Why do my joints hurt?

 Do you ever feel like the Tin man needing some WD 40 just to get moving? Let's talk about what causes joint pain and how to prevent and treat it.

 I'm Dr.Vickie Petz Kasper. If you're ready to take control of your health, you're in the right  place. Whether you're focused on prevention or you're trying to manage a condition. I'll give you practical steps to start your own journey toward better health because healthy looks great on you. 

Episode 164. Why do my joints hurt?  When I sit for a while the urge to groan when I stand up comes pretty naturally and I'm really trying hard to fight it, but I've put  quite a bit of strain on my joints over the years, and I'm not alone. One in five adults have some form of arthritis.

Back in the day, old people called it rheumatism. I haven't heard that term in a while, but now I am old people. But rheumatism is used synonymously with arthritis. It's a catchall term and it doesn't necessarily refer to rheumatoid arthritis. And listen, there are over 100 different types of arthritis, but today we're only going to focus on osteoarthritis because it's by far the most common affecting over 32 million people in the United States. 

And the prevalence is increasing, making it the third most common disease that is going upward behind high blood pressure and dementia. Grandpa can tell it's going to rain because his rheumatism is acting up, and in fact, damp weather can make arthritis pain flare,  but it's more than just aches and pains. Osteoarthritis is serious. In fact, it's the leading cause of disability in the United States. It's also expensive. The price tag is reported to be over $150 billion a year. Some of that is lost wages and some is because of joint replacement, and it is important to see a doctor and have your pain evaluated.  

Let's go to mini medical school and learn about joints. No, not that kind of joint. Although CBD oil and marijuana have been studied for joint pain and they are effective - every bit as effective as placebo, that  smells like weed. Go figure. But I meant the articulation between bones and other structures that allow us to move. Now that I think about it, the word joint can refer to your banking account, something you smoke, a fastener to hold the roof on your house, or in this case, a place where bones meet.

So let's look at all the players that gather in this meeting place besides bones. You've got ligaments and tendons that hold the joint together, and both of these are strong bands of connective tissue. The ligaments connect bone to bone. And that supports and limits movement while tendons connect muscle to bone and that controls movement.

You've also got cartilage that covers the surface where two or more bones meet and that's designed to reduce friction. You know when two or more are gathered, there's always friction, so you need something to smooth things out. Another structure that helps reduce friction is a fluid filled sac called the bursa, and this is filled with a thick, clear, sticky fluid called synovial fluid that is secreted by the synovial membrane and that lines the joint and seals it into a capsule.

And there are lots of different types of joints besides the ones I mentioned earlier. Some of them move in just one direction, like your elbow, and those are called hinge joints. Others allow rotation like your neck. That's called a pivot joint. Shoulders and hips are the ball and socket joints to allow movement in several directions. And the wrist is similar, but without pivots, so it's called an ellipsoidal joint.

Okay. Now you've completed orthopedics 101. Oh, wait. Since we're discussing osteoarthritis today, you probably need to know that osteo means bone. And you've probably heard people say that they had a knee replacement because it was bone on bone. Well, osteoarthritis occurs when the cartilage is gone, and it's a gradual process that occurs over many years usually.  

You probably know that the biggest risk factor for osteoarthritis is age. But listen, it's not a normal part of aging due to wear and tear, though clearly it can develop where there's been a prior injury. It's hard to think about it when you're young and doing back handsprings or shooting hoops or making tackles, but often those old injuries do eventually catch up with you.

But, even without an injury, repetitive occupational or avocational activities can leave their mark. But get this, being sedentary does its own damage.

Does that mean that runners are destined to ruin their knees? Actually no. Even though they're asking a lot from that three to five millimeter layer of cartilage, genetics plays a role too. So choose your parents very wisely. But even if your parents have osteoarthritis, it doesn't mean that you will, because lifestyle is a huge factor. And since I'm here to talk to you about lifestyle medicine. Let's talk about the things you can control, and we're mostly going to focus on two pillars of lifestyle medicine, and that's physical fitness and diet. 

