Joint pain is a very common complaint in middle aged- and older adults. The are many causes of joint pain such as: gout, septic arthritis, psoriatic arthritis, reactive arthritis, juvenile arthritis, acute injury, infections, cancer, bursitis, and vitamin D deficiency.

But the two major causes of arthritis are rheumatoid arthritis and osteoarthritis.

Osteoarthritis (OA) is the most common cause of joint disease. It is a type of degenerative joint disease which leads to a decrease in cartilage in the joint, causing deep aching pain and stiffness.1 It usually impacts large joints like the hips and knees. Some things that may increase your risk for OA can be grouped into modifiable or non-modifiable risk factors. Some modifiable risk factors are: body mass, joint injury, occupation, muscle weakness, structural misalignment. While non-modifiable risk factors include: gender, age, race, and genetics.1

Rheumatoid arthritis (RA) is an autoimmune disease which means something trigger the immune system to attack the joints in the body like it would an invading pathogen. This leads to pain, stiffness, and swelling in joints. RA usually impacts the smaller joints in the wrists and is less common in men than OA.1 While OA usually impacts older adults in their 50’s and 60’s, RA is more prevalent in women between ages 35-50. Some modifiable risk factors for RA are: smoking, reproductive and breast-feeding history and some non-modifiable risk factors are: genetics, gender, age, like in OA.1

Although there are different disease processes behind OA and RA, they both involve inflammation.

RA is usually seen as the inflammatory arthritis, inflammation plays a major role in both OA and RA.2 In OA, the cartilage in the joint is damaged, this creates an inflammatory response and inflames the synovium (connective tissue around the joint). This release of proinflammatory chemicals creates further cartilage degradation.2 RA on the other hand, is an entirely immune-mediated inflammatory disease so we see immediate activation of Inflammatory pathways which leads to thickening of synovial fluid creating joint pain, swelling, reduced range of motion of the joint.3

Knowing that inflammation plays an essential role in both OA and RA allows us to prevent and manage the disease by controlling inflammation in the body. A major source of inflammation in North Americans is diet. The Standard American Diet (SAD) is high in refined carbohydrates, processed meats, sugars, and, omega-6 oils, while low in fruits and vegetables. This inflammatory diet not only increases joint pain, but has several deleterious impacts on overall health and chronic disease. 

So, what can we do?

Increase fruit and vegetable intake. Fruits and vegetables are high in antioxidants which can protect tissues from damage and modulate inflammation in the body. Look for dark, colourful fruits and vegetables as they are more potent sources of antioxidants. Examples: berries, dark leafy greens.

Decrease simple sugars. Swap out sodas and juice for water. Add in some lemon or cut up fruit in your water to flavour it. Cut back on desserts, packaged snack foods, pastas, and cereals. Instead, add in whole grains like quinoa, millet, and steel cut oats. Not only will these decrease inflammation, but they will keep you full for longer.

Get rid of inflammatory oils like canola, sunflower, grapeseed, soy and corn oil in your diet. The inflammatory seed oils are high in omega 6 fatty acids which are highly vulnerable to oxidation. Through oxidation, molecules called reactive oxygen species are formed which lead to DNA damage and whole-body inflammation. To make matters worse, when these oils are used at high temperatures, they are further damaged, creating more of these reactive oxygen species.

Add in more olive oil into your diet. Not only is olive oil less toxic, but it has several health benefits. Unlike the above fats, olive oil is stable, so it isn’t vulnerable to oxidation. If you’ve ever tasted a good olive oil and felt a burning at the back of your throat- this is due to oleocanthal. This plant compound is a type of phenol which is a potent anti-inflammatory molecule. This anti-inflammatory effect is so powerful that in a study it was comparable to 1 dose of 200mg Advil.4 

Increase your fish intake. Fish is not only a lean source of protein, but it is high in omega-3 fatty acids. Fish with high amounts of omega-3 fatty acids include: Salmon, tuna, sardines, herring, anchovies, scallops and other cold-water fish. The American Heart Association recommends about four ounces of fish, twice a week, however, more is needed for those with arthritis. Most studies which look at the use of omega-3 fatty acids in joint pain use high doses of about 130mg/kg/day.5 On average, there’s about 200-500mg of omega 3 fatty acids per one ounce of fish.6 So, even if you’re consuming the recommended 8oz per week- that’s only 4000mg per week- not even a daily dose! Adding in a high quality, pharmaceutical grade fish oil along with your anti-inflammatory diet is a good way to get your target dose of omega-3s.*

Having a perfect diet isn’t realistic for anyone, but making a few small changes can have a big difference in the inflammatory pathways in your body; translating into decreased pain and increased functionality

*Always consult a healthcare provider before adding in any supplements to your current routine.

About the Author

Dr. Maille Devlin

Dr. Maille Devlin, ND is a licensed and registered Naturopathic Doctor who graduated with a Doctor of Naturopathic Medicine degree from the Canadian College of Naturopathic Medicine (CCNM). She completed her internships at the Robert Schad Naturopathic Teaching Clinic, Sherbourne Health Centre and Rose Health Clinic. Prior to CCNM, Dr. Devlin obtained an undergraduate degree in Honours Biomedical Sciences at the University of Guelph.

Throughout her time studying naturopathic medicine, Dr. Devlin gained a deep appreciation for both the interconnectedness of the human body and the uniqueness of every person. As a Naturopathic Doctor, she approaches each patient with an evidence-informed and individualized approach in order to support specific wellness goals.

Dr. Devlin has particular interests in: corporate wellness, stress management, anxiety, gut health, cardiovascular health, metabolic health, weight loss and optimizing brain function. She considers true health not only the absence of disease, but rather a state where an individual is thriving both physically and mentally. Dr. Devlin believes that education and preventative medicine are the greatest steps toward wellness and is focused on empowering individuals to take the appropriate steps towards being their own health advocate.

Dr. Devlin is a member of the OAND, CAND, and CONO.

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