Tips for Managing Pain: Arthritis

According to the CDC, an estimated 78.4 million adults will have some form of physician-diagnosed arthritis (one in four of the population) by the year 2040 with about 35 million adults reporting arthritis-attributed activity limitations. In osteoarthritis, the cartilage that caps the bones in your joints is degraded whereas in rheumatoid arthritis, the membrane that protects and lubricates the joints is inflamed which leads to joint erosion.

I’ll share some movement tips and herbs for managing the discomfort and pain associated with arthritis in the first blog of this series. Also, check out my earlier blog on natural options to manage pain.

Movement

Strength Training

Regular exercise and movement can alleviate arthritis pain, decrease stiffness of joints, improve flexibility and may help you reduce your prescription or over-the-counter medication. Although the thought of exercising when in pain may not be appealing, it is a necessity for maintaining healthy weight and lubricating our joints. You can start with just 15 minutes of exercise and gradually ramp up intensity and duration based on your body’s response.

Did you know that strength training can enhance the benefits of your aerobic exercise program? The great thing about strength training is that it can be done without any high impact aerobic activity and builds muscles to keep your body and metabolic rate strong. According to this analysis of 17 clinical trials, strength training exercises were effective in reducing discomfort and pain of participants with rheumatoid arthritis based on two metrics: Disease activity score measuring level of pain; and blood ESR measuring levels of inflammation.

Yoga

Yoga-based mind-body intervention provides a holistic approach to treating rheumatoid arthritis as co-morbid depression is often associated with and can adversely affect the outcome of treating this condition.

https://pubmed.ncbi.nlm.nih.gov/30714983/, eight weeks of yoga not only decreased the severity of rheumatoid arthritis based on reduction in inflammatory markers but was also accompanied by a statistically significant decrease in symptoms of depression.

Relaxing and restorative yin yoga can go a long way towards pain relief and lubricating the joints through its gentle movement. How about this one to try?

Herbs

Stinging nettle

Known as urtica dioica, it is a flowering plant covered in hairs that cause a painful stinging sensation when touched. Stinging nettle is an established herbal remedy that is known for anti-inflammatory actions combined with minerals (boron, calcium, magnesium and silicon). It has been studied for its impact on rheumatoid arthritis. Using nettle may help you decrease the amount of medicines you take so discuss with your practitioner if you are planning to supplement.

Here’s an extract of the stinging nettle leaf you can try:  

Burdock root (Arctium Iappa L. or arcticum minus)

Burdock root has active sterols, tannins and fatty oils which provide anti-inflammatory benefits. It is commonly eaten in Asia but not many Americans are aware of its power as a superfood. Unless you are cuisine curious and want to try cooking with burdock root, I suggest you go for the tea to reap the same awesome benefits.

This study showed that burdock root tea improved the inflammatory and oxidative stress markers on osteoarthritis patients.

Here’s one you can try:

Licorice

Licorice is a powerful anti-inflammatory and acts like your body’s own natural corticosteroid to fight inflammation and ease pain. In this review of extensive literature done through 2015, the active compounds of licorice (glycyrrhizin and glycyrrhetinic acid) exerted potential anti-inflammatory effects while diminishing the adverse effects of NSAIDS (Nonsteroidal anti-inflammatory drugs) and anti-rheumatic drugs. Licorice in large amounts is NOT recommended for those with high blood pressure, potassium deficiency, and impaired kidney or liver function so it’s best to avoid if you have any of these conditions. Also, licorice candy contains very little of the active compound and has too much sugar and other additives so opt for several cups of this tea instead:

Cat’s claw

Cat’s claw (Uncaria tomentosa and Uncaria guianesis) hails from the Amazon where it has been widely used as a medicinal plant to treat conditions such as arthritis, gastritis and osteoarthritis. Cat’s claw is an antioxidant and an inhibitor of TNFalpha which exhibits anti-rheumatic properties. This study has shown the effectiveness of Cat’s claw in decreasing inflammation in patients with osteoarthritis.

Here’s a tincture form of cat’s claw which I prefer over the dried herb – it’s not tasty so I add some lemon or mix with flavored seltzer:

Managing Mood with Diabetes

Managing diabetes is no easy task – it requires making concerted changes to your daily routine including diet (what to eat and avoid), exercising and moving more and eliminating bad habits (smoking, excess alcohol and disruptive sleep). These changes can be mentally draining and one of the reasons why people living with diabetes (Type 1 or 2) are at increased risk for anxiety, stress and depression.

So in this blog, I’ll share some evidence-based self-care tips to keep your spirits up while managing diabetes.

Aromatherapy

Essential oils have been widely used for centuries for managing stress, anxiety and depression and are effective due to their ability to access the area of the brain that impacts mood. Research indicates that smells are first processed by the olfactory bulb in the nose which has direct connections to the areas of the brain that are associated with emotion and memory (the amygdala and hippocampus). Also, this study demonstrated the efficacy of lavender oil on sleep quality, mood status and quality of life for participants with Type 2 diabetes. 

