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PRESENTS… PRESENTS…
Dr. Michael Long ND BSc & Dr. Katie McKeown ND BSc
Natural Approaches to Arthritic Conditions
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INFLAMMATION AND ARTHRITIS
Section I
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Inflammation
• Inflammation is a very complex reaction to injurious agents (i.e. infections, trauma, chemicals, etc.)
• First described in 3000 BC, by the four signs of inflammation: 1. Rubor: redness 2. Tumor: swelling 3. Calor: heat 4. Dolar: pain
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Inflammatory Process
• When part of the body is damaged, various cellular and vascular changes take place
4 Figure 2-1: Pathologic Basis of Disease, Robbins and Cotran
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Inflammation at the Cellular Level
5 Figure 2-2: Pathologic Basis of Disease, Robbins and Cotran
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Inflammation Protects Us!
• Allows the body to ‘get rid of’ the causative agent – Without it, wounds would never heal,
infections would never go away, and life would be largely unsustainable
• But what happens when the inflammatory process doesn’t turn off?
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Inflammation: The Underlying Cause of All Disease
• When the inflammatory process acts improperly or fails to shut off, the result can be debilitating disease – Called ‘Chronic Inflammation’ – Constant redness, swelling, and pain – Eventually it can permanently scar or
disfigure joints, causing extreme pain
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Developing Chronic Inflammation
• Various causes – Persistent infections – Prolonged exposure to toxins – Wear and tear – Autoimmunity
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-itis Means Inflammation
• -itis: a Greek suffix denoting disease characterized by inflammation
• This way, you can recognize inflammatory diseases:
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• Appendicitis • Arthritis • Blepharitis • Bronchitis • Conjunctivitis • Diverticulitis
• Meningitis • Nephritis • Tonsillitis • Vasculitis • Etc. etc.
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What is Arthritis?
• Arthritis: painful inflammation and stiffness of one or more joints
• It can affect any joint in the body • 70% of people over 65 are affected
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Types of Arthritis
• There are over 100 different forms of arthritis
• The most common types are – Rheumatoid arthritis ~ chronic, systemic inflammation – Osteoarthritis ~ degenerative joint disease – Gout ~ deposition of crystals in the joint space
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RHEUMATOID ARTHRITIS Section II
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Rheumatoid Arthritis (RA) • Chronic inflammatory condition that
affects the entire body – Typically the joints of the hands, feet, wrists,
ankles or knees are affected – Other organs and tissues can also be affected
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Causes
• Autoimmune reaction where the body develops an immune attack against certain tissues (typically joint tissue)
• Many factors contribute to the disease – Genetics – Environmental factors
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Symptoms • Fatigue, low-grade fever, weakness and
stiffness precede painful swollen joints • Typically symmetrical (i.e. both hands,
wrists, ankles etc…) • Affected joints are often warm and
tender to touch and visibly swollen • As disease progresses can cause
deformities in the joints of the hands and feet
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Treatment Options • Diet
– Pineapple – contains bromelain which helps reduce inflammation
– Ginger – helps inhibit inflammation – Brightly coloured fruits and vegetables
• Anti-oxidants – Vitamins A, C, E – Zinc, Selenium – Bioflavonoids – support collagen structure and reduce
inflammation (found in citrus fruit, berries, red wine, dark chocolate)
• Physical Therapy – improves comfort and preserves joint and muscle function – Strengthening and range-of-motion exercise – Hot Epsom salt baths : increases absorption of trace
minerals (magnesium, zinc, selenium) causing relaxation, anti-inflammatory, and anti-oxidant reaction
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OSTEOARTHRITIS Section III
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Osteoarthritis (OA)
• Joint degeneration and loss of cartilage – Typically found in the weight bearing joints
(hip, knee, spine) and hands are affected – 2 types
• Primary • Secondary
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Causes Primary OA or “Wear-and-tear”
– Degeneration of the cartilage from chronic use and stress
