Joint pain and dietary intervention

I posted the following question on my Facebook page:

Here is one of the responses:

Yes, it was almost three months ago. Guilt has finally got the better of me!

I am assuming Ivan suffers from joint pain or some other joint problem. Before I list some foods he could try, I need to explain that when it comes to dietary intervention, there is no one-size-fits-all approach. Why? We are all biochemically unique. What will work for one person will not necessarily work for another and may actually make things worse.

If Ivan was my client, I would be asking him some questions. The complete list might take him an hour or two to complete, but here are a few:

• Are your joint problems due to injury or did they just appear?
• How long have you had the problem?
• What is your current diet like?
• What type of exercise are you doing?
• Is your energy good all day long?
• Are you getting adequate sleep?
• Are you exceptionally stressed?
• Do you have blood sugar issues?
• Are you on any medications?
• Have you had any major illnesses?
• Have you been exposed to chemical toxins?
• Do you smoke?
• Do you drink excessive amounts of alcohol?
• Do you suffer from constipation/diarrhoea?

At this point, Ivan might be thinking, “I just want some relief for my joint pain. Why all these unrelated questions?”

Joint pain, as with any symptom, is a sign of imbalance in the body

Think of the body’s cells, organs, and systems. They are all in constant communication with each other, exchanging messages via the nervous system and via hormones, nutrients, and immune markers in the blood. When these lines of communication are working optimally, the body is in a state of ease (homeostasis).

Our diet and lifestyle can be sources of stressors (chemical/biochemical, mental/emotional, and physical/biomechanical) that interfere with these lines of communication. As a result, malfunction in the body’s cells, organs, and systems occurs. This leads to a state of dis-ease (disruption to homeostasis), and given time, symptoms may occur. Symptoms are the outer expressions of underlying malfunction or imbalance.

The type of symptoms or where in the body they occur doesn’t really matter, as malfunction occurs way before symptoms appear. Symptoms may not even appear at all, but when they do, it is a sure sign of dis-ease and therefore malfunction at a cellular, organ, or system level.

Note too that symptoms are often far removed from the actual underlying cause or malfunction.

A whole-body approach

Ivan could take anti-inflammatories, and my guess is that he’s tried that. Although symptoms may go away or decrease with the use of drugs, or even natural pain relief, if the underlying malfunctions have not been addressed, they often come back with a vengeance.

To enable Ivan’s body to restore function, he needs to be making sure he is helping it in every way possible: through optimising his nutrition (there are ways to get very specific about finding out what foods are best for your body), his sleep, and his exercise routine, as well as reducing stress in his environment.

If Ivan hasn’t done so already, I would suggest he get checked out structurally. Also, depending on his responses to my questions, I might also suggest functional lab testing to help identify internal stressors that might be causing problems. For example, gut dysfunction, blood sugar dysregulation, hormone imbalance, or the presence of pathogens can manifest as joint pain. Identifying these stressors means we can start to address them.

Nutritional supplements too—for example, Boswellia,[1] glucosamine sulphate,[2] MSM (methylsulfonylmethane),[3] curcumin,[4] probiotics[5], and antioxidants[6]—could be useful. A word of caution: as I said above, everyone is biochemically different. It is not uncommon for people to have adverse reactions to supplements, and for that reason they should only ever be taken under the direction of a healthcare professional. In my practice, I would teach Ivan how to monitor his reactions and find the correct dosage for his body. Generally speaking, if you are improving everything else (diet, sleep, exercise, and stress reduction) you should only need to be taking them for a short while.

If Ivan was to use this whole-body approach to address the root cause of his joint pain, he can have reasonable expectations that his symptoms will improve.

Inflammatory foods to avoid

Even though I have stated that everyone is biochemically unique, the following foods can be problematic for people with an inflammatory condition, so I would suggest that anyone with joint pain remove these from their diet for a period of time. Aim for 3 months, but try 3 weeks and see how you feel.

• Vegetable oils high in omega-6 fatty acids[7]
• Alcohol[8]
• Sugar[9]

In addition, you can go even further and find out what foods are inflammatory for your body with an elimination diet, or you can run a food sensitivities test.