If you have joint pain, you've got to keep moving because if you stop, you might not be able to start again. Being fit helps with pain and stiffness. It improves your joint mobility, and all of that helps with quality of life, and mood. But here's the deal. Your skeletal system consists of joints, bones, and muscles.

So if people with arthritis don't maintain that musculoskeletal strength, it leads to a whole cascade of events.  Weaker muscles leads to less balance that can result in a decline in function, which leads to less stability and that can result in falls with injuries like brain trauma and hip fractures.

In fact, 95% of hip fractures are caused by falls, and falls are the leading cause of disability and death in seniors and exercise helps prevent falls. Not only does it keep you stronger, it boosts your confidence because oddly enough, people who are afraid of falling actually fall more than the less cautious people.

Now, I'm not telling you to be reckless, but I am suggesting that you exercise. And get this strengthening muscles even reduces joint pain. And if you have arthritis, one of the best exercises is walking.

Tai Chi is also recommended, and I've visited China before and it's very common to see elderly people. I'm talking about really elderly people gathered in outdoor spaces participating in this ancient martial art. It involves slow, continuous movement that is specifically tailored to improve strength and balance. But if you currently don't have access to a park in China, then maybe you could find a YouTube video and even better find a friend and a park nearby  and use a YouTube video. 

And if you have access to a swimming pool. Oh, swimming is such an excellent exercise for people with arthritis.  But whatever you do, don't do nothing. Keep moving. Park in that spot that's furthest from the door. Don't ever drive to the mailbox. Find something you enjoy and keep moving.

Inactivity is the very worst thing you can do if your joints hurt. Now, of course, you should consult your doctor or healthcare provider first. And I'm not talking about joint pain from an acute injury. I'm talking about old fashioned aches and pains. Any joint in the body can be affected, but the most common ones are knees, hands and hips.

Check, check, check. Actually, my knees are pretty good, but I definitely have hip pain and intermittently pain in my hands.  But guess what? It is not from cracking my knuckles. That's a myth. Osteoarthritis is referred to as wear and tear arthritis, and that makes sense. I delivered a lot of babies with these hands and did a lot of surgeries, and probably gymnastics took a toll on my hip as well.

But listen, you don't have to abuse your joints to get osteoarthritis. You can also get it from neglect. Being sedentary increases your risk for... you name it. So if you sit all day, set your watch and at least get up and move around every hour. So we've covered age, previous injury, repetitive motion overuse, and inactivity as risk factors for osteoarthritis.

But you wanna know what else puts a lot of strain on your joints.  Obesity. In fact, weight loss can really help with osteoarthritis, especially of the knees, if only it were that simple. But get this, losing one pound takes four pounds of pressure off your knees. 

There are lots of different treatments from ointments to over-the-counter pain relievers, prescription medications physical therapy and surgery.  But sometimes you can't fix joint pain and you have to focus on managing it instead of trying to cure it. Whatever you do, take care of your body by being fit, active and maintaining a healthy weight, which by the way depends way more on diet than exercise  and eating a joint friendly diet.  So what kind of diet should you eat for arthritis? You know, there's the DASH diet for high blood pressure and the MIND diet for cognitive health, the Mediterranean diet for heart health.

But is there a diet for joint health? Not specifically, but all of the above diets have some things in common. They reduce inflammation and they promote whole unprocessed foods and avoiding foods that make inflammation worse.  You know those that are easy to grab and eat.

You do need protein for your joints, but don't fall into the trap of buying packaged food that touts 30 grams of protein on the front label. My mom kept a little carton of a protein drink that her friends had recommended because it had 30 grams of protein.  I reminded her don't pay attention to the front of the package. It's just marketing. Turn it over and read the nutrition label. I really think you should go back and listen to my episode on this. It's one of my favorites, and I put a link in the show notes.  

