Madeeha Syed

Glucosamine For Arthritis: Does It Really Work?

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Humza Khizer

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I Like To Move It, Move It. Do You?

Introduction

In arthritis, it is necessary to participate in joint-friendly physical activity to improve arthritis pain, mood, function, and quality of life. Choose activities which place less stress on the joints and are associated with a reduced risk of injury. Walking, biking and swimming are examples of joint-friendly activities. Being physically active can also delay the onset of arthritis-related disabilities and help with the management of other chronic conditions (diabetes, heart disease, and obesity). 
&nbsp;

These exercises should be revisited if there is a change in symptoms.&nbsp;

It is important to learn how to exercise safely and enjoy the benefits of increased physical activities with these &ldquo;SMART&rdquo; tips. 
&nbsp;

<ul>
	<li>Start low, go slow.</li>
	<li>Modify activities according to the severity of symptoms.</li>
	<li>Activities should be &ldquo;joint-friendly.&rdquo;</li>
	<li>Recognize ways to be active.</li>
	<li>Talk to a health professional. 
	&nbsp;</li>
</ul>

<h5>Start Low, And Go Slow</h5>

When starting or increasing physical activity, start slow and pay attention to how the body tolerates the exercise. People with arthritis will take more time for their bodies to adjust to the new level of activity. In the beginning, it is much better to start with a small amount of activity, for example, 3-5 minutes. Add a little at a time (like 10 minutes at a time), and allow sufficient time for your body to adjust to the new time frames introduced, before adding more time. 
&nbsp;

<h5>Modify Activities According To The Severity Of Symptoms And Stay Active.</h5>

Arthritis symptoms (stiffness, and fatigue) may come and go, and the affected person may have good and bad days. Try to modify your activity according to these highs and lows, but try to stay as active as possible, in a safe way.

&nbsp;

<h5>Activities Should Be &ldquo;Joint-Friendly.&rdquo;</h5>

Exercises should be easy on the joints. Walking, bicycling, water aerobics, or dancing are good examples of activities which have a very low risk of injury, and do not place undue stress on the joints.

&nbsp;

<h5>Recognize Ways To Be Active.</h5>

Safety is very important for starting and maintaining an activity plan. Before starting any exercise, it is advisable to consult a professional. You can also start with joining group classes offered by certified trainers. In case you decide to opt for making an exercise plan yourself, then ensure all safety measures are in place. For example, if your exercise plan is centered around walking, then use a route which is levelled, free of obstructions, well-lit and away from heavy traffic.

&nbsp;

<h5>Talk To A Health Professional</h5>

Your doctors can help you design personalized activity plans/goals along with addressing any related concerns.&nbsp;

&nbsp;

Here are some examples of exercise that you can choose:

<ul>
	<li>
	<h5>Low-Impact Aerobics Activities</h5>
	</li>
</ul>

These activities will not put stress on the joints and they include brisk walking, light gardening, group exercise classes, cycling, swimming, water aerobics, and dancing. 
&nbsp;

<ul>
	<li>
	<h5>Muscle-Strengthening Exercises</h5>
	</li>
</ul>

&nbsp;You can add some muscle-strengthening activities using light weights in your workout routine. Working with resistance bands and yoga could be a good alternative to explore on days when you are not in the mood for a walk on the treadmill.&nbsp; 
&nbsp;

<ul>
	<li>
	<h5>Flexibility Exercises</h5>
	</li>
</ul>

&nbsp;These are recommended for people with arthritis. Many people with arthritis have stiff joints that make daily tasks difficult. Doing daily flexibility exercises will help to maintain their range of motions. 
&nbsp;

<ul>
	<li>
	<h5>Balance Exercises</h5>
	</li>
</ul>

Standing on one foot, walking backwards, and tai chi are some exercises recommended for arthritis patients with balance issues.&nbsp;

&nbsp;

It&rsquo;s normal to have a little pain, stiffness, and swelling after starting a new physical activity plan. It may take 6- 8 weeks for joints to get used to the new activity level, but sticking with the activity program will result in long-term relief in pain. 
&nbsp;

Here are some tips to manage pain during and after physical activity to stay on track with your activity plan:&nbsp;&nbsp;

<ul>
	<li>Continue modifying your physical activity program by exercising less frequently (fewer days a week), or for shorter periods of time (less time for each session) till you experience pain relief.&nbsp;</li>
	<li>Try different types of exercises that are joint friendly, for example, switch from walking to water aerobics.</li>
	<li>Proper warm-up and cool-down before and after exercise is essential.</li>
	<li>Exercise at a comfortable pace</li>
	<li>Use well-fitted and comfortable shoes.</li>
</ul>

&nbsp;

<h4>"Exercise releases endorphins, which help reduce stress. Try our <a href="https://www.merisehat.pk/page/sehat-scan/" target="_blank">sehat scan </a>to monitor your stress level!"</h4>

Understanding importance of exercise for arthritis patients

For people with rheumatoid arthritis (RA), exercise is hugely beneficial for relieving pain and joint stiffness. 
&nbsp;

People with RA who exercise will find that they have less pain than those who do not. Exercise reduces painful symptoms, improves flexibility &amp; joint functions, increases range of motion, and boosts mood. 
&nbsp;

It is best to seek medical advice before starting any type of exercise plan, and work with a doctor and physical therapist to develop a proper exercise plan.

&nbsp;

The following types of exercise may help to get relieved the pain, joint stiffness, and other symptoms of RA: 
&nbsp;

<ul>
	<li>
	<h5>Stretching</h5>
	</li>
</ul>

Stretching can&nbsp; improve flexibility, increase range of motion and reduce stiffness. Daily stretching is important for relieving RA symptoms.

The ideal stretching routine is different for each person. The routine depends on which joints are affected and what symptoms occur. Stretches often involve slow and gentle movement of the joints of the knees, hands, and elbows.

&nbsp;

A typical stretching routine consists of:

<ul>
	<li>Warm-up by walking in place or pumping the arms while sitting or standing for 3 to 5 minutes.</li>
	<li>Hold each stretch for 20 to 30 seconds before releasing it. 
	&nbsp;</li>
</ul>

Repetition of each stretch 2 to 3 times. Yoga straps will help people maintain proper form while stretching. A dog leash is an alternative to yoga.

