By Dr. Mercola
Do you crack or "pop" your knuckles? Some believe it may cause, or worsen, joint conditions such as arthritis. However, according to the featured research,1, 2 knuckle-cracking does not appear to be a risk factor for osteoporosis in that joint.
About one in five adults, or nearly 50 million Americans, have been diagnosed with arthritis, the most common form of which is osteoarthritis.3
If you have osteoarthritis, the cartilage within your joints is progressively being damaged, and the synovial fluid that keeps your joints lubricated and cushioned is typically reduced as well.
The pain and joint stiffness that you feel is a result of your bones starting to come into contact with each other as cartilage and synovial fluid is reduced, and if you don't take action, it can become progressively worse until you are unable to carry out your normal daily activities.
In conclusion, the authors stated that:
"Total past duration (in years) and volume (daily frequency x years) of knuckle-cracking (KC) of each joint type also was not significantly correlated with OA at the respective joint. A history of habitual KC - including the total duration and total cumulative exposure 'does not seem to be a risk factor for hand OA.'"
Twenty years ago, I co-authored a paper titled "Cracking down on 'neck cracking,' which was published in the journal American Family Physician.4 In it, I argued that self-manipulation can lead to lax ligaments. Personally, I don't think it's wise to crack your joints on a regular basis, even if it doesn't directly lead to arthritis of the joint. That said, what can make arthritis worse, and how can you address arthritic conditions?
What's the Difference Between Osteoarthritis and Rheumatoid Arthritis?
Osteoarthritis usually occurs in older individuals, but can also be caused by repetitive stress or acute trauma. Rheumatoid arthritis, on the other hand, can affect you at any age, including children. Fortunately, juvenile rheumatoid arthritis (JRA) is relatively rare.
Understanding the differences between the two types of arthritis will help you distinguish which one you have.
Osteoarthritis – Degenerative joint disease usually affects the distal joints, or the joints at the end of your fingers and toes, not the middle ones. Additionally, it's not symmetrical, so typically you may have it on just one joint, or on one hand or foot and not the other.
Rheumatoid arthritis – RA, on the other hand, is an autoimmune disease that causes your body to break itself down. Therefore, it tends to be bilateral and symmetrical, meaning it's the same on both sides of your body. If you only have a specific joint affected on one side of your body, it is far less likely to be RA. It also affects your middle joints, and is associated with joint deformities, especially your hands and fingers. It can be very crippling, and people do die from rheumatoid arthritis, so it's not something to be treated lightly.
Little-Known Risk Factors for Rheumatoid Arthritis and Osteoarthritis
Recent research5 has identified several lifestyle factors and pre-existing conditions that may increase your risk of developing rheumatoid arthritis, including:
As for osteoarthritis, a recent analysis6 found that the greater a woman's exposure to perfluorinated compounds (PFCs), the greater her risk for developing osteoarthritis. Interestingly, the same correlation was not found in men. It's believed the reason for this is the impact of these chemicals on women's hormones. PFC's are commonly found in nonstick cookware, takeout containers and carpeting, just to name a few.
Even though osteoarthritis and rheumatoid arthritis are two entirely different diseases, they can be treated in much the same way as foundationally inflammation as at the core of the pain. So even though osteoarthritis is typically caused by wear-and-tear on your joints due to lifestyle, diet and aging, and rheumatoid arthritis is an autoimmune disease in which your body starts destroying itself, you may gain relief from the following treatments regardless of which type of arthritis you have.
First: Basic Lifestyle Changes to Address Arthritis
I believe improving your diet using my nutritional guidelines is crucial for your success. It addresses all of the nutritional guidelines presented in this article, and more. In addition, there are some general principles that seem to hold true for virtually everyone and these include:
- Eliminating sugar, especially fructose, and most grains. For most people with rheumatoid arthritis, you'll want to be very careful to limit fructose to just 15 grams per day or less, and this includes fructose from whole fruit.