You can use a diffuser (they are widely available with many inexpensive options) with water and several drops of lavender oil. Here are some to try:

Diffuser:

Lavender essential oil:

Here are my top 10 essential oils for stress and anxiety.  https://community.wholistics.health/top-10-essential-oils-for-stress-and-anxiety/

Exercise

Consistent exercise is not only a cornerstone of diabetes management but physical and mental health are inextricably linked as each has an impact on the other. According to this study, 12 weeks of aerobic exercise training had significant effects on mental health, self-esteem, anxiety and insomnia of Type 2 diabetic patients. So it’s important to get moving – go for a vigorous walk, hike or find a team sport that you like to engage in. You need about 150 minutes of exercise a week so aim for 30 minutes 5-6 times a week.

Meditation

Meditation is the practice of focusing one’s mind for a period of time and being in the present moment. This is often done in silence but can include bells, chanting and music. There are many different forms of meditation (guided, transcendental, mindfulness, etc.) which I won’t go into here – what’s notable is that meditation has been clinically linked to improvements in psychological health which, in turn, affects physical health. This study showed that meditation can impact stress reduction, blood sugar control and blood pressure in diabetic patients and advocates meditation strategies as part of the lifestyle modification to improve patient wellbeing.  

How about this 20-minute guided meditation to reduce anxiety and stress:

Music

Are you aware that music therapy has been shown to improve outcomes in diabetes patients? In this study, music-assisted relaxation and music therapy showed significant changes in systolic blood pressure, and anxiety and stress levels in both Type 1 and 2 diabetic patients. Here are some beautiful relaxing tunes to bring you inner calm and joy:

Routine

Having a regular routine to get your day off to a good start each morning can help you make the necessary changes and create healthy habits to manage diabetes. Studies have shown the importance of a routine to gradually incorporate lifestyle changes that will be sustainable for the long-term.  Routines can actually help you better manage stress and anxiety as this study found.

So, focus on things that you can control and make a list of things you typically do in a day. Include the tasks that are needed to support your health like exercise, prepping for meals, and shopping for groceries, and make it a priority on your list. Then experiment with the times of the day that make you most compliant (for example, I am 99% more likely to stick with an exercise regimen if I work out in the morning) and plan these activities around these times. Last but not least, a well-established routine takes time so give yourself some grace if you don’t complete all the key tasks each day. There’s always tomorrow…

Yoga

Yoga is a physical, mental and spiritual ancient Indian practice which is designed to promote physical and mental well-being. The well-established benefits of yoga practice are accelerating its growth and it has now become mainstream. This study showed the benefits of yoga practice in improving the stress response by our sympathetic nervous system (which controls our fight or flight behavior).

Yoga is also effective in improving physiological markers of health with this study showing the impact of a yoga protocol on total cholesterol, LDL and triglycerides reduction in Type 2 diabetic participants. What’s not to like about yoga? If you are like me and don’t have much patience, start with a short practice and build up from there. How about this 10 minute yoga to try:

It’s important to talk to your healthcare provider if you are struggling with mental health issues so that appropriate care options can be discussed. Remember that you are in charge of your life so speak up and ask for help.

Heart Disease Fighting Foods

As mentioned in my previous blog, cholesterol is just one factor in a comprehensive approach to managing risks for heart disease. Lifestyle factors such as diet, exercise, alcohol, smoking, and toxins/pollution have a significant impact on our vascular health. So in this blog, I will highlight some superfoods that you can incorporate into your diet to keep your arteries in tip-top shape. 

Avocados and avocado oil

Avocados are nutrient dense and packed with healthy, monounsaturated fat. In this study, participants who ate an avocado daily had significantly lower levels of oxidized LDL (the kind that clogs up your arteries).

Avocado oil is mild so it doesn’t impart flavor to the food and comes with a high smoke point (over 500F) so it’s a great option for cooking and stir-frying all types of food. I no longer use olive oil for frying as the high cooking temperature can damage the oil. In general, the safest way is to stir-fry the food in water or some broth and then add in oil towards the end to minimize high temperatures.

Here is an avocado oil to try:

Berries

Berries are low in sugar and loaded with disease-fighting phytonutrients like flavonoids and antioxidants. In this study of over 1,200 subjects, regular consumption of berries significantly lowered LDL cholesterol, systolic blood pressure, fasting glucose levels and Hemoglobin A1c.  What’s not to like about blueberries, raspberries and blackberries? I buy fresh berries in season but most of the time, I opt for frozen – they store well with many varieties available anytime.

