Nonpharmacological approaches to managing Osteoarthritis
by David Dunaief
Apr 14, 2021 | 4183 views | 0 0 comments | 551 551 recommendations | email to a friend | print
Dr. David Dunaief is located in Downtown Brooklyn and focuses on the integration of medicine, nutrition, fitness and stress management.
Dr. David Dunaief is located in Downtown Brooklyn and focuses on the integration of medicine, nutrition, fitness and stress management.
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Osteoarthritis most commonly affects the knees, hips and hands. If you suffer from it, you know it can be painful to perform daily tasks or to get around.

The most commonly used first-line medications are acetaminophen and nonsteroidal anti-inflammatory drugs, such as ibuprofen. Unfortunately, while medications treat the immediate symptoms of pain and inflammation, they don’t slow osteoarthritis’ progression, and they do have side effects, especially with long-term use.

Here, we’ll focus on nonpharmacologic approaches you can use to ease pain, and perhaps slow worsening of your osteoarthritis.

Does dairy help or hurt?

With dairy, there is conflicting information. Some studies show benefits, while others show that it may contribute to the inflammation that makes osteoarthritis feel worse.

In the Osteoarthritis Initiative study, an observational study of over 2,100 patients, results showed that one-percent and nonfat milk may slow the progression of osteoarthritis in women.

The researchers looked specifically at joint space narrowing that occurs in those with affected knee joints. Compared to those who did not drink milk, patients who did saw significantly less narrowing of knee joint space over 48 months.

The result curve was interesting, however. For participants who drank more than 10 glasses per week, there was less beneficial effect. There was no benefit seen in men or with the consumption of higher-fat products, such as cheese or yogurt.

However, the study had significant flaws, since it was based on patient recall of dairy consumption for a 12-month period and it didn’t examine confounding factors, such as orange consumption.

On the flip side, a study of almost 39,000 participants from the Melbourne Collaborative Cohort Study found that increases in dairy consumption were associated with increased risk of total hip replacements for men with osteoarthritis.

Getting more specific, a recently published analysis of the Framingham Offspring Study found that those who consumed yogurt had statistically significant lower levels of interleukin-6 (IL-6), a marker for inflammation, than those who didn’t eat yogurt, but that this was not true with milk or cheese consumption.

We are left with more questions than answers. Would I recommend consuming low-fat or nonfat milk or yogurt? Not necessarily, but I may not dissuade osteoarthritis patients from yogurt.

Vitamin D

Over the last decade, the medical community has gone from believing that vitamin D was potentially the solution to many diseases to wondering whether, in some cases, low levels were indicative of disease, but repletion was not a change-maker.

Well, in a two-year randomized control trial of almost 150 men and women, vitamin D had no beneficial symptom relief, nor any disease-modifying effects.

Weight loss

In a study involving 112 obese patients, there was not only a reduction of knee symptoms in those who lost weight, but there was also disease modification, with reduction in the loss of cartilage volume around the medial tibia.

On the other hand, those who gained weight saw the inverse effect. A reduction of tibial cartilage is potentially associated with the need for knee replacement.

In an 18-month study, diet and exercise trumped the effects of diet or exercise alone. Patients with osteoarthritis of the knee who lost at least 10 percent of their body weight experienced significant improvements in function and a 50 percent reduction in pain, as well as reduction in inflammation, compared to those who lost less.

Therefore, concentrate on lifestyle modifications if you want to see potentially disease-modifying effects. In terms of low-fat or nonfat milk, the results are controversial at best.

For yogurt, the results suggest it may be beneficial for osteoarthritis, but stay on the low end of consumption. And remember, the best potential effects shown are with weight loss.
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