Nutrition strategies for managing osteoarthritis

March 1, 2002 in Nutrition for Older Adults

Nutrition strategies for managing osteoarthritis

What is Osteoarthritis? 

Also known as degenerative joint disease, osteoarthritis is thought to be caused by 'wear and tear' of the joints. Inside each joint is a tough, slippery tissue, called cartilage, which covers the ends of bones. Healthy cartilage allows the bones to glide smoothly over one another when we move. It also acts as a shock absorber to protect the joints from the stresses and strains of daily activities.

Over time, repeated use and unusual stresses cause the cartilage to crack and wear away. Once the protective layering of cartilage disintegrates, the bones rub painfully against each other, further restricting movement. The bones may even thicken and grow spurs along the edges of the joint.

Osteoarthritis usually targets weight-bearing joints, such as the hips, knees, feet and spine. Although the finger joints and joints at the base of the thumb are not weight bearing, they are also common sites for arthritis. Scientists aren't sure what causes osteoarthritis, but they think that genetics may play a role. This type of arthritis might be caused by abnormalities in the cells that manufacture cartilage. Another theory suggests that the disease is actually a disorder of the bone rather than the cartilage. Failure of the bone to respond to impact may lead to damage of the overlying cartilage.

Osteoarthritis may also develop from known causes such as infection, deformity, injury or diseases such as diabetes and high blood pressure. People working in certain occupational groups may be more susceptible osteoarthritis if their job involves repetitive heavy, physical work. High-intensity, high-impact sports may have a similar, damaging effect on the joints. Being overweight also contributes to osteoarthritis. The excess weight puts additional stress on the knees and hips and may also be associated with metabolic abnormalities that may affect the cartilage.


Damage from this osteoarthritis progresses slowly and affects only one or two joints in the early stages. Once symptoms begin, the disease will continue to progress, gradually limiting the motion of the joint and leading to severe disability in many cases. Symptoms of osteoarthritis include the following:

  • Pain in the joint that may be made worse by exercise
  • Stiffness in the joint after sleep or periods of inactivity
  • Swelling in the joint, particularly after use
  • Reduced range of motion in the joint
  • Joint may crackle or grind when moved
  • Joint may be painful to the touch
  • Bony lumps may develop in the joints of the fingers or the base of the thumb

Who's at risk?

Older adults - osteoarthritis is more likely to develop in people over age

  • 45 Older women - women have higher tendency to develop osteoarthritis in older age groups and to develop more severe symptoms
  • People with a family history of joint disease
  • People who are obese
  • People who work in occupations that involve repeated, heavy physical work
  • People who engage in high-intensity, high-impact sports
  • People who have rheumatoid arthritis and gout
  • People who have medical conditions, such as diabetes and high blood pressure

Managing Osteoarthritis with Diet 

Maintain a healthy weight. To help protect your joints from further damage, it is very important to control your weight. Studies have found that obesity and higher levels of and obesity are significantly related to osteoarthritis pain. Some researchers believe that losing body fat is more important than losing body weight when it comes to relieving joint pain.

To determine if you are at a healthy weight, click on 'healthy weight assessment' from the home page of my website. Having a BMI over 25 indicates overweight and a BMI greater than 30 is defined as obese.

Vitamins and Minerals

Vitamin C. Since free radical damage may be involved in the progression of osteoarthritis, researchers have hypothesized that higher intakes of antioxidant nutrients might be associated with lower rates of the disease. The best evidence to date is for vitamin C. One large study conducted among 640 patients with knee osteoarthritis found that those who consumed the most vitamin C in their diet, had a threefold-reduced risk for the disease progressing, compared to people who consumed the least. High vitamin C appeared to protect from cartilage loss. Those with the highest vitamin C intake also had a 70 percent lower risk of developing knee pain.

Vitamin C acts as an antioxidant and it also supports collagen synthesis, both of which may be important in slowing the progression of osteoarthritis. The best food sources are citrus fruit, strawberries, kiwi fruit, cantaloupe, broccoli, bell peppers, Brussels sprouts, cabbage, tomatoes, and potatoes. To supplement, take 500 milligrams of Ester C once or twice daily.