It is beneficial to work with a physical therapist who understands RA to learn the correct way to perform these stretches. 
&nbsp;

<ul>
	<li>
	<h5>Walking</h5>
	</li>
</ul>

Walking is a low-impact form of exercise that helps with aerobic conditioning, heart and joint health, and mood.

It is essential to stay hydrated and wear proper shoes, even if the walking is not strenuous. It is recommended to walk slowly initially, and then increase the pace gradually. 
&nbsp;

<ul>
	<li>
	<h5>Flowing Movements, Like Yoga And Tai Chi&nbsp;</h5>
	</li>
</ul>

Both tai chi and yoga combine gentle poses, deep breathing, flowing movements and meditation. They increase flexibility, balance, range of motion, and also helpful in reducing stress. 
&nbsp;

<ul>
	<li>
	<h5>Pilates</h5>
	</li>
</ul>

Pilates increases flexibility for enhanced joint health and is a low-impact activity. Pilates can also help with stability.&nbsp; 
&nbsp;

<ul>
	<li>
	<h5>Water Based Exercises</h5>
	</li>
</ul>

Water helps to support body weight by minimizing gravity, which means that water exercises do not place a lot of stress on the joints.

Water aerobics, swimming, and other gentle water exercises increase flexibility, range of motion, strength, and aerobic conditioning. They can also reduce joint stress and stiffness. 
&nbsp;

<ul>
	<li>
	<h5>Cycling</h5>
	</li>
</ul>

Cycling is extremely helpful for the improvement of cardiovascular functions. As RA patients are at risk of cardiovascular disease, it is vital to keep the heart as healthy as possible. 
&nbsp;

Riding a stationary bike is a safe way to get the joints moving while improving cardiovascular fitness.&nbsp;Cycling also helps in reducing stiffness, increasing range of motion, and building endurance. 
&nbsp;

<ul>
	<li>
	<h5>Strength Training</h5>
	</li>
</ul>

Strengthening the muscles around the affected joints can help to increase strength, while reducing pain and other RA symptoms. Using a resistance band is one way to challenge the body, and build muscle over time. 
&nbsp;

<ul>
	<li>
	<h5>Hand Exercises</h5>
	</li>
</ul>

RA sometimes leads to limited use of the hands. The person with RA may lose their grip strength and find that they are dropping things. Slowly curling the fingers, bending the wrists up and down, spreading the fingers wide on a table and squeezing a stress ball are some ways to help increase strength and flexibility in the hands. 
&nbsp;

<ul>
	<li>
	<h5>Gardening</h5>
	</li>
</ul>

Light gardening can be a beneficial exercise for a person with RA.&nbsp;

&nbsp;

The following tips will help to improve comfort and safety for exercising with RA: 
&nbsp;

<ul>
	<li>
	<h5>Be Consistent</h5>
	</li>
</ul>

People need to exercise consistently to achieve meaningful results. It is important to practice regularly. RA patients will certainly benefit from consistent and lifelong aerobic and muscle strengthening exercises. 
&nbsp;

<ul>
	<li>
	<h5>Accessorize For Comfort And Protection</h5>
	</li>
</ul>

The following methods can help people exercise more comfortably with less injury risk and falls: 
&nbsp;

<ul>
	<li>always use a slip-resistant mat for yoga</li>
	<li>wear comfortable clothes&nbsp;</li>
	<li>wear good supportive shoes for preventing injuries and maintaining balance</li>
	<li>Seek variety 
	&nbsp;</li>
</ul>

RA symptoms may vary daily, and tend to come in waves. People often face flares and periods of remission. Doing an exercise and mixing up the daily routine will help people to avoid overworking one set of muscles and particular joints. For example, a person doing morning stretches on a daily basis may choose to add strength training twice a week, a water workout once a week, and yoga or tai chi twice a week, if symptoms permit. 
&nbsp;

<ul>
	<li>
	<h5>Adjust Exercises According To Symptoms</h5>
	</li>
</ul>

You should adjust your routine according to your symptoms, for example if experiencing hand pain, place your resistance band around your forearms, instead of holding it in your hands. On painful days, switch from cycling or swimming to taking a leisurely stroll.&nbsp; 
&nbsp;

<ul>
	<li>
	<h5>Listen To Your Body</h5>
	</li>
</ul>

Listen to your body! It is crucial to avoid discomfort or injuries. It is vital to listen to the body and choose the right pace. If exercise causes discomfort or a flare, reduce the session. Do 10 minutes rather than 30.&nbsp; 
&nbsp;

<ul>
	<li>
	<h5>Pay Attention To Small Things</h5>
	</li>
</ul>

Most exercises focus on large muscular groups. It is essential to make time for smaller groups, such as the hands and fingers. It is also important to do exercises with your toes and feet. Exercises that help in maintaining balance are equally important such as yoga. 
&nbsp;

<ul>
	<li>
	<h5>Work With A&nbsp;Physical Therapist</h5>
	</li>
</ul>

Working with a physical therapist who specializes in RA is an absolute must. These professionals will develop safe and personalized routines for you. This collaboration is particularly beneficial for people with a new RA diagnosis and those who are experiencing a severe flare.

&nbsp;

Conclusion

People with RA should avoid all those exercises that cause pain and are strenuous. These may include high-impact exercises that put excessive strain on the joints.&nbsp;

&nbsp;

Key Points

<ul>
	<li>Exercise is tremendously important for people with rheumatoid arthritis (RA).&nbsp;</li>
	<li>Exercise helps improve aerobic fitness, boosts mood, helps with daily functioning, relieves symptoms, builds strength, improves joint function and increases flexibility.</li>
	<li>Exercise helps with management of RA by reducing flares.</li>
	<li>A personalized exercise plan should be created after consulting your doctor and a licensed physiotherapist.&nbsp;</li>
</ul>

&nbsp;

Disclaimer: This article is intended to increase awareness about the benefits exercise offers to patients suffering from arthritis (especially rheumatoid arthritis), and is not a substitute for a doctor&rsquo;s advice. Consult your doctor and physiotherapist before starting any exercise.&nbsp;

&nbsp;

[1]. Physical Activity Guidelines for Americans

[2]. Medically reviewed by Amy Elizabeth Wolkin, PT, DPT, MBA — Written by Kat Gál — Updated on April 12, 2021

Zareena Mushtaq

Online Consultation

Ismail Munir

Psoriatic Arthritis And Its Effect On The Spine

Understanding the Spinal Impact of Psoriatic Arthritis

Psoriatic arthritis (PsA) is a chronic inflammatory condition that affects joints, entheses, and the spine.

