Arthritis Pain: Symptoms, Causes, and Possible Treatments
What is arthritis?
Arthritis is not a single disease, but rather an informal way of referring to joint pain or joint disease. There are more than 100 types of arthritis and related conditions. People of all ages, sexes, and races can have arthritis, and it is the leading cause of disability in America (“Understanding Arthritis”).
Types of Arthritis – Pain and Causes
Common types of arthritis include:
Degenerative arthritis or osteoarthritis is the most common type of arthritis. When the cartilage wears away, bone rubs against bone, causing pain, swelling, and stiffness. As a result, over time, joints can lose strength and this may lead to chronic pain.
Risk factors for this type of arthritis include family history, excess weight, age, and previous injuries like an ACL tear, for example. It can also be prevented by staying active, maintaining a healthy weight, and avoiding injury and repetitive movements.
A healthy immune system generates internal inflammation in order to rid the body of infection and prevent disease. However, with inflammatory arthritis, a dysfunctional immune system mistakenly attacks the joints with uncontrolled inflammation, which may lead to joint erosion.
Inflammation can also damage internal organs, eyes, and other parts of the body. Examples of inflammatory arthritis include rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis, and gout, among others. A combination of genetics and environmental factors (like smoking tobacco) may trigger autoimmunity.
With autoimmune and inflammatory arthritis, early diagnosis and aggressive treatment is key to slow disease activity and thus minimize or prevent permanent joint damage.
Infectious arthritis results from a bacterium, virus, or fungus that enters the joint and triggers inflammation. Salmonella, shigella (food poisoning), chlamydia and gonorrhea, and hepatitis C can all infect joints.
Timely treatment with antibiotics may clear the joint infection, but sometimes the resulting arthritis may become chronic.
Uric acid is a natural byproduct of the body breaking down purines, a substance found in human cells and many foods. High levels of uric acid may be present in some people because they naturally produce more than the body needs or the body cannot get rid of it quickly enough. This uric acid buildup can form needle-like crystals in the joint, resulting in sudden spikes of extreme joint pain, or a gout attack. A person may experience temporary episodes of gout, however, if uric acid levels aren’t reduced, the gout can become chronic and cause ongoing pain.
According to the CDC, nearly 1 in 4 adults with arthritis (15 million people) report experiencing severe joint pain as a result of their arthritis. Additionally, nearly half of adults with arthritis have persistent and chronic pain.
Solutions for Arthritis Pain
Extra weight can put more pressure on the joints, especially the knees, hips, and feet. Weight management can help improve mobility, decrease pain, and prevent future joint damage.
This can assist in weight management, as well as keeping the joints flexible and strengthening the muscles around the joints, which offers the joints greater support. Examples of low-impact activities that are beneficial to those with arthritis include walking, cycling, tai chi, yoga, swimming, and other water activities.
A diet rich in fresh fruits, vegetables, and whole foods improves overall health and can also help boost the immune system. A 2019 review in Frontiers of Neuroscience suggests that a plant-based diet can reduce inflammation and improve symptoms related to rheumatoid arthritis, especially when compared to diets higher in fat and animal products (which can aggravate inflammation).
Specific foods can also help alleviate the pain associated with arthritis (particularly inflammatory arthritis):
Decrease inflammation by removing free radicals from the body
EX/ Green tea has polyphenol antioxidants that are anti-inflammatory, improving arthritis-related immune responses and significantly reducing cartilage damage
Helps produce collagen, a major component of joints, and sweeps out harmful free radicals
Plays a role in the production of collagen in joints and may protect joints from osteoarthritic damage
Omega-3 Fatty Acids
Excellent for reducing inflammation and soothing joints
Too little calcium raises the risk of osteoporosis, a brittle-bone condition that accelerates if a person has rheumatoid arthritis
Can mimic NSAIDs, the front-line drugs for arthritis pain relief, by curbing pain-causing chemicals that are part of the body’s inflammatory response without the side effects common with NSAIDs
Are antioxidants, and also contain an anti-inflammatory chemical called eugenol that interferes with bodily processes that trigger arthritis
Contain capsaicin, which reduces swelling and blocks a neurotransmitter called substance P, which is responsible for sending pain signals to the brain
Hot and Cold Therapy:
Heat and cold treatments can help relieve arthritis pain and inflammation.
Examples of heat treatments include taking a long, hot shower or bath to help ease stiffness (especially in the morning), and using an electric blanket or moist heating pad to reduce discomfort (especially overnight).
Topical ointments and creams containing capsaicin (a common ingredient) also provide warmth that soothes joint pain.
Cold treatments can help relieve joint pain, swelling, and inflammation. Examples include wrapping a gel ice pack or a bag of frozen vegetables in a towel and applying it to painful joints or quick relief.
