What can you do about osteoarthritis?
If you have arthritis, you must accept the fact: Once the cartilage tissue is broken down, it's gone. No medication, exercise, or supplement can bring it back. Arthritis is not curable. But you can do a lot to live with it as best as possible.
For one person, pure pain shoots into the knee when climbing stairs. Another struggles every time they try to open a jar of pickles and their fingers are stiff. People with arthritis sometimes feel: My joints just don't want to do what I want them to.
The disease usually occurs with increasing age, with the knee and hip joints being most commonly affected. When people think of arthritis, they often think of the wear and tear on the joints. "But that doesn't take into account another important biological aspect of arthritis: inflammation," says Professor Hanno Steckel, an orthopedist in Berlin. The joints not only hurt and are restricted in their movement, but they are often also swollen and filled with joint fluid. That means: Fluid accumulates inside the joint.
Arthritis is not curable. Once cartilage mass has been broken down, there is no medication, exercise, or dietary supplement that can restore it. "But you can reduce this inflammatory reaction and treat arthritis with many small adjustments to achieve a good quality of life," says Steckel. This is especially true if the disease is not yet advanced.
But it's also important to understand the disease first. Here are the key points.
I've been diagnosed with arthritis. What exactly has happened to my joints?
If you look closely at a joint, you'll see: It's not bone on bone. The respective bones are covered with cartilage tissue at the joint surfaces. This is a unique tissue, as Sven Ostermeier from the joint clinic in Gundelfingen explains.
It contains cartilage cells, but mostly consists of water bound by collagen fibers. "These fibers are woven in a unique way and hold the water," says the leading orthopedist. "That's what makes our cartilage tissue so elastic." In certain intervals, there are cartilage cells in this tissue that keep it upright and stable.
In the case of arthritis, the cartilage tissue changes: Cartilage cells die off. "The collagen fiber tissue then bursts open in some places," Ostermeier describes. As a result, important ingredients of the cartilage are lost. All this has consequences: "The cartilage loses its elasticity, its resistance, and becomes increasingly destroyed."
The inflammatory process begins. In the advanced stage of arthritis, bone rubs on bone because there is no cartilage tissue in between. At this point, daily life is marked by pain. "Because bones have nerve cells, unlike cartilage," says Sven Ostermeier.
What causes arthritis?
A typical risk factor is overloading the cartilage, for example through an injury. "If the kneecap dislocates, for instance, it really damages the cartilage," says Sven Ostermeier.
Overloading doesn't have to be due to a single event, it can also be a long-term problem. If you're a hairdresser who strains your thumb saddle joint every day at work. Or if you walk through life with untreated leg misalignments. "In O- or X-legs, we have a point overload of a cartilage area in the knee joint, which then also leads to the breakdown of cartilage," says Ostermeier.
Obesity also puts a constant strain on the joints and is therefore "one of the biggest risk factors for arthritis," as Hanno Steckel says. Incidentally, genetics also play a role: Some people are more prone to arthritis than others.
What can I do myself now?
In general, the less advanced the cartilage loss, the more can be achieved with changes in lifestyle, says Sven Ostermeier.
Doctors agree: If the scale shows too much, losing weight is worthwhile. "When walking, the forces acting on the hip and knee are approximately 2.5 times the body weight," says Steckel. "So, for example, losing 15 kilograms has a tremendous effect." The joints are relieved, further wear and tear and inflammation are slowed down.
And what is the biggest lever if you have a normal weight? For example, in the case of hip arthritis, Steckel says, "Mobility brings incredible benefits. If you keep the joint mobile, don't let it stiffen, many patients get along well with their arthritis for a very long time." Sports that specifically train mobility - such as yoga or Pilates - can help.
So, there is great potential in a change of lifestyle: towards more movement, a balanced diet. Also, with regard to arthritis, it is worthwhile to quit smoking. Especially those who regularly take painkillers should also avoid alcohol to prevent interactions.
By the way, what should I eat with arthritis? And what not?
Anti-inflammatory diet is the keyword here. This includes avoiding products that fuel inflammatory processes in the body. For example, white flour products, sugar, and highly processed meat products, as Steckel lists. Fried food should also be avoided because it contains trans fats.
Instead, the doctor recommends, "Less meat, more vegetables, complex carbohydrates like whole grain products." Those who also incorporate unsaturated fatty acids, especially omega-3 fatty acids, into their diet can also slow down inflammatory processes. The latter are found, for example, in fatty fish such as salmon or mackerel, but also in walnuts and flaxseeds.
And those who love warm-spicy curries or teas are already doing something right for their joints: Spices like turmeric or ginger are anti-inflammatory, says Sven Ostermeier. However, they are not miracle cures.
By the way, this also applies to dietary supplements that are specifically designed for arthritis sufferers. "Products with collagen, hyaluron, and glucosamines have a very thin scientific basis regarding their effect. I would not recommend that as a doctor," says Hanno Steckel.
And what about movement?
Definitely, say the experts - but with one condition: It should be sports that do not overly stress the joints. Hanno Steckel advises against volleyball, jogging, or tennis. In these sports, there are typical impact movements and sudden changes of direction, which is not good for the joints. "Jogging is poison for damaged knee and hip joints," says the orthopedist.
Gentler activities include cycling, swimming, Nordic walking, yoga, or Pilates. It's beneficial if those affected also strengthen their muscles, thus training their strength. "The muscles surround the joint and can thus stabilize it," says Sven Ostermeier. "The better the muscles are trained, the better one can move such a joint." Inflammation can also be reduced through strong muscles.
However, excessive ambition in the gym can cause damage. "Due to arthritis, one should reduce the load on the joint. That means: use less weight and do more repetitions," advises Ostermeier.
It's best to focus not only on strength but also on endurance, flexibility, and coordination, advises Steckel. The latter is important to prevent falls - and thus further joint damage. It can be trained through balance exercises.
The disease, arthritis, leads to the loss of joint flexibility and elasticity due to the breakdown of cartilage tissue. This tissue, unique in its water and collagen fiber structure, becomes destroyed as cartilage cells die off and collagen fibers burst open, causing the joints to hurt, move poorly, and fill with joint fluid.
Arthritis is typically caused by various risk factors such as overloading the cartilage, obesity, genetics, or injuring the cartilage tissue, ultimately leading to its breakdown and the resulting symptoms.