The signs and symptoms of PsA can vary from person to person, but patients commonly exhibit<a href="#accordion"> [2][3]</a>: 
&nbsp;

<ul>
	<li>Stiff joints</li>
	<li>Swollen joints, toes, and fingers</li>
	<li>Enthesitis or tenderness and pain at the points where tendons and ligaments attach to bone</li>
	<li>Psoriasis, a skin condition characterized by scaly, red, and itchy patches of skin</li>
	<li>Nail changes, such as pitting or separation from the nail bed</li>
	<li>Fatigue</li>
	<li>Uveitis or eye inflammation</li>
	<li>Back and shoulder pain and stiffness</li>
	<li>Chest and rib pain</li>
	<li>Foot pain</li>
	<li>Deformed joints from chronic inflammation 
	&nbsp;</li>
</ul>

When psoriatic arthritis affects the spine and the joints in the pelvis, the condition is known as psoriatic spondylitis. The symptoms then can also include<a href="#accordion">[14]</a>:

<ul>
	<li>Inflammation and stiffness in the neck or lower back that lasts for more than 30 minutes in the morning or after a period of rest</li>
	<li>Pain in the spine, especially in the sacroiliac joints</li>
	<li>Reduced range of motion</li>
	<li>Difficulty standing or sitting for long periods 
	&nbsp;</li>
</ul>

Although the precise cause of psoriatic arthritis is unknown, genetic, environmental, and immunological factors are believed to be responsible<a href="#accordion">[22]</a>: 
&nbsp;

<ol>
	<li>Genetics:The disease runs in families, indicating a genetic component of the disease.</li>
	<li>Environmental Factors:Certain environmental factors, such as obesity, bacterial and viral infections, heavy lifting, and trauma, have been linked to an increased risk of psoriatic arthritis. There is an inverse connection between psoriatic arthritis and smoking, except in individuals who are HLA-C*06-positive.</li>
	<li>Immune System Dysfunction:This type of arthritis is thought to be caused by an abnormal immune response, although the exact mechanism is not fully understood. 
	&nbsp;</li>
</ol>

You&rsquo;re Not Alone!

Generally, the condition affects 0.3-1% of individuals. Around 20% of patients with psoriatic arthritis will develop psoriatic spondylitis<a href="#accordion">[6]</a>. 
&nbsp;

The treatment of psoriatic arthritis aims to relieve symptoms, control inflammation, prevent joint damage, and improve function and quality of life. The treatment approach may vary depending on the severity and type of PsA and the individual&#39;s response to treatment.

The following are some commonly used treatments for PsA<a href="#accordion">[21]</a>: 
&nbsp;

<ol>
	<li>Nonsteroidal Anti-Inflammatory Drugs (NSAIDs):These medications can help reduce pain and inflammation in joints and other affected areas. Examples include ibuprofen and naproxen.</li>
	<li>Disease-Modifying Antirheumatic Drugs (DMARDs):DMARDs can slow down the progression of joint damage and improve symptoms. Examples include methotrexate, sulfasalazine, and leflunomide.</li>
	<li>Biologic Agents:Biologics are a type of DMARD that target specific proteins involved in the inflammatory process. Examples include tumor necrosis factor (TNF) inhibitors (e.g., adalimumab, etanercept) and interleukin (IL)-17 inhibitors (e.g., secukinumab, ixekizumab).</li>
	<li>Corticosteroids:These medications can help reduce inflammation and pain, but are generally used for short periods due to their potential side effects.</li>
	<li>Physical Therapy And Exercise:These interventions can help improve joint flexibility, strength, and function.</li>
	<li>Surgery: Surgical treatment options are generally reserved for cases that don&rsquo;t respond to other treatments or where joint damage is so severe that there is a risk of the joints becoming permanently damaged. The most common surgical procedures are joint replacement, such as a hip or knee replacement, and joint fusion. 
	&nbsp;</li>
</ol>

Surgical options like decompression surgery or spinal fusion are recommended when the condition affects the spine. 
&nbsp;

While there is currently no known cure for psoriatic arthritis, several preventive measures can help reduce the risk of developing the disease or delay its onset. Some of these factors include<a href="#accordion">[21]</a>: 
&nbsp;

<ol>
	<li>Maintain A Healthy Weight: Since obesity is a risk factor, individuals may reduce their risk of developing the disease by maintaining a healthy weight through a balanced diet and regular exercise. Also, keeping the joints moving eases stiffness.</li>
	<li>Avoid Smoking And Alcohol: Smoking has been associated with this disease. Quitting smoking not only reduces this risk but also improves overall health. 
	Alcohol, too, can interact with the medications, so it&rsquo;s best to quit drinking alcohol to alleviate symptoms.</li>
	<li>Managing Stress: Chronic stress has been linked to an increased risk of developing autoimmune diseases, including psoriatic arthritis. Mindfulness meditation and yoga are stress-reducing techniques that can help lower the risk of developing the disease.</li>
	<li>Use Hot And Cold Packs: This helps ease muscle soreness. Cold packs, in particular, can reduce joint pain. 
	&nbsp;</li>
</ol>

Psoriatic arthritis is closely linked to psoriasis. Hence, early detection and treatment of psoriasis may help prevent the development of the condition or at least reduce its severity.

Also, people with a family history of psoriatic arthritis or with other risk factors for the disease should be monitored regularly by a healthcare provider. This will allow them to detect the disease early when treatment is most effective.