Acupuncture, a practice of Traditional Chinese Medicine, involves the insertion of very thin, sterile needles into the skin at specific points along the body’s lines of energy called meridians, and can be used to target areas of inflammation in order to reduce pain. Practitioners assert that by restoring the proper flow of energy (known as qi in Traditional Chinese Medicine) and fluids around the body, acupuncture can help fight swelling and inflammation at affected joints, and can reduce sensations of pain and discomfort related to different types of arthritis.
Massage therapy can increase blood flow to affected joints and thus decrease pain and inflammation and improve mobility. It can also improve sleep patterns and boost energy levels.
Over-the-counter pain relief drugs like acetaminophen and nonsteroidal anti-inflammatory drugs (NSAIDs) like ipubrofen can be effective.
Acetaminophen can help ease mild pain. However, doses must be taken carefully and not in excess, so as not to cause any damage to the liver. People with liver disease or alcoholism may not be able to take acetaminophen, and it should not be taken while drinking alcohol.
NSAIDs can lower swelling and ease pain, but they do not have a significant effect at these lower doses. People who’ve had a heart attack should be careful using NSAIDs, as it raises their chances of having another heart attack. It also keeps the stomach from making substances that protect it from acids, thus when taken for a long time can cause side effects like stomach irritation and bleeding.
Prescription NSAIDs (stronger than over-the-counter ones) are more effective at treating arthritis pain and inflammation. However, like over-the-counter NSAIDs, taking these medications for a long time can cause serious side effects like heart attack, stroke, kidney disease, and stomach irritation and bleeding.
If NSAIDs don’t help, steroid medications can ease pain by lowering inflammation. They are typically administered as a shot into the affected joint. They act quickly but help only for a short time. Some less serious side effects can occur, including infections, allergic reactions, bleeding, skin discoloration, etc. Because frequent injections to the same joint an damage the joint structures, generally no more than three shots in the same site per year should be administered.
In special cases, opioids (such as codeine, hydrocodone, or oxycodone) may be prescribed to help people with arthritis pain. When taken exactly as prescribed, these drugs can be safe and work well against pain. However, they can cause serious side effects if used for a long time, such as nausea, constipation, dizziness, drowsiness, dependence, and addiction. Driving and operating heavy machinery can be dangerous on these medications.
Boswellia (aka Indian frankincense)
Resin herbal extract with anti-inflammatory properties
Has been used in natural medicine for centuries
Boswellia capsules can help with arthritis pain
Derived from tropical vine found in the Amazon
In an 8-week study (Mehta et al., 2007), a supplement of cat’s claw and maca root reduced pain and stiffness in people with osteoarthritis (patients also needed pain medication less frequently)
Can be taken as a liquid extract, capsule, powder, or tea
Herbal preparation taken as a tablet
Its active ingredient, salicin, reduces the production of pain-inducing chemicals in the nerves
Limited evidence suggests it may have a moderate effect in treating pain caused by osteoarthritis, however it is possibly less effective than NSAIDs
Has anti-inflammatory properties and can be directly applied to the skin as a gel or taken orally as a pill or powder (limited evidence) to relieve osteoarthritic pain
The plant leaves contain tannins, which may help swelling and pain related to arthritis, and can be used topically (especially in aromatherapy)
Initial studies (ex/ Hunter et al., 2018; National Academies of Sciences, Engineering, and Medicine, 2017) and anecdotal evidence suggest that cannabis and its non-psychoactive derivative cannabidiol (CBD) could be effective for chronic pain in adults, as it may have powerful anti-inflammatory properties.
It can be administered via topical creams and lotions, tinctures, oils, pills, and more, and comes in a few distinct forms: “Full Spectrum CBD”, “Broad Spectrum CBD”, and “CBD Isolate.” Full-Spectrum CBD contains all the phytochemicals naturally found in the hemp plant, including CBD, trace cannabinoids, terpenes, and essential oils, and comes with trace THC contents (<0.3%). Broad-Spectrum CBD contains cannabidiol and all the other compounds within the hemp plant, however the THC is completely removed after the initial extraction. CBD Isolate is pure CBD that was extracted from the hemp plant, and then isolated from all other ingredients, resulting in a 99% pure CBD extract.
Even so, many CBD products have been proven to contain less CBD than they claim to, and can reduce in efficacy after ingestion, as much of that CBD is not rapidly bioavailable. In contrast, C’bella Naturals’ CBD high-concentration products, developed by an experienced team of scientists in a state-of-the-art lab, consistently deliver. In particular, the 3,000mg CBD Nano Lotion 5% is engineered for optimal absorption, stability, penetration, and retention, retaining 90% or more of the original CBD amount even after 24 months. As such, this lotion can be used for surface area issues, and can also penetrate deeper beneath the skin. C’bella’s proprietary Micellar Nano Particle Technology converts cannabinoid particles to nanoparticles, enhancing the surface area for absorption up to a hundred-fold and increasing bioavailability, making them that much more effective.