Osteoarthritis

Charlotte is 39 years old.  She has a busy life.  She studied dietetics and manages her own nutrition practice.  She is a marathon runner.  And, she’s a Mum of 4 kids.

She came to see me because her left hip was giving her trouble.  She’d always felt her left leg was a lot weaker than her right but now, she was experiencing pain, stiffness and she was unable to keep up with her running training.  She’d been to see a physiotherapist for ultrasound, cryotherapy and stretching but it only made her symptoms worse.

We did a scan of her hip and it confirmed osteoarthritis.  A blood test showed high inflammation, low vitamin D and high cortisol.

Charlotte was devastated.  She came into my office and burst into tears.  ‘Does this mean I can never run again?  Do I need a hip replacement?’

I explained to Charlotte that although osteoarthritis is a mechanical problem and often due to wear and tear, there are lifestyle strategies we can use to slow down the progression, and perhaps even reverse some of the damage.

Firstly, I asked about her nutrition.  She looked a little embarrassed and said:  ‘Doc, you know how the mechanics car is always broken down… That’s me!  I make sure everyone else is eating healthy but I often don’t have time to pay attention to my own diet’.  She would often grab a cereal bar for breakfast, a panini or slice of pizza for lunch, pretzels or nuts and fruit for an afternoon snack.  A smoothie with berries and sweetened yoghurt after her run in the afternoon.  Dinner was whatever the kids didn’t finish:  Fish fingers and mashed potato or spaghetti bolognaise.

She acknowledged that she was not including the types of foods that support joint health and reduce inflammation:

• Foods rich in omega-3 fatty acids:  Walnuts, chia seeds, flax seeds and fatty fish (salmon / mackerel / tuna / sardines / herring / trout)
• Foods high in antioxidants and anti-inflammatory phyto-chemicals:  Leafy greens, citrus fruits, berries, bell peppers and chilies, cruciferous vegetables like broccoli, brussels sprouts and cabbage.
• Foods with anti-inflammatory properties:  Turmeric (curcumin), ginger and black pepper.
• Foods containing healthy fats for joint lubrication:  Olive oil, avocados, coconut, almonds and Brazil nuts.
• Foods that support bone health:  Dairy (unsweetened yoghurt and cheese), eggs and poultry, and bone broth.

And she understood that processed foods like cereal bars, white bread / pizza, pretzels, sweetened yoghurt and fish fingers would promote inflammation.

I then asked about her training routine.  She explained that she didn’t have much time to do anything except running.  The stretching the physio had recommended caused her more pain so she had stopped.

And, when I enquired about her stress levels and sleep quality… she started crying again.  I could see she was overwhelmed by all her responsibilities.

My suggestions were:

Try intermittent fasting.  As a dietician, this didn’t sit too comfortably but when I explained that fasting can improve inflammation, stimulate growth hormone and trigger autophagy… all of which would benefit osteoarthritis, Charlotte agreed to give it a bash.  She was excited because it meant she didn’t have to think about breakfast in the morning, and she could focus on one healthy meal for her per day including those foods that would help reduce inflammation and promote joint health.

Targeted exercise including strength training.  It is absolutely vital for anyone with osteoarthritis to ensure the muscles around the affected joint are strong and well-conditioned to keep the joint in good alignment and protect the joint from injury.  I referred her to an exercise physiologist.

Focus on sleep hygiene and practice breathwork before bed.  It was absolutely essential that Charlotte get enough good quality sleep and do some relaxation exercises to lower her cortisol in order to promote healing.

Supplements:  Vitamin D.  It was unrealistic to expect Charlotte to spend enough time in the sun to get her vitamin D back in the optimum range.

The outcome:  After 9 months, Charlotte was running comfortably and training for her 7th marathon.  She was feeling much better generally with increased energy and more control of her life.  She was enjoying strength training and said that it really helped her to run better.  We did not repeat her scan because on examination, her hip mobility was significantly improved and she wasn’t limited by hip pain anymore.  It would have been unnecessary exposure to radiation.  She was delighted with her improvement.

This case shows that although osteoarthritis is generally a progressive condition characterised by wear and tear, there is hope for amelioration.  It is possible to improve joint health through lifestyle change.  It is possible to improve inflammation, and promote joint healing by changing your diet, incorporating intermittent fasting and including exercises that strengthen the structures supporting your joints.

Here are my top tips for managing osteoarthritis naturally:

Targeted exercise.  Focus on strength training to condition the muscles and soft-tissue structures supporting your joints.  It’s helpful to seek professional advice from a physiotherapist, bio-kineticist or exercise physiologist.

Try intermittent fasting.  It has powerful anti-inflammatory and healing benefits.

Eat a nutritious, whole-food diet including anti-inflammatory and antioxidant foods that help reduce inflammation and promote repair.  Avoid ultra-processed and high-sugar foods known to trigger inflammation.

Specific supplementation.  Certain natural supplements are supported by research studies and may be helpful… But always consult your doctor or healthcare provider on the safety and efficacy if you are considering taking any of these.