Although these preventive measures reduce the risk of developing PsA, it is important to remember that some people still contract the disease. 
&nbsp;

It is a chronic illness, which means it is long-lasting. As such, it affects a person&#39;s quality of life. However, most patients can control their symptoms with care and management. They can also move around and do their everyday tasks. 
&nbsp;

In conclusion, psoriatic arthritis can be a real pain in the back, but it doesn&#39;t have to be a life sentence of discomfort. With early diagnosis and proper treatment, many people with psoriatic arthritis can manage their symptoms and maintain their quality of life. And who knows, maybe we&#39;ll even discover a cure one day!

In the meantime, let&#39;s take a moment to appreciate the strength and resilience of our spines and the power of modern medicine to help us overcome even the toughest challenges. Now, if you&#39;ll excuse me, I need to go stretch my back and do some cat-cow yoga poses. 
&nbsp;

Key Takeaways

<ul>
	<li>People with psoriasis may experience psoriatic arthritis, a kind of inflammatory arthritis. It can develop at any age, but it is most commonly diagnosed in people between 35 and 55 years. In the juvenile form, the onset occurs around 9-11 years.</li>
	<li>The pain and disability caused by psoriatic arthritis can significantly impact a person&#39;s quality of life, including their ability to work and engage in social activities.</li>
	<li>Symmetric psoriatic arthritis affects the same joints on both sides of the body, such as the wrists, ankles, and knees.</li>
	<li>Asymmetric psoriatic arthritis affects different joints on each side of the body and can involve the fingers and toes. It does not have a specific pattern of joint involvement. It usually involves less than five joints at any one time.</li>
	<li>Arthritis mutilans is a rare and severe form of psoriatic arthritis that can cause joint deformities and bone resorption.</li>
	<li>The signs and symptoms of the condition vary from person to person, but some common ones include joint pain, swelling, and enthesitis.</li>
	<li>The first step in diagnosing the disease is a physical examination by a medical professional, which may involve a complete assessment of joints and the spine.</li>
	<li>The treatment of psoriatic arthritis aims to relieve symptoms, control inflammation, prevent joint damage, and improve function and quality of life. 
	&nbsp;</li>
</ul>

[1] National Psoriasis Foundation. (n.d.). About Psoriatic Arthritis.

[2] WebMD. (n.d.). Psoriatic Arthritis and Your Spine

[3] Ritchlin CT, Colbert RA, Gladman DD. Psoriatic Arthritis. N Engl J Med. 2017;376(10):957-970. doi: 10.1056/NEJMra1505557. PMID: 28273019.

[4] Villani AP, Rouzaud M, Sevrain M, et al. Prevalence of undiagnosed psoriatic arthritis among psoriasis patients: systematic review and meta-analysis. J Am Acad Dermatol. 2015;73(2):242-248. doi: 10.1016/j.jaad.2015.05.008. PMID: 26184080.

[5] Queiro R, Sarasqueta C, Belzunegui J, Gonzalez C, de Dios JR, Torre JC, Figueroa M. Psoriatic spondyloarthropathy: a comparative study between HLA-B27 positive and HLA-B27 negative disease. Semin Arthritis Rheum. 2002 Dec;32(3):157-63. doi: 10.1053/sarh.2002.35334. PMID: 12480076.

[6] Gladman DD. Psoriatic Arthritis: Epidemiology, Clinical Features, Course, and Outcome. Ann Rheum Dis. 2005;64(Suppl 2):ii14-ii17. doi: 10.1136/ard.2004.032482. PMID: 15708921; PMCID: PMC1766866.

[7] Memon AA, Samiullah S, Iqbal MP, Suhail S, Memon JM. Prevalence of psoriasis in Pakistan: An epidemiological assessment. Int J Dermatol. 2017;56(7):723-728. doi: 10.1111/ijd.13541. PMID: 28480996.

[8] Dogra S, Kaur I. Epidemiology of psoriasis in India. Indian J Dermatol Venereol Leprol. 2013;79 Suppl 7:S3-S9. doi: 10.4103/0378-6323.115500. PMID: 24051889.

[9] Coates LC, Helliwell PS. Psoriatic arthritis: state of the art review. Clin Med (Lond). 2017 Feb;17(1):65-70. doi: 10.7861/clinmedicine.17-1-65. PMID: 28148567.

[10] McGonagle D, Tan AL, Møller Døhn U, Benjamin M. The concept of a "synovio-entheseal complex" and its implications for understanding joint inflammation and damage in psoriatic arthritis and beyond. Arthritis Rheum. 2007 Nov;56(11):2482-91. doi: 10.1002/art.22819. PMID: 17968946.

[11] Ciccia F, Quartuccio L, Bazzichi L, Carubbi A, Di Napoli G, Giacomelli R, De Vita S. The impact of psoriatic arthritis on the spine: A systematic review and meta-analysis. Autoimmun Rev. 2021 Jul;20(7):102788. doi: 10.1016/j.autrev.2021.102788. Epub 2021 Apr 21. PMID: 33894202.

[12] Aletaha D, Smolen JS. Diagnosis and management of psoriatic arthritis. JAMA. 2018;320(18):1969-1970. doi:10.1001/jama.2018.13837.

[13] McInnes IB, Schett G. The pathogenesis of rheumatoid arthritis. N Engl J Med. 2011;365(23):2205-2219. doi:10.1056/NEJMra1004965.

[14] Kahlenberg JM, Fox DA. Advances in the medical treatment of rheumatoid arthritis. Hand Clin. 2011;27(1):11-20. doi:10.1016/j.hcl.2010.09.004.

[15] Gladman DD, Farewell VT, Wong K, Husted J. Mortality studies in psoriatic arthritis: results from a single outpatient center. II. Prognostic indicators for death. Arthritis Rheum. 1998;41(6):1103-1110. doi: 10.1002/1529-0131(199806)41:6<1103::AID-ART13>3.0.CO;2-5. PMID: 9627022.

[16] Rahimi H, Ritchlin CT. Altered bone biology in psoriatic arthritis. Curr Opin Rheumatol. 2019;31(4):330-336. doi: 10.1097/BOR.0000000000000623. PMID: 30920491

[17] Eder L, Thavaneswaran A, Chandran V, et al. Obesity is associated with a lower probability of achieving sustained minimal disease activity state among patients with psoriatic arthritis. Ann Rheum Dis. 2015;74(5):813-817. doi: 10.1136/annrheumdis-2013-204080. PMID: 24013658.

