Osteoarthritis & Rheumatoid arthritis: the differences & causes
Early-morning stiffness is one of the first symptoms. Then you’re going to get: pain in the joint, swelling in the joints, loss of function in the joints, I’m so happy to welcome integrative medical doctor, David Nye back with us today. It’s a big topic so we’re going to split this up into shorter video clips. We’re talking about arthritis, osteoarthritis, rheumatoid arthritis. Welcome, David. Thank you, Daleen. Pleasure to be back. Let’s unpack this whole thing. What are the differences between these conditions? Well, I think we need to sort out the terminology because arthritis is a very general term. And arthritis is like an over-arching name For a whole lot of different kinds of inflammation. So arthritis really means inflammation of a joint. And under that we get different kinds of arthritis like osteoarthritis, rheumatoid arthritis, psoriatic arthritis, gouty arthritis and many others. So each one has different causes, effects, origins, treatments – and often is confused. I think, if we can get the terminology right, then we can be more specific. Okay. How would one identify which one you have? How do they vary in symptoms? Well let’s take for example, comparing osteoarthritis and rheumatoid arthritis. Osteoarthritis is very much has to do with a degeneration and lack of build-up of cartilage in the joints, there could be hereditary factors there. Rheumatoid arthritis on the other hand is very much more an inflammatory process where there is actually inflammation destroying the synovial membranes and destroying the lining of the joints and destroying the cartilage. So they have different causes which make the treatments very different. And symptomatically, how different are they? Talking pain levels and activity management. All arthritis is going to have a lot of common symptoms. You’re going to maybe start off with some early-morning stiffness, is one of the first symptoms. Then you’re going to get: pain in the joint, swelling in the joints, loss of function in the joints. Sometimes redness. And all these symptoms can be quite common. So just be looking at the symptoms alone, it doesn’t always tell you what arthritis it is. And the causes of it? I think a lot of it can be genetic so it can be passed on in families if your ancestors had osteoarthritis you will often have a tendency to get it. You get primary osteoarthritis which is really where the joints start wearing down primarily in the fingers and the weight-bearing joints; like your knees, your ankles and hips – and that comes on as you get older, in your 40s and 50s your joints start wearing down because of overuse and you get the symptoms developing from that. You can get a secondary osteoarthritis which can rise from having trauma, maybe you were a rugby player when you were young and you hurt your neck and then maybe 40/50 years later you start getting osteoarthritis in the neck. You can get secondary osteoarthritis from other causes as well, like disease. So like running for example as well? I mean, impact on your knee joint. Absolutely. Okay. You’re going to have extra overuse of those joints which makes them more prone to damage if you’re not healthily building up that cartilage again. But that’s difficult to do, building cartilage. It can be, yes. You need a healthy diet. You need all the right circumstances to build up that cartilage or to regenerate the cartilage when it wears down. But you’re more an advocate of: prevention always, better than cure. Absolutely. I think having a healthy diet, having lots of antioxidants which you will get from all your brightly coloured fruits and vegetables. Antioxidants are very important for osteoarthritis, so you need to have a healthy diet. You need to have exercise. You need to put your joints through moderate exercise not excessive exercise, so that the circulation is flowing, the blood is coming into the joints so that they can rebuild the cartilage. If someone is in pain it’s difficult for them to move but you’re saying movement is still very important. So would you say something like swimming or (I don’t know) gentle bouncing on a trampoline rather than hard running on the road? Yes, gravity is obviously what brings it on in the first place so you don’t want to have heavy-impact kind of exercise, so gentle exercise like a rebounder or swimming where gravity is taken away. But you’ve also got to listen to your body as well. If your body is screaming in pain then don’t go and exercise. But if you’ve got mild pain or morning stiffness and you can relieve that by going for a nice gentle walk then that’s the best thing to do because that’s really going to relieve the pain and improve the blood flow and circulation into the joints. And your own management of it, you know. Of course we can talk about other modalities like acupuncture and that kind of thing, but I mean massaging your joints – is that something you can do before you go to bed at night? Or anything else you can do yourself without ending up with a drug treatment protocol? There are lots of things one can do. Lots of things like massaging certain natural products into the joints to improve the circulation, to improve lymphatic drainage and take toxins away from the joints, exercise, rest – all those things are appropriate – heat therapy, cold therapy. And I think when we talk about the management we’ll cover these things in more detail. And then also the inflammatory component that needs to be managed. The inflammatory component is very different and it takes a completely different approach. For example, with rheumatoid arthritis which is very inflammatory. We need to look at what’s causing that inflammation. Are there foods perhaps that the person’s eating that the body might be intolerant to that’s triggering the inflammation through a leaky gut mechanism that stimulates inflammation via the immune system? And there one needs to find out is the person perhaps eating gluten which might be causing the inflammation; there are other foods that might be causing the inflammation? And very important to remove those from the diet otherwise you don’t have any hope of any kind of healing. Is there any hope for someone to reverse any or all three of the different components of arthritis? Absolutely. I do think that there’s every hope to get enormous progress. Maybe not 100% resolution but certainly to relieve the pain, to stop the progression of the illness. There’s a lot of things one can do. Great. Another thing that I think is important that one needs to look at is toxicity, because toxicity in the system particularly from mercury or those kinds of things can have a very important impact on something like rheumatoid arthritis where your immune system wants to be functioning 100% and mercury toxicity would hamper the immune system working. Are you seeing that in your practice? Yes, we see a lot of people with mercury toxicity. Unfortunately, we are the generation who had mercury fillings put into our teeth when we were kids and until all those fillings have been taken out and the mercury is clean out of the body we’re going to see a lot of problems ongoing relating to that. I would love to have you back just talk about that and potentially the treatment of that. Sure. But let’s get another episode going where we talk about the management of arthritis. Thank you, David. You’re welcome.