Joint pain and arthritis — quieting the inflammatory noise
by Marcelle Pick, OB/GYN NP
When you got out of bed this morning, were you pain-free? Or did your hips and knees
ache? Did your hands feel stiff when you poured your tea? Many of my patients brush
off these kinds of aches and pains, thinking they’re just normal signs of
aging. As the years pass, many women find the pain intensifies, and begin to rely
on regular doses of Motrin or Tylenol to feel well. Eventually, they may even stop
doing the things that give them pain — even their most meaningful and cherished
activities, like picking up a grandchild, playing an instrument, or gardening.
As we experience pain and swelling in our fingers, wrists, knees or any joint, it’s
easy to jump to the conclusion that our joints are “wearing down” from
use, like car parts. We may even think we’re developing arthritis. But our
bodies are not made up of mechanical pieces with built-in obsolescence; they are
made up of living cells that can actually strengthen and grow when fully nourished
and used properly.
In my clinical experience, I’ve seen many things that can lead to chronic
joint pain. More often than not, it is the simmering fires of inflammation, not
old age. The pain that you feel is your body’s way of telling you that it’s
irritated and needs your help. So instead of brushing it off or tuning it out with
a pill or two, take the time to listen.
How our joints work
Let’s get a better picture of what a joint looks like. All joints —
whether fixed, hinge, pivot or ball-and-socket — are formed when two bones
meet. The bones are connected to one another by strong flexible bands called ligaments.
Muscles, which provide the pulling force to move the joints, are attached to the
bones by tough fibrous tendons (sinew). Both the ligaments and tendons
are housed in protective mucous sheaths.
A healthy joint is surrounded by a joint capsule, and between the muscles and the
joint capsule lie protective fluid-filled pockets called bursae. Within
a joint capsule, the bones are protected from wear and tear by a pliable lining
made up of cartilage, a smooth sheet-like coating that allows bones to
move directly over each other, and synovium, which is more like a cushiony
“inner-tube” that protects and lubricates the joint surfaces as well
as brings nourishment to the surrounding tissues. These various tissues and fluids
both within and outside of the joint serve as packing and reduce friction between
all the moving parts.
If something happens to just one aspect of the joint, it can lead you to experience
Happily, there are so many ways to naturally soothe your pain and calm the inflammation
at its root, arthritis or not, including the most inexpensive medicine around: food.
Let’s look at the possible causes of your joint pain and explore some solutions
that will have you moving — and feeling — like your old self again.
What’s causing your joint pain?
Joint pain can flare up for a number of reasons — some of which may be overlooked
by conventional practitioners. Many of my patients, even younger women, ask me if
their pain is being caused by arthritis. Sadly, it is estimated that one in five
Americans has been diagnosed with some form or arthritis. There are over a hundred
different arthritic conditions, rheumatoid arthritis and osteoarthritis being the
most well known.
Rheumatoid arthritis is an autoimmune disease causing inflammation in the
synovial fluid of the joint. It sets itself apart from other forms of arthritis
with some telltale features: a general appearance in the hands or feet, a hot or
warm feeling in the joint, stiffness for over 30 minutes in the morning, the same
joint affected on both sides of the body, polyarthritis (more than one joint affected
at a time), and pain that can last through the night. With this form of arthritis,
most of my patients notice the pain eases the more they use the joint.
Osteoarthritis, on the other hand, feels worse the more we exercise and
as the day wears on. Also linked to inflammation, this type of arthritis can be
traced back to a breakdown in your joint cartilage. It generally affects the hips,
knees, spine, hands and feet and develops as more of a wear-and-tear situation,
whereas rheumatoid arthritis is closely tied with genetic factors that lead to an
autoimmunity problem. It’s hard to tell if our overworked joints have progressed
to arthritis, but new technology in thermal imaging will soon be able to show us
how much inflammation is present in our joints.
Inflammatory causes of joint pain
Forms of arthritis associated with joint pain
Other causes of joint pain
Osteoarthritis (OA), also known as degenerative joint disease, or DJD
Rheumatoid arthritis (RA)
There are many other causes of joint pain outside of arthritis. The table at right
lists a few types of arthritis and non-arthritic conditions commonly associated
with joint pain.