[18] Chimenti MS, Caso F, Alivernini S, Costa L, Tolusso B, Gremese E. Psoriatic arthritis and sacroiliitis. Front Med (Lausanne). 2018;5:224. doi: 10.3389/fmed.2018.00224. PMID: 30151431

[19] Singh JA, Guyatt G, Ogdie A, et al. Special Article: 2018 American College of Rheumatology/National Psoriasis Foundation Guideline for the Treatment of Psoriatic Arthritis. Arthritis Care Res (Hoboken). 2019;71(1):2-29. doi: 10.1002/acr.23870. PMID: 30748084.

[20] Karmacharya, P., Chakradhar, R., & Ogdie, A. (2021). The epidemiology of psoriatic arthritis: A literature review. Best practice & research. Clinical rheumatology, 35(2), 101692. https://doi.org/10.1016/j.berh.2021.101692

[21] Watson S. Psoriatic arthritis. Healthline

[22] Anwar Al Hammadi MD. Psoriatic arthritis. Practice Essentials, Background, Pathophysiology and Etiology

Arbaz Ansari

Does Glucosamine Work? Benefits, Dosage, and Side Effects

Overview

As we age, the wear and tear on our joints can lead to discomfort, stiffness, and reduced mobility. In the quest for relief, many turn to dietary supplements, and one such popular option is glucosamine. But does glucosamine really work, and if so, what are its benefits, appropriate dosage, and potential side effects? In this article, we&#39;ll delve into the science behind glucosamine to help you make an informed decision about whether it&#39;s a suitable addition to your joint health regimen. 
&nbsp;

Glucosamine is a naturally occurring compound found in the cartilage of our joints, as well as in the shells of shellfish and some fungi. It plays a crucial role in maintaining the integrity and function of joint cartilage, which cushions and protects our joints, allowing for smooth movement.

Glucosamine is available in various forms, with the most common being glucosamine sulfate, glucosamine hydrochloride, and N-acetylglucosamine. Glucosamine supplements are widely used for the management of osteoarthritis, a common form of joint degeneration, and other joint-related conditions. 
&nbsp;

Benefits Of Glucosamine

<ol>
	<li>Osteoarthritis Management</li>
</ol>

The primary reason people turn to glucosamine supplements is for the management of osteoarthritis. Osteoarthritis is a degenerative joint disease that affects millions of people worldwide, leading to pain, inflammation, and reduced joint function. Research suggests that glucosamine may help alleviate some of these symptoms.

Studies have shown that glucosamine supplementation may reduce pain and improve joint function in individuals with osteoarthritis. It is believed to work by providing the body with the building blocks needed to repair and maintain joint cartilage.

<ol start="2">
	<li>Cartilage Repair And Maintenance</li>
</ol>

As mentioned earlier, glucosamine is a key component of joint cartilage. It helps in the formation and repair of cartilage, which is essential for joint health. By taking glucosamine supplements, you may be providing your body with the extra support it needs to repair damaged cartilage and slow down the progression of joint degeneration.

<ol start="3">
	<li>Anti-Inflammatory Effects</li>
</ol>

Inflammation is a common factor in many joint-related conditions. Some studies have suggested that glucosamine may have mild anti-inflammatory properties, which could help reduce joint inflammation and pain. However, it&#39;s important to note that glucosamine is not as potent as dedicated anti-inflammatory drugs.

<ol start="4">
	<li>Potential For Improved Joint Mobility</li>
</ol>

Glucosamine supplements may also have the potential to improve joint mobility, making it easier for individuals with joint problems to engage in physical activities and maintain an active lifestyle. Improved mobility can have a positive impact on overall quality of life. 
&nbsp;

Dosage Recommendations

Determining the appropriate dosage of glucosamine can be challenging, as recommendations can vary based on the form of glucosamine and individual needs. However, here are some general guidelines to consider:

<ol>
	<li>Glucosamine Sulfate: A common form of glucosamine, it is often recommended at a dosage of 1,500 mg per day, divided into three doses of 500 mg each.</li>
	<li>Glucosamine Hydrochloride: This form is typically taken at a higher dosage, around 1,500 mg to 2,000 mg per day, divided into multiple doses.</li>
	<li>N-Acetylglucosamine: Dosages for N-acetylglucosamine are usually lower, ranging from 500 mg to 1,000 mg per day. 
	&nbsp;</li>
</ol>

It&#39;s important to note that individual responses to glucosamine may vary, and it may take several weeks to months of consistent use before experiencing noticeable benefits. Consulting with a healthcare professional before starting any supplement regimen is always advisable, as they can provide personalized recommendations based on your specific needs and medical history. 
&nbsp;

While glucosamine is generally considered safe for most people, there are potential side effects to be aware of: 
&nbsp;

<ol>
	<li>Gastrointestinal Issues: Some individuals may experience mild gastrointestinal symptoms such as upset stomach, diarrhea, or constipation when taking glucosamine supplements. These side effects are usually mild and can often be alleviated by taking the supplement with food or reducing the dosage.</li>
	<li>Allergic Reactions: People with shellfish allergies should be cautious when using glucosamine supplements, as they are often derived from shellfish shells. However, there are vegetarian and synthetic versions of glucosamine available that do not pose this risk.</li>
	<li>Blood Sugar: There is some concern that glucosamine may affect blood sugar levels, particularly in individuals with diabetes. If you have diabetes or are at risk of developing it, consult with your healthcare provider before taking glucosamine supplements.</li>
	<li>Interaction with Medications: Glucosamine may interact with certain medications, including blood-thinning drugs like warfarin and anti-diabetic medications. Always inform your healthcare provider about any supplements you&#39;re taking to avoid potential interactions.</li>
	<li>Limited Long-Term Safety Data: While short-term use of glucosamine appears to be safe for most individuals, there is limited long-term safety data available. Therefore, it&#39;s essential to monitor your health and discuss any concerns with your healthcare provider. 
	&nbsp;</li>
</ol>

Bottom Line

The question of whether glucosamine works is one that continues to be explored by researchers. While evidence suggests that it may offer benefits for joint health, individual responses can vary, and not everyone may experience significant relief. As with any dietary supplement, it&#39;s crucial to approach glucosamine with a balanced perspective.

