Health News and Information

Shawna had been struggling with bulimia for a long time when she went to my colleague, endocrinologist Dr. Ed Klaiber, because she hadn’t had a period for over three years. Fair and small-boned to begin with, Shawna now had almost no body fat. When she had her estrogen levels tested, they were very low. Among other things, that put her bones at risk. Unfortunately, a bone density scan confirmed her doctors’ fears: 25-year-old Shawna had the bones of a 65-year-old woman.Working with her regular doctor, she finally seemed to be getting her eating disorder under control at this point. Following Dr. Klaiber’s advice, she also began taking Fosamax and estrogen. Combining therapies in this way was unorthodox at the time, though studies now confirm that various drugs in combination provide increased responses over any one alone. It surely worked for Shawna: she’s gotten back 18 percent of her bone in one year.*24\228\2*

Physical therapists offer a number of options that may help arthritis. These can include investigating your work habits to see if it’s possible to minimize the stress you put on your body (an ergonomic study), and perhaps relaxing the muscles and tendons surrounding your joints by using ultrasound therapy.
Some physical therapists use transcutaneous nerve stimulation, or TENS, to give temporary relief from pain.
The direct application of heat or cold to an affected joint can provide at least short-term relief. A survey of participants with rheumatoid arthritis and osteoarthritis attending a clinic found that 60% of them used warm baths or other forms of heat applied to the skin. Another 22% liked to apply cold to painful areas. This is certainly a low-cost plan, and it is quite safe as long as you follow the generally recommended procedures: keep a towel between your skin and a cold pack, don’t fall asleep on your heating pad, and don’t leave either on your skin for a prolonged period of time.
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Weight Reduction for Osteoarthritis
Can losing weight help your arthritis? The results are not conclusive.
One observational study suggested that weight loss can reduce the risk of developing symptomatic osteoarthritis of the knee in women. This seems reasonable, as excess weight increases the stress on the knee joint. However, to date, no studies have tested weight loss as a treatment for osteoarthritis. One study did look at the possibility that the positive results seen in other studies on changes in diet were caused by weight loss, but found no correlation between the amount of weight loss and the improvement of symptoms.
Nonetheless, if you are overweight, you should make every attempt to lose weight. Increased weight is associated with accelerated progression of the disease.

Exercise
Exercise can play a central role in keeping your joints healthy.
It was once thought that exercising a joint with osteoarthritis would cause it to “wear out” faster. Recent evidence, however, suggests that exercise can play a central role in maintaining a healthy joint. Furthermore, research shows that exercises designed to strengthen the muscles surrounding an osteoarthritic joint can lead to improved function and better psychological health. However, the fact that it is difficult, if not impossible, to do “placebo” exercise makes these studies suggestive only.
Two controlled studies on osteoarthritis of the knee have found that strengthening the muscle that straightens the leg (the quadriceps) allows participants to have less disability and possibly less pain. Another couple of studies suggested that a regimen of moderate aerobic exercise, like walking or swimming, also improves the ability to function with osteoarthritis. In one study, which also included stretching and psychological support, physical activity increased by 24% and pain decreased by 14%. The use of medications was also lower. However, because all three elements of the treatment were combined, we don’t know if the positive effects were because of the exercise, the stretching, or the psychological support – or all of them.
Both of the studies that included aerobic exercise indicated that participants with moderate to severe osteoarthritis of the knee can benefit from participating in activities equivalent to walking or swimming for 30 minutes 3 times a week. Putting all this information together, it appears that regular exercise should probably be a part of your treatment plan if you develop osteoarthritis.
Consult with your doctor or a physical therapist for recommendations about the type of exercise and its intensity.
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One of the best studies of glucosamine was a double-blind placebo-controlled study that involved 252 participants with osteoarthritis of the knee. A total of 241 participants completed this 4-week trial. Of the 120 participants who received the glucosamine, 55% experienced a reduction in pain and stiffness. This was significantly better than the 38% rate of improvement among those who received the placebo.
Not only was glucosamine effective, it did not cause any significant side effects. To be precise, minor side effects, mostly upset stomach and allergy symptoms, were seen in about eight people taking glucosamine. However, similar side effects were seen in 13 people receiving   placebo!   When   a treatment causes fewer side effects than placebo, it is reasonable to call it side-effect free for all practical purposes.
The major weakness of this trial was that it lasted only 4 weeks. For a chronic disease like osteoarthritis, you’d really like to have a study of at least 3 to 6 months’ duration. But it still provides impressive evidence that glucosamine can be an effective treatment for osteoarthritis.
Similar results were seen in two other double-blind placebo-controlled studies, involving a total of 120 participants.
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