Seven questions for women with joint pain or arthritis
To get to the real root of a woman’s joint pain, I ask my patients a series
of questions when they come to the clinic with this concern. And while I ask the
usual what, when and where questions that relate directly to their symptoms, I am
also interested in hidden, seemingly less related issues that may contribute to
the pain, issues that may be emotional as well as physical irritants.
1. Is this pain relatively new?
Think back over the past few months or years. If you’ve had a sports injury
or trauma, such as an accident or a fall, your pain could be related to that. It’s
not at all unusual for joint pain to develop and escalate after the date of the
injury itself. Torn ligaments and tendons lack blood flow, so they can’t heal
themselves and must be repaired surgically. Sprains can take a long time to repair
themselves. With any kind of injury, it’s important to give your body the
right nutritional support and enough time to heal.
2. Is the pain seasonal or related to changes in the weather?
Complaints of joint pain increase during colder weather because your blood doesn’t
circulate to your extremities as well in the colder months. And it doesn’t
help that pain receptors are more sensitive in cold weather. A drop in barometric
pressure, such as before a rain or snow storm, can also cause any inflamed tissues
to expand and become more painful.
3. Can you associate the pain with any specific activity?
For instance, does your neck or elbow hurt if you type for more than 30 minutes?
Do your knees hurt only after a work-out? Does your hip give way only after a long
drive? Overuse and misalignment are common causes of joint pain, whether from just
a day of stress and strain or over a period of years. This kind of mechanical injury
can inflame the bursae (causing bursitis), or the tendons (causing tendonitis),
or eventually wear down the cartilage and cause osteoarthritis.
4. Is it the muscle or the joint?
You may actually be experiencing pain in the muscles close to a joint and think
that the joint is the problem. Muscle pain is generally associated with over-exercise
or movement that has caused excess strain on the muscle, ligament or tendon. This
kind of pain should resolve within two to three days of rest. You might also notice
a point of tenderness or “trigger point” on the muscle in this case.
Muscle pain may also respond positively to stretching or massage therapy.
5. Is your pain worse in the morning?
It might be useful to start tracking your pain by using our
Wellness Diary page: if your pain lasts for longer than a half hour in the
morning and gets better during the day, there is a possibility that it could mean
rheumatoid arthritis. Look closely at your sleeping habits and mattress. Changes
here may be a simple solution. It’s also interesting how some women who eat
(or drink) refined carbohydrates at night are also more likely to have fluid retention
and morning pain, and how changing just this one habit can turn joint pain around
— almost overnight.
6. What’s going on right now in your life?
In my experience, joint pain is often reflective of some aspect of a woman’s
“inner” life. In Eastern medical traditions, pain is a sign of energy
blockage, and this can also mean emotional energy and life force. Pain in the knees
may indicate an inability to move forward for fear of criticism or a lack of self-acceptance.
Some women feel neck or back pain only while they’re at work or around certain
people who make them feel tense or burdened. And while it may seem like a big leap
to connect emotional stress with joint pain, we have all come to accept the idea
that the body stores tension in the muscles, so it shouldn’t be difficult
to accept the notion that your emotional life can impact your joints.
7. What is your family history?
Some forms of arthritis, such as rheumatoid arthritis, are connected to genetic
make-up, and if anyone in your family has had it, this places you at higher risk
— but not the certainty — of developing it. Just as important
are the emotional qualities of your childhood and upbringing. I strongly believe
these emotional overtones can be carried forward on a subconscious level and manifest
themselves in our bodies as pain or disease in adulthood that keeps us stuck in
a certain pattern. Like a needle stuck in a groove, we keep playing the same scratchy
refrain. Luckily, our bodies often know better than we do what they need to be healthy
— and often it’s simply a matter of gaining the strength to pick the
needle up and put it on another song.
What’s important for every woman to know is that whatever the cause of your
joint pain, there are ways to increase your mobility and decrease — or even
eliminate — your pain. And the best place to start in almost every case is
to address issues of inflammation.
Joint pain and inflammation
Most forms of joint pain involve some kind of inflammation — either local
or systemic. When injured, a chain of events in your immune system known as the
inflammatory cascade is triggered. In a careful balance of give and take,
this process starts with pro-inflammatory hormones calling out for white blood cells
to clean up damaged tissue and clear out infection. This is what causes the redness,
swelling and pain we often see with injury.