– Associated with age, excess weight, inactivity
Secondary OA – Predisposing factor
responsible for degeneration
• Injury or Trauma • Genetics • Other inflammatory
disease (RA, gout, lupus etc…)
• Abnormal cartilage
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Symptoms • Early morning stiffness • Stiffness after rest • Pain worse with activity • Swelling of the affected joint • Loss of joint function • Asymmetrical – one or more joints
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OA vs RA Osteoarthritis Rheumatoid Arthritis
Morning Stiffness Less than 1 hour More than one hour
Pain Worse with movement Better with movement
Cause Wear and tear Autoimmune
Joints Affected Asymmetrical: typically starts in the fingers near nail beds, spreading to large weight bearing joints
Symmetrical: small and large joints
Nodules Herberden’s (DIPs)and Bouchard’s (PIPs) nodes
Extensor surface nodules
Gender 50:50 Women > Men (3:1)
Treatment Anti-inflammatories (NSAIDs)
Anti-Inflammatories, anti-rheumatics (methotrexate) and steroids
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Treatment Options
• Diet – Remove nightshade vegetables (potato, tomato, eggplant
and pepper) which can trigger inflammation – Brightly coloured fruits and vegetables
• High Vitamin C – reduces cartilage loss • Glucosamine sulphate (an amino sugar), Condroitin,
MSM – Improves cartilage repair and inhibits degeneration
• Physical therapy – Swimming & walking – Weight loss – reduce strain on joints
• Topical application of menthol or capsaicin to relieve pain – E.g. Tiger balm (contains both)
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GOUT Section IV
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Gout
• Deposition of uric acid crystals in the joint – Typically found in big toe, but can also be
deposited in other joints, tendons, kidneys and other tissues
– Often associated with kidney stones
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Causes
• High levels of uric acid in the blood caused by: – Genetics – Insulin resistance – High blood pressure – Poor kidney function – Obesity – Poor diet (high fat, simple carbs, excess protein) – Excess alcohol
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Symptoms • Acute intense local joint pain (typically
at night) – Hot, Swollen, Red
• Periods without symptoms between attacks
• Uric acid kidney stones
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Treatment Options
• Diet – Eliminate alcohol – Eliminate organ meat, red meat, shellfish, yeast, sardines
and anchovies – Reduce intake of dried legumes, spinach, asparagus and
mushrooms – Increase fluids – 8+ cups of water per day – Cherries – 2 oz. of cherry juice per day decreases uric acid
content – Low fat, high fibre diet
• Weight Loss – Exercise and healthy diet
• Quercetin – Bioflavonoid that inhibits uric acid production
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REDUCING AND TREATING INFLAMMATION
Section V
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Fish Oils • Omega-3 fats are helpful for reducing
the molecules associated with inflammation and tissue damage
• Reduces pain and stiffness • Improves recovery and repair
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Curcumin • Medicinally active component of turmeric • Significant anti-oxidant and anti-
inflammatory effects • Properly formulated curcumin is as
effective as cortisone and other potent anti-inflammatory drugs at reducing acute inflammation without side effects
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Anti-Inflammatory Diet
• Eliminating or reducing the most inflammatory foods from the diet can greatly reduce symptoms of pain and inflammation
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Acupuncture • Effective at reducing pain and
improving mobility in arthritic joints – Triggers release of endorphins that inhibit
the perception of pain – Improves blood flow and nerve
conduction which reduces the pain signal – Encourages muscle relaxation to reduce
excess tension on joints
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Hydrotherapy
• Hot packs and cold packs are used alternately to increase blood flow through areas of pain thus reducing inflammatory by-products and reducing pain – 3 minutes hot water, 1 minute cold water,
repeat 3x – Always end on cold! – Can be done locally with water basins, or
full body in the shower (very refreshing!)
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Exercise
• Increasing exercise reduces weight, strengthens muscles and reduces strain on joints affected by arthritis – Allows for improved mobility and reduced
pain
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Upcoming Lectures/Appearances:
Oct 29, 2012 – Colds and Flues
Nov 5, 2012 – Diabetes Dec 3, 2012 – Healthy Holidays
Today’s lecture is available for download on our website.