Broccoli sprouts

Compared to standard broccoli, broccoli sprouts have 30-50X more glucoraphanin – a known antioxidant and anti-carcinogenic compound. In this study, consumption of high glucoraphanins resulted in significantly reduced LDL. You can find broccoli sprouts in the produce section – they come in a small container by the alfalfa sprouts section. You can add some broccoli sprouts to top off salads or add them to your morning shake. 

Dark chocolate

Dark chocolate is a rich source of flavonoids (powerful antioxidants) due to the high cocoa content and has been proven to lower the risk of cardiovascular disease. In this study, an analysis of interventional studies done with dark chocolate/cocoa products showed it reduced low-density LDL and total cholesterol levels. If you love chocolate but don’t want the sugar, try these sugar-free options. I ate these while wearing a continuous glucose monitor and noticed how my blood sugar was smooth and steady even after eating a whole bar!

55% Cacao:

My personal favorite:

70% Cacao:

Fibers from legumes and beans

  • Chickpeas, which are a type of legume, are full of fiber and have been shown to reduce total cholesterol levels and fasting insulin.
  • Lentils are another great plant fiber food. In this study, the substitution of red meat with legumes improved glucose control and cholesterol profiles among diabetic patients. 
  • Other heart-healthy beans to try include kidney beans, pinto beans, black beans and cannellini beans.

Green tea

Green tea is rich in catechins, which are antioxidants (a major active compound is epigallocatechin gallate – EGCG) and have been widely used and studied for reducing inflammation, aiding in weight loss and preventing heart and brain disease. In this clinical trial, subjects treated with green tea extract showed significant reduction in LDL cholesterol and an increase in leptin (the satiety hormone). In this study, daily supplementation with green tea extract improved blood pressure, insulin resistance, inflammation and oxidative stress along with lipid profile.

It’s a superfood with many benefits. In lieu of extracts, I prefer to drink green tea daily. Here are the ones I would try:

Green tea has also been highlighted for fighting diabetes – check out my blog on this topic.  

Konjac root fiber

Konjac plant, or the root, is a Japanese root vegetable that is full of fiber. It has been used by people in East Asia for thousands of years and is mainly grown in Asian countries. Similar looking to an odd-shaped potato (as they come from the same family as potatoes), it contains a fiber called glucomannan – a viscous soluble fiber that is being studied as a dietary intervention for reducing cardiovascular risk. In this study, the use of konjac root significantly lowered LDL cholesterol and non-HDL cholesterol. Did you know that konjac root is used to make noodles and rice? They are called shirataki noodles and are available as a low carb, low calorie substitute for pasta and rice dishes. I use the shirataki noodles to put in soups and the shirataki rice to blend with regular white or brown rice. Here are my favorites:

Spaghetti

Rice

Oat Bran

Oat bran contains high levels of beta-glucan, a viscous, soluble fiber that is associated with a reduced risk of cardiovascular disease. This systematic review showed that oat beta-glucans have a lowering effect on LDL cholesterol and very low density lipoproteins (which are artery clogging) and hence recommended as part of a vascular health dietary regimen. 

Here’s one to try:

Olive Oil

The vascular protective properties of the Mediterranean Diet have been well documented, with the importance of olive oil highlighted in lowering the risk of heart attacks and strokes. In this study, consuming at least half a tablespoon of olive oil per day was associated with a 21% lower risk of heart disease. Olive oil, particularly, the extra virgin kind, contains the highest concentrations of polyphenols – the powerful antioxidants which have been shown to reduce oxidized LDL cholesterol, improve HDL cholesterol and reduce blood pressure. 

To insure I’m not ingesting any oxidized olive oil (resulting from high temperature and long storage), I buy olive oil in small quantities and use it as a finishing oil (when stir-frying to minimize heat contact) and for room-temperature dressings and toppings. Unfortunately, the olive oil industry is rife with fakes and oil blends. In a future blog, I’ll share what to look for when buying olive oils. These two have been tested by an independent lab to be pure olive oil and are noted for their high polyphenol content: 

Red Grapefruit

Red grapefruit contains higher quantities of bioactive compounds and higher antioxidant potential than the blond variety. In this study, a diet supplemented with red grapefruit improved lipid levels, triglycerides and serum antioxidant activity.

Salmon

Salmon is fabulous not only for its flavor but also for the high concentrations of heart-protective omega 3 fatty acids. This study has shown that intake of fatty salmon reduced triglycerides and increased HDL cholesterol levels when compared to lean fish (cod). Opt for wild salmon whenever possible as it is higher in minerals and contains less contaminants than farmed salmon (pesticides, PCBs). For convenience, I opt for frozen salmon.

Walnuts

Are you nuts for nuts? How about some walnuts for heart health as they are rich in healthy fats, vitamin E and folate? In this study, inclusion of walnuts in the diet for six months improved endothelial function and LDL cholesterol levels.