Vitamin D. Low intakes and low blood levels of vitamin D may impair the response of bone to osteoarthritis making progression of the disease more likely. In a study of 556 patients with knee osteoarthritis, the risk of disease progression increased threefold in those who had lower vitamin D intakes and reduced blood levels of the nutrient. Reduced vitamin D levels were associated with cartilage loss. Another study also found that low blood vitamin D was associated with a narrowing of the joint space in elderly women with hip osteoarthritis.

The best foods sources of vitamin D include fluid milk, fortified soy and rice beverages, oily fish, egg yolks, butter, and margarine. Most multivitamin/mineral supplements provide 200 to 400 IU of vitamin D.

Herbal Remedies

Capsaicin cream. Capsaicin is responsible for the 'heat' of chili peppers and it has a long history of use as a topical agent for pain disorders. A few studies have found that capsaicin cream is effective at providing osteoarthritis pain relief. When applied to the skin, capsaicin depletes substance P, a compound that transmits feelings of pains from the nerves to the spinal cord. As a result, pain relief is achieved.

Capsaicin creams are available with or without a prescription. Zostrix, Capzasin-P and Capsin are all available over-the-counter. Buy a cream with 0.025 to 0.075% capsaicin (the greater strength may be more effective). Capsaicin cream will produce a burning sensation, which will diminish after several applications. Use a small amount to begin with. When you no longer feel burning, increase the amount of cream used. Be careful not to touch your eyes or other sensitive tissues after applying capsaicin cream. Wash your hands after using the product.

Other Natural Health Products

Chondroitin sulfate. This compound belongs to a family of compounds called glucosaminoglycans that are a normal part of cartilage. Studies show that supplemental chrondroitin sulfate can reduce the painful symptoms of hip and knee osteoarthritis and improve walking distance. When compared with non-steroidal anti-inflammatory drugs (NSAIDs), chondroitin sulfate takes longer to produce results, but unlike NSAIDs, pain relief lasted three months after treatment was stopped.

There is also evidence that chondroitin supplementation may actually slow the progression of osteoarthritis. When researchers looked at the effects of chondroitin in 119 people with osteoarthritis, they found that those using chondroitin experienced much less joint damage over three years compared to the placebo treatment.

Chondroitin may work by providing joints the building blocks they need to repair cartilage. Some experts believe that chondroitin increases the amount of hyaluronic acid in the joints - a fluid that keeps the joints lubricated. Chrondroitin may also inhibit the activity of enzymes that break down cartilage. Chondroitin also possesses anti-inflammatory properties, which may provide pain relief.

The recommended dose is 400 milligrams taken three times daily. One study found that 1200 milligrams taken once daily was equally effective and well tolerated. It may take two to four months of treatment to notice significant improvement in osteoarthritis symptoms.

Occasionally, chondroitin supplements may cause stomach upset and nausea. There is a potential for allergic reaction in some individuals from chondroitin supplements made from animal sources.

Glucosamine sulfate. The body uses glucosamine sulfate to make a family of compounds called mucopolysaccharides, which are a normal part of cartilage. Findings from studies lasting one month to three years have found that glucosamine significantly improved pain and mobility in people with osteoarthritis of the knee. Whereas conventional medications appear to take two weeks to improve symptoms, glucosamine takes four weeks to have an effect. Research suggests that glucosamine supplements stop and possibly even reverse degenerative diseases of the joints.

The recommended dose is 500 milligrams taken three times daily. One three-year study found that 1500 milligrams taken once daily was effective. Glucosamine supplements may cause nausea, heartburn, diarrhea and/or constipation in some individuals.

Glucosamine supplements are made from chitin, a substance found in shrimp, lobsters and crab or it is produced synthetically. There is potential for glucosamine supplements made from shellfish to cause allergic reactions in people with a shellfish allergy. If your have such an allergy, call the manufacturer to determine the source of glucosamine (this is not always on the label).

Recommended Websites

The Arthritis Society (National Office)

National Institute of Arthritis and Musculoskeletal and Skin Diseases Information Clearinghouse, National Institutes of Health

Arthritis Foundation

American College of Rheumatology

Source: Leslie Beck's The Complete A-Z Nutrition Encyclopedia

All research on this web site is the property of Leslie Beck Nutrition Consulting Inc. and is protected by copyright. Keep in mind that research on these matters continues daily and is subject to change. The information presented is not intended as a substitute for medical treatment. It is intended to provide ongoing support of your healthy lifestyle practices.