Next, anti-inflammatory compounds take over to heal the area once the threat is
diminished. When this process, known as local or acute inflammation,
waxes and wanes in response to injury it’s a sign of a healthy immune system.
Yet when the symptoms of inflammation don’t disappear, it tells us that your
immune system is unable to turn itself off when it should.
Just as the flame of a burning fire can help or hurt, our body’s internal
fire has the dual power to heal and to cause us pain. Think of inflammation
like a burner on your gas stove; local injuries and infections cause our bodies
to turn the flame up high in the area of the injury, while with systemic or chronic
inflammation, our bodies keep the burner on simmer, even when we’re
not suffering an injury. This slow burn has been associated with range of health
conditions and degenerative diseases, including asthma,
allergies, skin problems,
irritable bowel syndrome, heart disease,
Alzheimer’s and yes, arthritis.
In terms of our joints, pain stemming from an injury or even short-term overuse
can set off localized inflammation in the cartilage, tendons, or bursae. As the
injury heals, players in your inflammatory cascade will perform their tasks and
disappear. If the inflammation persists it can lead to a more chronic condition.
Luckily, we now have a few tests that tell us a great deal.
Testing for inflammatory markers
We can now test the blood for inflammatory markers, such as CRP (C-reactive protein)
and alpha-lipoprotein (some lump homocysteine in this group as well), to determine
whether patients are more likely to develop inflammatory conditions. Trace amounts
of CRP are healthy. And there may certainly be a rise in CRP with a local injury
or an acute infection. But prolonged elevated CRP levels indicate systemic inflammation.
Though CRP and other markers of inflammation are easy to test, many conventional
doctors aren’t sure how to treat elevated levels and end up avoiding these
tests altogether. In our practice we recommend major dietary changes and nutritional
supplements that can moderate these inflammation markers.
Many of my patients think they have to accept joint pain and learn to live with
it for the rest of their lives (which often means relying on regular use of NSAID’s
like Motrin, Tylenol and Aleve, even though they can cause stomach, liver and kidney
concerns with long-term use). Let me assure you that this is just not the case!
Chronic inflammation and its associated diseases can often be overcome or prevented
with a number of integrative and natural approaches. Start by looking at your hormonal
Hormones and “menopausal arthritis”
Lots of women come into the clinic noticing joint pain for the first time during
perimenopause. To be honest, this is the first time I noticed my joints aching.
Studies have shown that lower estrogen levels during perimenopause and menopause
are frequently associated with joint pain. Although the relationship between estrogen
and our joints is not completely understood, we do know that estrogen has an anti-inflammatory
effect in the body.
I always tell my patients that estrogen quiets the inflammatory “noise”
in our joints — along with the noise in many other parts of the body! As hormone
levels initiate their natural shift during perimenopause, any imbalances that estrogen
has quietly been covering begin to rise to the surface, leaving us perplexed by
issues we never before encountered. The truth is, most of us probably had inflammation
in our joints for some time, but estrogen was cloaking our sensitivity to the pain.
A lot of my patients find their pain eases when their hormones return to balance,
though for some, this is only one piece of the picture. The foods you’re eating
can be the determining factor in restoring balance and quieting the inflammatory
Joint pain, nutrition and digestion
Though food is often looked at solely in terms of its impact on weight gain, it’s
also the safest, most effective, and cheapest medicine for preserving and restoring
overall health. Many foods contain micronutrients that positively impact the inflammatory
cascade upstream of where medications such as Advil, Motrin, and COX-2 inhibitors
act, making these drugs (and all their side effects) avoidable. Foods rich in omega–3
fatty acids are a perfect example.
Many women who suffer from joint pain also report digestive problems. This is because
persistent imbalances in the GI tract (such as
dysbiosis, leaky gut, and inflammatory
bowel disease) are often associated with chronic inflammation and allergens.
I urge anyone with joint pain start with an
elimination diet or request an ELISA blood test from their healthcare practitioner
to pinpoint food sensitivities.
Inflammation-fueling “hot” foods
Hot foods — avoid!
