive muscles tend to waste and become thin. Make sure you know what to do and do not overdo it. Exercise also makes you feel generally better.

Resting an inflamed joint will help it to improve and prevent further damage. If you are not sure ask a professional. Resting a joint is fine as long as you do not rest it too long. Combine it with some stretching exercise after some time.

If you are overweight, losing weight will help your arthritic joint. By losing weight you are putting less pressure on the joint. With arthritis a person may be inclined to reduce activity or in some case cut down considerably. This could end with weight gain if the calorie intake remains the same. It is best to aim for your ideal weight.

It is not clear whether special diets have any effect on arthritis. I feel it does not. However, fish oils and vegetables are supposed to reduce slightly joint inflammation. Alcohol does not affect arthritis but be aware that it could interact with over the counter treatment or prescribed medications. Make sure you are aware of this. If in doubt ask you doctor.

Arthritis that causes persistent pain and discomfort could lead to anxiety and depression. Get professional help if this happens. These conditions can increase your perception of pain and increase the intensity. Learn relaxation techniques and get help if you cannot control your anxiety. Any treatment that will create a positive attitude to your arthritis will impact very well on your general well being.

I strongly believe that a positive mental attitude will help you enormously in coming to terms and living with arthritis.

Dr. Phil Hariram

Arthritis Treatment.

There are ways you can help osteoarthritis treatment. Lifestyle changes can make a significant effect on your condition. Obesity affects the bio-mechanics of weight bearing joints. Maintaining the correct weight (BMI) will reduce progression of arthritis especially in the knees.

Maintain a good level of activity and improve on exercise. This improves the strength of the muscles and wasting, and has a positive benefit on osteoarthritic joints and general well being.

If there in deformity of the knees such as valgus then insoles and patello-femoral strapping will help. Using shoes with softer soles help spread the load and absorb impact. Use trainers when you can instead of hard sole shoes. Walking stick helps distribute the load.

It is important that osteoarthritic patients remain positive about their condition. A positive mental attitude is an invaluable tool when addressing the level of pain and disability.

A patient with osteoarthritis should pay particular attention to potential problems and hindrance at work, home or when going out and look at ways to overcome them.

Drug treatment of osteoarthritis have possible side effects and although maybe necessary, lifestyle modification is an important aspect of osteoarthritis treatment. In addition you feel a lot better being able to control your symptoms yourself rather than rely on drugs etc. as the only treatment for osteoarthritis.

Dr. Phil Hariram,

Arthritis Guide.

Image via Wikipedia

When the level of uric acid in the blood is too high, gout can develop. It was known as the patrician’s malady in the past because it was considered a disease of over indulgence amongst the wealthy.

High purine diet can affect gout and red meat is high in purine. The rich ate red meat while the poor could only afford grain.
Gout is predominantly a male disease up to the age of 50. It usually start around age 30 and the highest incidence is between 40 and 50 years. In pre-menopausal women, it is rare.

Gout can be classified as primary and secondary. In primary gout the body either produces too much uric acid or it cannot excrete it effectively to maintain a normal blood level. These patients benefit significantly from dietary changes.

Secondary gout develops as a result of other factors. Some medical conditions can raise uric acid level and trigger gout. These include renal disease and myeloproliferative disorders. In leukaemia, the imbalance is due to excessive production of uric acid, and in renal disease the excretion of uric acid is impeded.

Drugs can affect blood uric acid levels. These include diuretics especially thiazide diuretics, aspirin and cytotoxic drugs. Gout is also linked to obesity and alcohol.

Hippocrates wrote about gout as a disease of males and post-menopausal women and urate crystals were found in the big toe of an Egyptian mummy.
Acute gout often develops during the night. 70-90% of acute gout develops in the big toe and typically affects the first metatarso-phalangeal joint. This is called podagra. Within hours the pain becomes severe and throbbing. The big toe swells up and can feel hot.

It is extremely painful to the touch and even the touch of the bed sheath can induce excruciating pain. The acute episode resolves on its own but can take over a week. Medication can shorten this time.

Since the introduction in 1951 of probenacid and allopurinol in 1963, chronic gout is rare apart from non-compliant sufferers. Before these drugs were introduced chronic gout caused severe distress. Acute gout was frequent and severe. In addition urate crystals separated out into other joints, kidneys and other organs leading to polyarthritis, kidney stones, heart disease and tophi.

Diet and weight loss has an important role in gout management. A low intake of purine can reduce blood urate level by up to 20%. Foods high in purine are meat especially liver and other organ meat, sausages and other processed meat, seafood, milk, eggs and certain beans. Alcohol increases the possibility of gout. Beer is the worse culprit. It contains guanosine. This chemical is converted by the gut flora into uric acid.

Today, with screening and tests done regularly and even for insurance purpose, we are seeing a group of individuals with high uric acid without any signs of gout.

These people need to be monitored. Once all potential factors that can influence gout are eliminated or reduced and diet and weight loss in place, if the uric acid level remains high, then maintenance therapy in the form of allopurinol is recommended to keep the blood uric acid level within the normal range. This stops urate crystals separating out into important parts of the body.

Dr. Phil Hariram

Arthritis Treatment.

Image by ElvisHuang via Flickr

According to Deidre Murphy and Jennifer Walsh, two Obstetricians from Dublin, even small changes in Body Mass Index (BMI) between pregnancies can affect health. Mothers who put on or lose a lot of weight between pregnancies are putting themselves and their babies at risk.

A two unit increase in BMI doubles the risk of having a large baby, high blood pressure and pre-eclampsia. Larger increase adds to this risk and there is a greater risk of stillbirth and other complications.

Losing weight, on the other hand, increases the risk of having premature babies or low birth weight babies.

Their message is clear. Maintain a healthy weight before, during and after pregnancy and remain at the same weight before the next pregnancy.

Dr. Walsh said, “Women of reproductive age are bombarded with messages about diet, weight and body image. There is growing concern on the one hand about an epidemic of obesity, and on the other about a culture that promotes ‘size zero’ as desirable, irrespective of a woman’s natural build.

Pregnancy is one of the most nutritionally demanding periods of a woman’s life, with an adequate supply of nutrients essential to support foetal well-being and growth.

With at least half of all pregnancies unplanned, women need to be aware of the implications of their weight for pregnancy, birth and the health of their babies.”

Their review cited the Swedish Study of 207,534 women between 1992 and 2001 and assessed the link between BMI changes and the impact on the pregnancy and the mother’s health.

Tam Fry, member of the National Obesity Forum said, “I think these doctors are absolutely right.”
He said that being overweight is also associated with Polycystic Ovary Syndrome. This can result if difficulty in conceiving.

Women should be aiming for a normal weight before they have their second child.

Dr. Phil Hariram.
Diet and Pregnancy.