If you are considering adding glucosamine to your daily routine, consult with your healthcare provider to discuss your specific needs and any potential interactions with medications you may be taking. They can provide personalized guidance on dosage and help you make an informed decision about whether glucosamine is a suitable addition to your joint health regimen.

In the end, the effectiveness of glucosamine may depend on various factors, including the severity of your joint condition, your overall health, and your commitment to consistent use. Regardless of the outcome, it&#39;s essential to prioritize overall joint health through a combination of a balanced diet, regular exercise, and a healthy lifestyle.

Umna Salah

Natural Relief For Arthritis: Exploring Effective Remedies

Arthritis is a prevalent and painful condition affecting millions of people worldwide. Characterized by joint inflammation, stiffness, and pain, arthritis can significantly reduce the quality of life for those who suffer from it. While conventional treatments like medication and surgery are available, many individuals seek natural relief options to manage their symptoms and improve their overall well-being. In this article, we&#39;ll explore a variety of natural remedies for arthritis, ranging from dietary changes and supplements to physical therapies and mindfulness practices. 
&nbsp;

natural remedies

<ol>
	<li>
	<h5>Dietary Modifications</h5>
	</li>
</ol>

Diet plays a crucial role in managing arthritis symptoms. Certain foods and dietary habits can either exacerbate or alleviate the condition. Here are some dietary modifications that may provide natural relief for arthritis:

a. Anti-Inflammatory Foods: Incorporating anti-inflammatory foods into your diet can help reduce arthritis-related inflammation. These include fatty fish (like salmon and mackerel), nuts, seeds, and colorful fruits and vegetables rich in antioxidants, such as berries, spinach, and kale.

b. Omega-3 Fatty Acids: Omega-3 fatty acids, found in fish oil supplements or as part of a diet rich in fish, can help reduce inflammation and joint pain. These essential fats can be a natural remedy for arthritis.

c. Turmeric And Ginger: Both turmeric and ginger contain potent anti-inflammatory compounds. Turmeric&#39;s active ingredient, curcumin, has been studied for its potential to alleviate arthritis symptoms. You can incorporate these spices into your cooking or take supplements.

d. Avoid Trigger Foods: Some people with arthritis find relief by identifying and avoiding trigger foods. These can include nightshade vegetables (like tomatoes and peppers), dairy products, and processed foods high in sugar and trans fats.

e. Maintain A Healthy Weight: Excess body weight puts added stress on joints, aggravating arthritis symptoms. Maintaining a healthy weight through diet and exercise can help reduce pain and inflammation. 
&nbsp;

<ol start="2">
	<li>
	<h5>Supplements</h5>
	</li>
</ol>

Supplements can complement a balanced diet and provide essential nutrients to support joint health. Some supplements that may offer natural relief for arthritis include:

a. Glucosamine And Chondroitin: These compounds are found naturally in cartilage and may help alleviate joint pain and slow the progression of osteoarthritis. Consult with a healthcare professional for proper dosing.

b. Omega-3 Fish Oil: As mentioned earlier, omega-3 fatty acids can reduce inflammation and joint pain when taken as a supplement.

c. Vitamin D: Adequate levels of vitamin D are essential for bone health. A deficiency may worsen arthritis symptoms. Consult with a healthcare provider to determine if supplementation is necessary.

d. Methylsulfonylmethane (MSM): MSM is a sulfur compound found in some foods and available as a supplement. It may help reduce pain and inflammation in arthritis sufferers.

e. Boswellia: Extracted from the resin of the Boswellia tree, this supplement has anti-inflammatory properties and may be effective in managing arthritis symptoms.

It&#39;s important to note that individual responses to supplements can vary, so consulting with a healthcare professional before adding them to your regimen is advisable. 
&nbsp;

<ol start="3">
	<li>
	<h5>Physical Therapies</h5>
	</li>
</ol>

Physical therapies can be natural and effective methods for managing arthritis symptoms. These therapies aim to improve joint function, reduce pain, and increase mobility. Some common physical therapies for arthritis relief include:

a. Physical Therapy: A physical therapist can create a customized exercise program to strengthen muscles around affected joints, improve flexibility, and alleviate pain.

b. Occupational Therapy: Occupational therapists help individuals with arthritis develop strategies to perform daily tasks with less joint stress. They may recommend adaptive equipment or techniques.

c. Hydrotherapy: Water-based exercises in a heated pool can reduce joint pain and improve range of motion. The buoyancy of water supports the body and reduces stress on joints.

d. Tai Chi And Yoga: These mind-body practices can improve balance, flexibility, and strength while promoting relaxation. Regular participation may help manage arthritis symptoms.

e. Massage Therapy: Massage can help relieve muscle tension and reduce pain associated with arthritis. It can also improve circulation and joint mobility. 
&nbsp;

<ol start="4">
	<li>
	<h5>Mindfulness And Stress Management</h5>
	</li>
</ol>

Chronic pain from arthritis can be emotionally distressing, and stress can exacerbate symptoms. Mindfulness and stress management techniques can provide natural relief by promoting relaxation and improving overall well-being:

a. Meditation: Meditation practices can help reduce stress, improve mental clarity, and promote relaxation. Mindfulness meditation, in particular, has been shown to benefit those with chronic pain conditions.

b. Deep Breathing: Practicing deep breathing exercises can reduce tension and anxiety, helping to alleviate pain and discomfort.

c. Biofeedback: This technique allows individuals to monitor and control physiological processes such as muscle tension and heart rate, potentially reducing pain and stress.

d. Cognitive Behavioral Therapy (CBT): CBT helps individuals identify and change negative thought patterns and behaviors that can exacerbate pain. It can be a valuable tool in managing the emotional impact of arthritis. 
&nbsp;