- Opting for organic food, preferably locally grown, and eat your food as close to raw as possible
- Incorporating regular exercise into your daily schedule. Weight training has been found to be of particular benefit for those with rheumatoid arthritis and, contrary to popular belief, if you have osteoarthritis exercise is absolutely crucial to your well-being. Naturally, if you're in pain, you need to take certain precautions, so for more information on how to adjust your exercise if you have either of these conditions, please follow the links provided.
The Importance of Sulfur
Sulfur is just now becoming more widely appreciated as a really critical nutrient, without which many other things don't work properly, and many are not getting enough sulfur from their diet anymore. Sulfur is found in over 150 different compounds within the human body. There are sulfur components in virtually every type of cell, so it's extremely important. It plays a critical role in inflammatory conditions such as arthritis, as well as detoxification. Two ways to increase your sulfur intake include:
- MSM, either from food or supplement: A metabolite of DMSO, MSM primarily impacts your health by reducing inflammation. MSM is 34 percent sulfur by weight, but it's more than just a simple sulfur donor. It affects sulfur metabolism in your body, although it's still not entirely clear how. Perhaps most important, MSM helps protect against oxidative damage, and is widely used as a supplement for arthritic conditions.
While many opt for a supplement, MSM is in most raw foods, such as leafy green vegetables. Raw milk has the highest naturally occurring content of MSM.
One caveat is cooking and pasteurization. While MSM is stable to extremes of pH and temperature, it volatilizes and turns to gas very easily. It's also very water-soluble. So when cooked at high temperatures, it simply wafts off in the steam. That's why it's easily removed during cooking and processing. Pasteurization cuts the MSM content by approximately 50 percent. So, in order to ensure you're getting the most MSM from any food, it must be either raw or as minimally processed as possible.
Fortunately, toxicity studies have shown that MSM is extremely safe and can be taken at very, very high doses. Even if you have a very rich diet full of raw vegetables and MSM-rich foods, you can still supplement and not hit that toxicity level. Clinical research studies have found that the effective amounts range from about 1.5 grams to 6 grams. For comparison, intake of MSM from natural sources such as fruits and vegetables would be in the milligram per day range of about 2.3 to 5.6 mg/day.
- Bone broth: Simmering leftover bones over very low heat for an entire day will create one of the most nutritious and healing foods known to man. Make sure the bones are from organically raised animals. The connective tissues are sulfur-rich, and when you slow-cook the bones, you dissolve these nutrients out of the bone and into the water.
You can use this broth for soups, stews, or drink it straight. Remember that the "skin" that forms on the top is the best part—this is what contains the most valuable nutrients, including sulfur, along with healthful fats—so make sure to stir it back into the broth.
Other Important Treatments That Work for Both Types of Arthritis
Almost universally, autoimmune diseases have an underlying vitamin D deficiency. For example, the further you go from the equator, the higher the incidence of rheumatoid arthritis becomes. From my perspective, it is now virtually malpractice to treat a person with RA and not aggressively monitor their vitamin D levels to confirm that they are in a therapeutic range of 65-80 ng/ml. This is so important that blood tests need to be done every two weeks, so the dose (whether you're using sun exposure or a supplement) can be adjusted to get within that therapeutic range.
It would also be helpful to review my comprehensive list of treatment suggestions for RA. For over 10 years treating patients with RA was one of my interests and I successfully treated a few thousand patients by applying simple effective strategies.
Research has also suggested that vitamin D deficiency may impair your body's natural protection against the bone changes associated with osteoarthritis.7 Research8 published in 1996 also found that low serum levels of vitamin D were associated with an increased risk for progression of the condition—those with low vitamin D levels had triple the risk compared to those who were not vitamin D deficient. Low serum levels of vitamin D also predicted loss of cartilage and degenerative bony spur formation.
The remedy, of course, is to optimize your vitamin D levels, ideally through appropriate sun exposure.
If you opt for a supplement, keep in mind that you may need FAR higher doses than typically recommended. According to research published by GrassrootsHealth from the D*Action study, the average adult needs to take 8,000 IU's of vitamin D per day in order to elevate your levels above 40 ng/ml -- the bare minimum requirement necessary for disease prevention. As mentioned, if you have RA, you'll want your levels to be higher than this (within the 65-80 ng/ml range), so you'll need to have your blood tested and tweak your dose/sun exposure accordingly. Also, if you opt for a supplement, keep in mind that you need to concurrently boost your intake of vitamin K2, either through your diet or with a supplement.