Cool foods —
- Fried foods
- Red meat from corn-fed animals raised with antibiotics and/or hormones
- Partially hydrogenated (trans) fats (found in margarine, chips, processed baked
- Saturated fats (e.g., animal fats such as butter and lard)
- Corn oil, safflower oil, sunflower oil or soy-based oils
- Soft drinks, including both diet and regular soda and fruit juices
- All forms of sugar, including natural and refined
- White flour and other processed grains
- Most fast-food and prepackaged meals
- Dark green vegetables (including spinach, kale, and seaweed)
- Antioxidant-rich fruits and vegetables, as well as vitamin C and E supplements
- Raw nuts and seeds (including almonds, pecans, and walnuts)
- Omega-3-rich fish, such as salmon, mackerel, and anchovies (or supplements containing
- Cold-pressed oils such as virgin olive, macadamia nut, grapeseed, and avocado
- Soups made from scratch with free-range poultry or meat bones (boiled bones can
release glucosamine and chondroitin)
- Limited amounts of gluten-free whole grains, especially amaranth, millet, and quinoa
Common problem foods associated with inflammation include citrus, corn and corn
products, dairy products, gluten grains (wheat, barley, oats, rye, spelt, kamut),
yeast, and eggs, as well as members of the nightshade family — tomatoes, potatoes,
peppers, and eggplant. Figuring out what you’re sensitive to may just make
all the difference with your efforts to reduce joint pain.
Ayurvedic and Chinese medical practitioners have been using food as medicine for
centuries. We’ve learned from these ancient medical practices that some common
foods worsen inflammation — these foods are known as pro-inflammatory, or
“hot” foods — and others “cool” the fire. Sadly, our
Western diet of high-sugar and overly-processed foods is of no help.
Overall, you can’t go wrong by favoring simple, whole foods as opposed to
processed convenience foods. Adjusting your diet away from “hot” foods
and more toward “cool” foods is a great way to move toward better overall
More specifically, there are many natural compounds found in foods that have long
been known to be effective anti-inflammatories. With all the controversy surrounding
the side effects of NSAID’s (Advil, Motrin) and COX-2 inhibitors (Vioxx, Celebrex),
it makes much more sense to look for natural pain relief. See our article on
natural anti-inflammatories for additional guidance.
Joint pain and toxicity
Another source of fuel for your body’s internal fire is its toxic burden.
Whenever toxic compounds are allowed to build up in the body, inflammation can also
increase and send our health into a downward spiral. A toxic chemical soup can accumulate
in our organs over time and weigh us down with a toxic load — everything from
alcohol and prescription drugs to the chemicals we use to clean our homes. Heavy
metals like iron, lead, and mercury are all also linked to joint pain.
And some of us are poorer detoxifiers than others. While we can’t avoid exposure
to these substances completely, we can limit their effects on our bodies. If you
have a lot of mercury amalgam fillings and suspect they’re tipping the scale
on your joint pain, consider talking to a biological dentist about having them replaced
with a less toxic substance. Try following our
two-week detox diet; if it helps your symptoms, you may want to pursue a
more regular or thorough program of detoxification.
Inflammation and toxic emotions
I encourage women to be aware of emotional toxins too. It’s no coincidence
that phrases like “burning mad,” “I was so angry I saw red,”
and “She has a fiery temper” remind us of inflammation symptoms. Research
has shown a direct correlation between negative emotions such as anger, lack of
forgiveness, shame, guilt, fear, and loneliness and an increase in inflammatory
conditions. Habitually negative people release higher levels of CRP than happier,
Studies have also shown that chronic stress impairs the immune system’s ability
to shut itself off after the infection or injury is fixed. This is because stress
involves the release of the hormone cortisol, which acts as fuel for the
pro-inflammatory fire. Additionally, normal hormonal cues that tell the brain everything
is okay never make it to their destination. So, the stressed-out body lives in a
constant state of emergency, or chronic inflammation, which only adds to the pain
in your joints.
Emotions like shame, guilt, and fear have been specifically linked to high CRP,
so it always helps to take the time to explore emotional issues you may have buried.