<ol start="5">
	<li>
	<h5>Herbal Remedies</h5>
	</li>
</ol>

Several herbal remedies have been used for centuries to alleviate arthritis symptoms. While scientific evidence on their effectiveness varies, some individuals find relief through the following herbal treatments:

a. Devil&#39;s Claw: Derived from the roots of a South African plant, devil&#39;s claw has anti-inflammatory properties and may reduce pain and stiffness.

b. Boswellia: As mentioned earlier, Boswellia extract has shown promise in reducing inflammation and arthritis-related symptoms.

c. Stinging Nettle: Nettle leaf may help reduce inflammation when taken as a supplement or brewed as a tea.

d. Willow Bark: Willow bark contains salicin, a compound similar to aspirin, which can reduce pain and inflammation. 
&nbsp;

<ol start="6">
	<li>
	<h5>Lifestyle Adjustments</h5>
	</li>
</ol>

In addition to dietary changes and natural remedies, making certain lifestyle adjustments can provide substantial relief for arthritis sufferers:

a. Rest: Adequate rest is essential for joint recovery and overall well-being. Ensure you get enough quality sleep each night.

b. Joint Protection: Using assistive devices like braces, splints, or ergonomic tools can reduce joint strain during daily activities.

c. Heat And Cold Therapy: Applying heat or cold packs to affected joints can alleviate pain and reduce inflammation.

d. Shoe Selection: Choosing comfortable, supportive footwear can help reduce stress on weight-bearing joints like the knees and hips.

e. Pacing Activities: Break tasks into manageable segments, and take regular breaks to avoid overexertion. 
&nbsp;

Natural relief for arthritis encompasses a broad spectrum of approaches, from dietary changes and supplements to physical therapies and mindfulness practices. While not all of these remedies may work for everyone, the combination of several methods can provide significant relief and improve the overall quality of life for individuals living with arthritis. It&#39;s essential to consult with a healthcare professional before starting any new treatment regimen, as they can provide personalized guidance and ensure that the chosen remedies are safe and appropriate for your specific condition. By exploring these natural relief options, arthritis sufferers can take steps towards managing their symptoms and enjoying a more comfortable, active life.

Unveiling The Sunshine Vitamin's Role In Arthritis: A Ray Of Hope

Arthritis, a collective term for more than a hundred different conditions affecting the joints, can be an agonizing journey for millions worldwide. While there is no one-size-fits-all solution for arthritis, recent research has cast a warm, sunny spotlight on vitamin D as a potential player in this painful puzzle. In this article, we will delve into the fascinating connection between vitamin D and arthritis, exploring how this sunshine vitamin might offer relief, hope, and a brighter future for arthritis patients. 
&nbsp;

Before we dive into the intricacies of the vitamin D and arthritis relationship, let&#39;s get to know the sunshine vitamin a little better. Vitamin D, often dubbed the &quot;sunshine vitamin,&quot; is a fat-soluble nutrient crucial for maintaining optimal health. The primary source of vitamin D for most people is sunlight exposure. When our skin is exposed to ultraviolet B (UVB) rays from the sun, it synthesizes vitamin D.

Vitamin D is vital for various bodily functions, including calcium absorption, bone health, immune system regulation, and reducing inflammation. Its role in the prevention and management of arthritis is currently under intense scrutiny. 
&nbsp;

Arthritis encompasses a wide spectrum of conditions, but the most common forms are osteoarthritis and rheumatoid arthritis.

<ol>
	<li>Osteoarthritis (OA): OA is often referred to as the &quot;wear and tear&quot; arthritis. It occurs when the protective cartilage that cushions the ends of your bones wears down over time. This can result in pain, stiffness, and limited joint mobility. 
	&nbsp;</li>
	<li>Rheumatoid Arthritis (RA): RA is an autoimmune disease where the immune system mistakenly attacks the synovium, the lining of the membranes that surround the joints. This leads to inflammation, pain, and joint damage. 
	&nbsp;</li>
</ol>

connection Between Vitamin D And Arthritis

The relationship between vitamin D and arthritis lies in their intricate interplay within the body. Let&#39;s explore the key aspects of this connection:

<ol>
	<li>Inflammation Reduction: Chronic inflammation is a hallmark of many forms of arthritis, including RA. Vitamin D has been found to possess anti-inflammatory properties, which can potentially help mitigate inflammation in arthritis patients. It modulates the immune system&#39;s response, reducing the production of pro-inflammatory molecules. 
	&nbsp;</li>
	<li>Immune System Regulation: Vitamin D plays a pivotal role in regulating the immune system, ensuring it functions efficiently without overreacting. In autoimmune diseases like RA, where the immune system attacks healthy tissues, vitamin D might help in restoring balance. 
	&nbsp;</li>
	<li>Bone Health: Osteoarthritis often leads to bone degeneration, and vitamin D is essential for maintaining strong and healthy bones. A deficiency in this vitamin can exacerbate bone-related issues, which are common in arthritis patients. 
	&nbsp;</li>
	<li>Pain Management: Arthritis is frequently accompanied by chronic pain. Vitamin D may help in reducing pain perception and improving the overall quality of life for arthritis sufferers. 
	&nbsp;</li>
</ol>

Numerous studies have explored the potential benefits of vitamin D in managing arthritis. Although the findings are promising, it&#39;s important to note that more research is needed to establish conclusive links. Here are some key studies and their findings:

<ol>
	<li>A study published in the Journal of Clinical Rheumatology in 2017 found that vitamin D supplementation was associated with a reduction in pain and disease activity in RA patients.</li>
	<li>Research published in the journal Arthritis Care &amp; Research in 2020 suggested that vitamin D supplementation may help prevent knee OA progression.</li>
	<li>A systematic review and meta-analysis published in the Journal of Bone and Mineral Research in 2017 indicated that vitamin D supplementation might have a role in reducing the risk of joint damage in RA.</li>
	<li>The Vitamin D for Knee Osteoarthritis (VIDEO) trial, a randomized controlled trial published in 2019, demonstrated that vitamin D supplementation improved knee pain and function in OA patients. 
	&nbsp;</li>
</ol>

While the potential benefits of vitamin D in arthritis management are exciting, it&#39;s essential to maintain optimal vitamin D levels. This can be achieved through a combination of sunlight exposure, dietary intake, and supplementation, if necessary.