Another primary treatment method for either of these conditions is a high quality source of animal-based omega-3 fats such as krill oil. Omega-3s are an essential component that your body needs to reduce inflammation.
Astaxanthin is another powerful anti-inflammatory antioxidant that could have very powerful benefits in controlling joint pain. I recommend starting with 2 mg per day, but for more serious conditions you may benefit from as much as 10-12 mg per day. If you are on a krill oil supplement, take that into consideration as krill oil naturally contains astaxanthin. Different krill products have different concentrations of astaxanthin, so check your label and adjust your dosage of astaxanthin accordingly.
Optimizing your gut flora is also important if you're suffering from any kind of inflammatory condition. I would strongly encourage you to eat 4-6 ounces a day of fermented vegetables, which will supply you with about 10 trillion beneficial bacteria. That's about 10 percent of the total microbial population of your gut, and can equate to an entire bottle of most probiotics supplements. Ideally you should consume them regularly if not daily. The best way to learn how to prepare them properly is to get the GAPS book or listen to my interview with Caroline Barringer.
Two Newer Kids on the Block—Curcumin and Naltrexone
Two additional treatment options deserve mention. The first is low dose naltrexone as an adjunct to help you wean off the nearly universal experience of toxic drugs that most people with rheumatoid arthritis (RA) are put on. Low dose naltrexone is one of the newer additions to my rheumatoid arthritis protocol, which I would encourage anyone with RA to try. It is inexpensive and non-toxic and I have a number of physician reports documenting incredible efficacy in getting people off of all their dangerous arthritis meds.
Although this is a drug, and strictly speaking not a natural therapy, it has provided important relief and is FAR safer than the toxic drugs that are typically used by nearly all rheumatologists. The other is curcumin—the pigment that gives the curry spice turmeric its yellow-orange color. At a dose of 200mg per day, curcumin was found to relieve pain and increase mobility in patients with osteoarthritis in one study.9 It's known for its potent anti-inflammatory properties, and the compound has been shown to influence more than 700 genes. It can inhibit both the activity and the synthesis of cyclooxygenase-2 (COX2) and 5-lipooxygenase (5-LOX), as well as other enzymes that have been implicated in inflammation.
In another study10 involving people with rheumatoid arthritis, a highly bioavailable form of curcumin was more effective in alleviating RA symptoms, including tenderness and swelling of joints, than the NSAID drug Voltaren. Not only that, those who were taking the curcumin only actually experienced the most improvement across the board. Along with relieving the most symptoms, the curcumin group had another benefit – lack of any observed adverse effects. No one in the curcumin group withdrew from the study due to side effects, but 14 percent of those in the NSAID group did so.
Several years back, in 2006, another study11 also found that turmeric supplements, which contain curcuminoids, profoundly lessened joint inflammation and destruction, presumably by blocking inflammatory pathways and thereby preventing the increased production of a protein that triggers swelling and pain.
Arthritis is Controllable without Drugs...
Unlike osteoarthritis, which is a degenerative joint disease, rheumatoid arthritis is an autoimmune disease that causes your body to break itself down – your immune system starts attacking your joints, leading to pain, deformities and a substantial loss of mobility. As a result, it is generally treated with very aggressive medications. In fact, the drugs used for rheumatoid arthritis are some of the most dangerous drugs used in medicine. High doses of prednisone are common, as well as immunosuppressants and anti-cancer agents to treat the severe pain and swelling.
Fortunately, you have many other options. While rheumatoid arthritis and osteoarthritis are different diseases, many of the treatments are identical, as discussed above.
Remember, for my full recommendations on how to treat rheumatoid arthritis naturally, please review my rheumatoid arthritis protocol. As for osteoarthritis, by exercising, eating right, optimizing your vitamin D levels and seeking natural, restorative options for pain, you can help to significantly slow down any further deterioration or loss of motion in your joints.