Many of our patients have had tremendous success with the
Emotional Freedom Technique and the
Quadrinity Process. We also recommend talk therapy based on family-of-origin
Quieting the fires within — Women to Women’s approach to joint pain
In the end, joint pain and arthritis are not simple equations with the sum total
equaling a lifetime of pain. By and large, the majority of women I see experience
significant relief from joint pain when they begin to understand the multifaceted
issues at the bottom of their pain — and so can you. Whether it’s pain
from an injury, cumulative trauma, or arthritis, a whole-body approach to joint
pain that quiets the inflammatory fires can help increase your mobility and decrease
It’s important to note right away that if you have been diagnosed with arthritis
and are on medication, we do not suggest abandoning your medications. We encourage
you to simply supplement your treatment with the following measures.
- First, rule out basics. Look carefully at injuries, under-
or over-exercise, work station ergonomics, bad mattresses — anything that
can be easily remedied with adjustments, time and rest.
- Track your pain. Keep a
detailed journal including date, time of day, present activity level, medications,
any recent injuries or illness, diet, and stress levels. Rate your pain on a scale
of 1–10, and see if you can identify any patterns. While you’re at it,
jot down what you are trying to accomplish when you experience pain, who you’re
with, and whether it invokes any memories. You may be surprised by some of the associations
revealed. By acknowledging the power in our stories we can free our energy for healing
and move on.
- Eliminate dysbiosis or leaky gut issues. Poor digestion
can lead to systemic inflammation and increase your joint pain. See our
digestion and GI health section for specific recommendations that can help
speed recovery from inflammation caused by digestive issues.
- Adopt a healthy diet rich in natural anti-inflammatories.
Choose a “cooling” diet of richly colored fruits and vegetables, lean
proteins, and omega-3’s. Add a high-quality, mercury-free omega-3 fatty acid
supplement, as well as a high-grade multivitamin/mineral complex, and natural vitamin
E supplements with the full range of vitamin E fractions. Refer to our
natural anti-inflammatories article for additional help.
- Rid your body of its toxic load with a detox diet. Toxicity
can add to the inflammatory fire. Whatever you can do to clear your body will help
when it comes to your joints. See our detoxification
section for further recommendations.
- Learn to love moving your body. Regular exercise can reduce
stress, control your weight and help with the symptoms of arthritis. It also ensures
an active blood supply within the synovial membranes, which means the tissues surrounding
your joints get the nutrients needed to keep them pliable and healthy. Keeping your
weight within a healthy range also lessens the burden on your joints. Just a few
extra pounds can wear your joints down over time and cause unnecessary pain.
- Reduce stress. Exercise, meditation, therapy, yoga, prayer
— there are so many ways you can “burn off” stress and lower inflammation
markers in your blood. Carve out some time to try one or two of these and see what
happens to your joint pain. The beauty of stress reduction is that it’s never
a waste of time — it serves you on every possible level.
- Consider alternative therapies. Chronic pain and inflammation
are signs that something in your life needs immediate attention — your diet,
your stress levels, your weight. Making lifestyle changes is a great start, but
they can take a long time to become a habit and you may need more immediate pain
relief. Acupuncture, massage, chiropractic, osteopathic, or psychotherapy can help
relieve the pain while you wait for your other lifestyle changes to take effect.
Listening to your pain
Most of us were raised with the idea that pain is all negative and that we should
try to get rid of it as quickly as possible, even if that means denying its presence.
But pain is not your enemy. It often surfaces to communicate a deeper message about
your life, and instead of pushing it away, try listening to what it has to say.
You might be surprised by what you learn.
Whether it’s paying more attention to your diet and nutrition, balancing your
hormones, detoxing, or sifting through your emotional history, getting better is
about making connections, figuring out which of any number of factors are contributing
to your pain — and which combination of therapies will help heal it. You certainly
don’t have to live your life in pain. With some effort and time to heal, you
will be doing the things you love and feeling like yourself again!
Our Personal Program is a great place to start
The Personal Program promotes natural hormonal balance with nutritional supplements,
our exclusive endocrine support formula, dietary and lifestyle guidance, and optional
phone consultations with our Nurse–Educators. It is a convenient, at-home
version of what we recommend to all our patients at the clinic.
If you have questions, don't hesitate to call us toll-free at
1-800-798-7902. We're here to listen and help.
Related to this article:
References & further reading on joint
pain or arthritis
Last Modified Date: 04/20/2011
Principal Author: Marcelle Pick, OB/GYN NP