The recommended daily intake of vitamin D varies depending on age, sex, and other factors, but a general guideline is 600-800 IU (International Units) per day for adults. However, individuals with arthritis or those at risk of vitamin D deficiency may require higher doses. 
&nbsp;

<h5>Sunlight, Diet, And Supplements</h5>

<ol>
	<li>Sunlight: Aim for 10-30 minutes of sun exposure on your skin a few times a week. Factors such as location, season, and skin tone influence how much sunlight you need.</li>
	<li>Diet: Include vitamin D-rich foods in your diet, such as fatty fish (e.g., salmon, mackerel), egg yolks, fortified dairy products, and fortified cereals.</li>
	<li>Supplements: Consult your healthcare provider before starting any vitamin D supplementation regimen. They can assess your specific needs and recommend the appropriate dosage. 
	&nbsp;</li>
</ol>

The relationship between vitamin D and arthritis is a captivating and evolving area of research. While promising findings suggest that vitamin D may play a role in reducing inflammation, managing pain, and improving overall joint health, more studies are needed to confirm these effects definitively.

If you&#39;re living with arthritis, it&#39;s crucial to consult with your healthcare provider to determine whether vitamin D supplementation is appropriate for your specific condition. Maintaining optimal vitamin D levels, whether through sunlight exposure, dietary choices, or supplements, can potentially offer a ray of hope in your journey towards managing arthritis and improving your quality of life.

As science continues to unravel the mysteries of this sunshine vitamin, arthritis patients can look forward to brighter days with the promise of reduced pain and improved joint health on the horizon.

Glucosamine is a naturally occurring compound found in the human body, particularly in the cartilage of joints. It plays a crucial role in maintaining the integrity and health of joint tissues, including cartilage, by supporting the production of molecules like glycosaminoglycans and hyaluronic acid, which are essential for joint lubrication and shock absorption.

The theory behind glucosamine supplements is that by providing additional glucosamine to the body, it may help to repair and protect damaged cartilage, alleviate joint pain, and improve joint function. These supplements are available in various forms, including glucosamine sulfate, glucosamine hydrochloride, and N-acetyl glucosamine, and can be found as over-the-counter products in health food stores and pharmacies. 
&nbsp;

Science Behind Glucosamine And Arthritis

<ol>
	<li>
	<h5>Osteoarthritis (OA)</h5>
	</li>
</ol>

Osteoarthritis is characterized by the gradual breakdown of cartilage in the joints, leading to pain and stiffness. Many studies have investigated the efficacy of glucosamine supplements in managing OA symptoms. Some of the key findings include:

<ul>
	<li>A notable study published in the New England Journal of Medicine in 2006 (the Glucosamine/Chondroitin Arthritis Intervention Trial, or GAIT) found that glucosamine and chondroitin sulfate, alone or in combination, provided no significant benefit for knee OA compared to a placebo in the overall study population. However, a subgroup analysis suggested that people with moderate to severe knee pain might experience some relief from the combination of glucosamine and chondroitin.</li>
	<li>A Cochrane review in 2015, which analyzed data from numerous randomized controlled trials (RCTs), concluded that glucosamine, in various forms, had a modest benefit in reducing pain and improving function in patients with OA. However, the authors noted that the quality of the evidence was low to moderate and called for further high-quality research. 
	&nbsp;</li>
</ul>

<ol start="2">
	<li>
	<h5>Rheumatoid Arthritis (RA)</h5>
	</li>
</ol>

Rheumatoid arthritis is an autoimmune disease that primarily affects the synovial lining of joints, leading to inflammation and joint damage. Unlike OA, RA involves a complex immune response. Therefore, the mechanisms by which glucosamine might work are less clear. Research on the effectiveness of glucosamine for RA is limited compared to OA, but some studies have explored its potential benefits:

<ul>
	<li>A small study published in the journal Rheumatology in 2007 found that glucosamine supplementation might reduce disease activity in RA patients. However, the sample size was small, and further research is needed to confirm these findings.</li>
	<li>A more recent review published in Frontiers in Immunology in 2018 discussed the immunomodulatory effects of glucosamine and suggested that it might have a role in regulating immune responses in autoimmune diseases like RA. Nevertheless, the authors emphasized that more extensive clinical trials were necessary to establish its efficacy. 
	&nbsp;</li>
</ul>

Consideration factors

<ol>
	<li>Dosage And Duration</li>
</ol>

The effectiveness of glucosamine supplements may depend on the dosage and duration of use. Some studies suggest that higher doses or longer-term use may yield better results, but this varies among individuals. Consulting with a healthcare professional is crucial to determine the appropriate dose for your specific condition. 
&nbsp;

<ol start="2">
	<li>Quality And Source</li>
</ol>

The quality and source of glucosamine supplements can vary widely among brands. Look for products that have been tested for purity and potency, and consider consulting with a healthcare provider or pharmacist for recommendations. 
&nbsp;

<ol start="3">
	<li>Potential Side Effects</li>
</ol>

Generally, glucosamine is well-tolerated with few side effects, mainly mild gastrointestinal symptoms such as nausea, diarrhea, or heartburn. However, individuals with shellfish allergies should avoid glucosamine supplements derived from shellfish sources. 
&nbsp;

The question of whether glucosamine supplements work for arthritis remains a subject of ongoing debate and research. While some studies suggest potential benefits, the evidence is not yet strong enough to definitively recommend glucosamine as a primary treatment for arthritis. However, it&#39;s essential to consider individual responses to glucosamine, as some people do report significant improvements in joint pain and function.

Ultimately, the decision to try glucosamine should be made in consultation with a healthcare professional, taking into account the specific type and severity of arthritis, as well as other treatment options available. Furthermore, a holistic approach to managing arthritis, including exercise, weight management, and other dietary supplements like omega-3 fatty acids and turmeric, may provide additional benefits when combined with glucosamine.

As research in this field continues to evolve, future studies may provide more conclusive evidence on the effectiveness of glucosamine supplements for arthritis. Until then, individuals seeking relief from arthritis symptoms should explore a variety of treatment options and work closely with their healthcare team to find the best approach to manage their condition and improve their quality of life.