Specific foods for healthy joints

Ivan has asked what foods can help, so here are some suggestions:

• Extra virgin olive oil has anti-inflammatory properties[10,11] and has been shown to be especially effective when taken in combination with fish oil.[12]
• Bone broth contains a range of nutrients including chondroitin sulphates, glucosamine, and other compounds. Although studies exist on the effects of supplementing with these compounds, I have yet to find any studies on bone broths specifically and whether bone broths contain sufficient quantities of these compounds to be of help with joint pain. People tell me it helps though, so give it a try.
• Flax seed (linseed) oil has anti-inflammatory and pain-killing properties.[13,14] Drizzle it over your salad—don’t heat it. You could also try ground flax seeds.
• Oily fish such as salmon and sardines contain large amounts of omega-3 fatty acids, shown to be effective in reducing joint pain.[15,16]
• Ginger too has anti-inflammatory properties.[17]

Please note that any of these foods may result in an adverse reaction in some people. So, if you are already eating these with no ill effect then continue to do so. Those you do not already eat, add to your diet one at a time (on different days) and assess how you feel. Any negative reaction (and not just in your joints), stop eating it.

Closing note

As a Functional Diagnostic Nutrition® practitioner, and for the reasons outlined above, I do not treat specific symptoms. So if someone has joint problems, my policy is not to recommend a food or supplement (natural or otherwise) to treat the symptom directly, but instead to build health in as many areas as possible and find out what is causing the malfunction in the first place. Only then can the problem be properly addressed and there be any hope of it disappearing for good.

Please consult your doctor before making any changes to your diet and exercise routine.

References

1. Umar S, Umar K, Sarwar AH, et al. Boswellia serrata extract attenuates inflammatory mediators and oxidative stress in collagen induced arthritis. Phytomedicine. 2014;21(6):847–856.
2. Hochberg MC, Martel-Pelletier J, Monfort J, et al. Combined chondroitin sulfate and glucosamine for painful knee osteoarthritis: a multicentre, randomised, double-blind, non-inferiority trial versus celecoxib. Ann Rheum Dis. Epub 2015 Jan 14.
3. Ahn H, Kim J, Lee MJ, et al. Methylsulfonylmethane inhibits NLRP3 inflammasome activation. Cytokine. 2015;71(2):223–231.
4. Chainani-Wu N. Safety and anti-inflammatory activity of curcumin: a component of tumeric (Curcuma longa). J Altern Complement Med. 2003;9(1):161–168.
5. Lescheid DW. Probiotics as regulators of inflammation: a review. Funct Food Health Dis. 2014; 4(7):299–311.
6. Haugen M, Fraser D, Forre O. Diet therapy for the patient with rheumatoid arthritis? Rheumatology. 1999;38(11):1039–1044.
7. Covington MB. Omega-3 fatty acids. Am Fam Physician. 2004;70(1):133–140.
8. Bradlow A, Mowat AG. Alcohol consumption in arthritic patients: clinical and laboratory studies. Ann Rheum Dis. 1985;44(3):163–168.
9. Batt C, Phipps-Green AJ, Black MA. Sugar-sweetened beverage consumption: a risk factor for prevalent gout with SLC2A9 genotype-specific effects on serum urate and risk of gout. Ann Rheum Dis. Epub 2013 Sep 11.
10. Beauchamp GK, Keast RS, Morel D, et al. Phytochemistry: ibuprofen-like activity in extra-virgin olive oil. Nature. 2005;437(7055):45–46.
11. Lucas L, Russell A, Keast R. Molecular mechanisms of inflammation. Anti-inflammatory benefits of virgin olive oil and the phenolic compound oleocanthal. Curr Pharm Des. 2011;17(8):754–768.
12. Berbert AA, Kondo CR, Almendra CL, Matsuo T, Dichi I. Supplementation of fish oil and olive oil in patients with rheumatoid arthritis. Nutrition. 2005;21(2):131–136.
13. Singh S, Nair V, Gupta YK. Linseed oil: an investigation of its antiarthritic activity in experimental models. Phytother Res. 2012;26(2):246–252.
14. Kaithwas G, Mukherjee A, Chaurasia AK, Majumdar DK. Anti-inflammatory, analgesic and antipyretic activities of Linum usitatissimum L. (flaxseed/linseed) fixed oil. Indian J Exp Biol. 2011;49(12):932–938.
15. Zivkovic AM, Telis N, German JB, Hammock BD. Dietary omega-3 fatty acids aid in the modulation of inflammation and metabolic health. Calif Agric (Berkeley). 2011;65(3):106–111.
16. Goldberg RJ, Katz J. A meta-analysis of the analgesic effects of omega-3 polyunsaturated fatty acid supplementation for inflammatory joint pain. Pain. 2007;129(1–2):210–223.
17. Grzanna R, Lindmark L, Frondoza CG. Ginger—an herbal medicinal product with broad anti-inflammatory actions. J Med Food. 2005;8(2):125–132.