Types and causes

Osteoarthritis is degeneration of bone caused by general wear and tear, overuse of a particular joint or being overweight. It causes stiffness, pain and immobility and affects 80 per cent of people over 50, especially post-menopausal women and the elderly.

Rheumatoid arthritis is inflammation of the tissues surrounding the joints caused by an immune-system imbalance. It’s characterised by red and swollen joints, aching and pain, and can be triggered by stress, diet and viral infections. The exact cause, however, is unknown.

Ankylosing spondylitis is inflammation of the bones of the spine. For more information about the condition, see the Arthritis guide.
Orthodox treatments

Anti-inflammatory drugs, painkillers, steroids, physiotherapy and heat treatment are all used to combat arthritic pain. In severe cases, surgery may be used to replace the joint.
Complementary approaches

* Dietary therapy – adopting a diet low in sugar, animal produce and refined carbohydrates but high in vegetables, wholegrains, fibre and essential fatty acids (EFAs) can help rheumatoid arthritis. Daily intake of omega-3 and omega-6 EFAs, found in fish and plant oils, helps to decrease inflammation and pain. Testing for food intolerance and then eliminating identified foods can also help. Common trigger foods include dairy produce, wheat, grains, tomatoes, citrus fruits and potatoes.

* Nutritional therapy – selenium, zinc, magnesium and vitamin E can help to prevent and treat osteo- and rheumatoid arthritis. Glucosamine and chondroitin supplements may help cartilage formation. Some patients find bromelian (derived from pineapple) or green-lipped mussel (Perna canaliculus) help to reduce inflammation. Avocado and soya bean derivatives may also provide long-term benefits for osteoarthritis.

* Herbal medicine – certain herbs have long been used for their anti-inflammatory properties, including devil’s claw, barberry, guggal and ginger.

* Acupuncture – is claimed to decrease arthritic pain and increase mobility. It can also help patients to reduce their reliance on pain-control medication. Early treatment is advisable for best results.

* Homeopathy – many sufferers report that individually tailored homoeopathic remedies can ease pain. One study found such remedies worked better than aspirin in reducing discomfort and pain.

* Electrostimulation – transcutaneous nerve stimulation (TENS) devices provide relief for some arthritis sufferers. However, research results are contradictory.

* Osteopathy, chiropractic and massage – can improve circulation around the joint and increase mobility. However, manipulation should only be performed with great care and may have to be avoided altogether in the case of severely arthritic joints.

* Hydrotherapy – mineral and thermal baths (balneotherapy) have been used for centuries to treat osteoarthritis. Cold compresses can relieve inflammation and pain, while gentle exercise in water can increase mobility.

Self-help tips

* Take regular, gentle exercise such as walking and swimming to keep the joints mobile and strengthen the supporting muscles.
* Lose weight or maintain your ideal weight to ease pressure on the joints.
* Change your diet and take nutritional supplements as appropriate to reduce pain and inflammation. Food intolerance testing may be helpful to identify specific sensitivities.
* Self-massage with oils or creams containing anti-inflammatory herbs.
* Make a cold compress by soaking a piece of cotton in cold water, then wringing it out and placing it over the affected joint to reduce inflammation. Cover with dry, warm material, such as wool or towelling, and leave for an hour or so.

This article was last medically reviewed by Dr Stephen Hopwood in April 2009.