Bad Knees? Time to Head to the Kitchen!

Dr. Amy's Wellness Tip for May

By: Dr. Amy Whittington
Published May 2, 2013

Please note that Dr. Amy Whittington's monthly wellness tips are now exclusively available online, through Trilogy Life Magazine.  Click here to view all past issues of Dr. Amy's monthly tips on her blog page.

Joint pain is a common complaint among much of the population, but especially for active adults. Many have specific joint pain focused on a knee, shoulder, or hip. They can often blame years of physical activity and a diagnosis of osteoarthritis (OA), or other wear and tear that left damaged ligaments or tendons in its wake. Often joint pain sufferers take anti-inflammatories, usually NSAIDs or acetaminophen, for years. These can wreak havoc on the digestive system or cause kidney and liver damage if used in excess or for an extended time. If anti-inflammatories are not helpful or must be stopped, sufferers are often told their options are arthroscopic or even joint replacement surgery, and they must decide whether invasive surgery is worth the risk.

If you are at this fork in the road, being forced to choose between chronic pain and surgery, consider this: there is a very good chance that an alteration in your diet could greatly decrease your pain. The answer to a pain-free life might not lie in a surgeon’s hands, but instead on your plate.

The first association that we tend to make between OA and nutrition is a need for weight loss. Studies associating a decrease in osteoarthritis pain with nutrition are nearly always focused on overweight subjects. After adopting a more balanced diet and weight loss, they have less inflammation, as well as less of a weight load on their joints. This popular correlation, although true, is disappointing to many of us who practice in the realm of natural medicine and nutrition. Clinically, we can report that - independent of weight loss - improved nutrition can greatly decrease or stop pain, even if there is a mechanical problem (like the bone-on-bone irritation often associated with OA). Unfortunately, most fit or non-overweight patients who suffer from OA are not ever exposed to the idea that nutrition could greatly improve their quality of life; instead, they are told that their only options are NSAIDs or surgery.

Many foods have anti-inflammatory properties that I’ve written about before, and I’ll give you a short list towards the end of this article, but that is not the focus here. The best way to see if you can decrease your pain with diet is not what you add, but what you need to avoid. As a treatment trial, you should stop eating all possible offenders for a short amount of time. Foods that can and often do promote inflammation include animal products (meat, eggs, dairy), sugar and high fructose corn syrup, wheat, and foods that you have an allergy or intolerance to. Before you panic, remember that we are talking about doing a trial of elimination as a test to see of your pain decreases drastically. Most foods can be added back later in moderation (no forced vegetarianism here).

You can specifically eliminate these groups of foods, which leaves you with a whole-foods (nothing from a box or package) vegetarian diet, using beans and fish as your protein, and with the avoidance of sugar, grains, and alcohol. Each meal should consist of one of these proteins along with vegetables or small amounts of fruit.  In my practice, I tend to use a 10-day detoxification program, which uses the nutritional limitations listed above along with caffeine avoidance and the use of particular amino acids to promote liver detoxification (see the article “Should you Detox?” in the Wellness archives of Trilogy Life Magazine). The idea of the 10-day program for OA, however, is not focused on detoxifying the liver, but instead on decreasing systemic inflammation by eliminating possible problematic foods, inflammatory foods, and sugars. Decreasing systemic inflammation to decrease generalized pain is not a new concept. However, the idea that specific joint pain can be relieved in this way is often not realized.

After 10 days or a couple weeks, you may find that you have significantly lower amounts of pain. Oftentimes, the only nutritional goals that need to be achieved are the ones that you should be striving for anyway. Much of your diet should be vegetables, beans, fish, and some fruit. Processed foods and sugars should be moderated, and high-fructose corn syrup avoided. Dairy and animal products can be added back in slowly, one at a time and separated by 4-7 days, to test for a direct link to inflammation. If you have a glass of milk and a couple of days later your pain has increased, you might have a dairy intolerance keeping your joints inflamed. Even if you don’t have intolerance to them, animal products and dairy are pro-inflammatory, and should be limited. If pain is a common occurrence for you, consume red meat only occasionally, and milk and cheese less than daily. Wheat should also be added in separately to test for intolerance. Wheat, as explained in last month’s article, should be moderated by all of us at less than daily consumption to avoid excessive inflammation that is linked to it.

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