But if you eat a well-balanced diet, you don't need more protein. Now, I might argue that if you get your protein from meat and dairy. You need better protein.  Things like whole grains, soy products, beans, legumes, lentils, nuts and seeds. And did you know that fruits and vegetables contain protein? Plus they have fiber, which is crucial for weight loss and a healthy gut. And they don't contain bad fat and cholesterol.

If you want to know more about growing your own protein, listen to my interview with Jill Mc Sheehy on her podcast, the Beginner's Gardener.  And she has a follow-up episode on how to actually grow that stuff in your garden. So if you're into gardening, this is a don't miss episode. And yes, there's a link in the show notes.  

Also, certain spices like garlic and turmeric may help with inflammation and joint pain, but please just add them to your food. I know, I know taking a supplement seems so much easier, but it's not better. Green tea and coffee also have some anti-inflammatory properties, so drink up. But only in the morning, so it doesn't interfere with your sleep.

And even though we're focusing on diet and fitness today, poor sleep, loneliness and stress all contribute to chronic inflammation. And of course, smoking is not good for your joints either.

Look, inflammation is a normal process in your body designed to help your body heal, but chronic inflammation is terrible for your body. Plants contain phytochemicals that lower inflammation like antioxidants, fiber polyphenols, and Omega-3 fatty acids and the Mediterranean diet and the dash diet. Also focus on whole foods that contain these, and it's great for your heart too. Use unprocessed olive oil when you cook and think variety.

Focus on adding more plants and more colors to your diet. It, but the standard American diet is really the complete opposite. It's pro-inflammatory things like sugar, which can hide in so many places like protein drinks. In fact, that carton that my mom gave me contained a ton of refined sugar, and that's what we're talking about, refined sugar, not whole fruits, fried foods, saturated fats, and dairy and meat - especially processed meats and lunch meats. That includes bacon, but it also includes deli turkey, cheeses, and most oils, which are in mayonnaises and salad dressings. Fast foods, processed snacks, donuts, pizza, french fries. Listen, if you go to the grocery store and buy something and you have to fight that little plastic bag to get it open to put your produce in there, it's probably good for you. But if you just pull it off the shelf and it's in a box or a package. Beware and at least turn it over and read the nutrition label and ignore the front. And don't fall for marketing. 

Processed carbohydrates and refined greens are found in breads, pastries cakes, pasta, cookies, crackers, and energy bars. You know, they're just cookies in disguise.  Did I just describe your pantry? Hmm? Let me add canned soups, which are extraordinarily high in sodium. And all things that contain MSG and artificial sweeteners like aspartame can also worsen inflammation as well as alcohol.

What about gluten?  I probably need to do a whole episode to discuss that, but gluten is found in processed grains as well as whole grains, and some people do have a sensitivity. I believe most people need whole grains in their diet, and yes, there are some that do not contain gluten, but be smart about your choices. There are lots of packaged foods that shout gluten free on the front, and they're just gluten-free junk food.

What I suggest instead is pay attention to the connection between your diet and your joints. For me, it's chips and cheese dip that make my joints hurt worse. Maybe it's the cheese with all that saturated fat, all that salt or the bad oils that they're cooked in. But chips and cheese dip are not whole unprocessed foods. They aren't healthy for me or you, and there's a price to pay for eating them.

So if you do figure out something that makes your joints hurt worse, eliminate that from your diet and see if it helps.  The bottom line is that plants are good for your joints and they're good for your health and healthy. Looks great on you. 

  LINKS:

Grow Your Own Protein: The Beginner's Garden Podcast

READ A NUTRITION LABEL

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The information contained in this podcast is for educational purposes only and is not considered to be a substitute for medical advice. You should continue to follow up with your physician or health care provider and take medication as prescribed. Though the information in this podcast is evidence based, new research may develop and recommendations may change.