The term arthritis is used to describe more than 100 conditions that affect joints, the tissues which surround joints, and other connective tissue. These conditions range from relatively mild forms of tendonitis and bursitis to systemic illnesses, such as rheumatoid arthritis. They are differentiated by how the condition evolved, the joints affected, and signs and symptoms. Arthritis is common in adults 65 and older, but it can affect people of all ages, races, and ethnic groups.

Two of the most common forms of arthritis are osteoarthritis and rheumatoid arthritis, and they have different causes, risk factors, and effects on the body:

  • Osteoarthritis – joint pain, stiffness, or inflammation most frequently appears in the hips, knees, and hands.
  • Rheumatoid arthritis – commonly affects the hands and wrists but can also inflict pain, stiffness and inflammation on areas of the body other than the joints.


Osteoarthritis (OA) is the most common form of arthritis and is often referred to as “Wear and Tear Arthritis”. In most cases, over time, the cartilage in joints breaks down, and symptoms begin to occur. Cartilage is the part of the joint that covers the ends of the bones that interact in the joint. Cartilage acts as a shock absorber, allowing the joint to move smoothly.
As cartilage breaks down, the ends of the bones thicken and the joint may lose its normal shape. With further cartilage breakdown, the ends of the bones may begin to rub together, causing pain. In addition, damaged joint tissue can cause the release of certain substances called prostaglandins, which can also contribute to the pain and swelling characteristic of the disease.

Osteoarthritis is most commonly found in the:

  • Knees
  • Hips
  • Hands and fingers
  • Spine

Wrists, elbows, shoulders, and ankles can also be affected by OA, but this occurs less frequently. When OA is found in these joints, there may have been a history of injury or stress to that joint.

While the exact cause of OA is unknown, it is believed to be repetitive movement or an injury that leads to damage in the joint. Both cases involve the erosion of the cartilage.

Risk Factors

  • Age – Age is the strongest risk factor for OA. Although OA can start in young adulthood, in these cases, it is often due to joint injury.
  • Obesity – The chances of developing OA generally increase with the amount of weight the body’s joints have to bear. The hips and knees are particularly affected because these are major weight-bearing joints.
  • Gender – OA affects both men and women. However, before age 45, OA occurs more frequently in men. After age 45, OA is more common in women.
  • Joint injury or overuse – Traumatic injury to joint increases your risk of developing OA in that joint. Joints that are used repeatedly in certain jobs or sports may be more likely to develop OA because of injury or overuse.
  • Joint Alignment – People with joints that don’t move or fit together correctly, like bowlegs, dislocated hips, or double-jointedness, are more likely to develop OA in those joints.
  • Heredity – An inherited defect in one of the genes responsible for manufacturing cartilage may be a contributing factor in developing OA.


Typically, OA comes on slowly. For many, the first signs are joints that ache after physical work or exercise. As the disease progresses, other common symptoms include:

  • Pain in a joint
  • Swelling or tenderness in one or more joints
  • Stiffness after periods of inactivity, such as sleeping or sitting
  • Flare-ups of pain and inflammation after use of the affected joint
  • Crunching feeling or sound of bone rubbing on bone (called crepitus) when the joint is used


If you experience joint pain, stiffness, and/or swelling that won’t go away; you should see your doctor. Your doctor will be able to determine if you have arthritis and, if so, what type. X-Ray and Joint Aspiration tests can help confirm the diagnosis and determine the extent of damage to the joint:

  • X-rays can help determine whether you have OA or rheumatoid arthritis (RA). A series of X-rays obtained over time can show how fast joint damage is progressing. X-rays of the affected joints can show cartilage loss, bone damage, and extra bone growth (spurs) that can develop on the surface of normal bones.
  • If your doctor is still uncertain about the diagnosis or suspects that you may have an infection, he or she may perform joint aspiration. In this procedure, your doctor withdraws and examines synovial fluid (a liquid that lubricates the joint) from affected joints using a needle.

Rheumatoid Arthritis (RA)

Rheumatoid Arthritis is an autoimmune disease where the body’s immune system attacks normal joint tissues, causing inflammation of the joint lining (called the synovium).

This inflammation of the joint lining can cause pain, stiffness, swelling, warmth, and redness. The affected joint may also lose its shape, resulting in loss of normal movement. RA is an ongoing disease, with active periods of pain and inflammation, known as flares, alternating with periods of remission, when pain and inflammation disappear.

RA can affect many different joints. In some people, it can even affect parts of the body other than the joints, including the eyes, blood, lungs, and heart.

The exact causes of RA are unknown. But research has shown that several factors may contribute to the development of RA:

  • Genetic. Certain genes play a role in the immune system — for some people, genetic factors may be involved in determining whether they will develop RA.
  • Environmental. In people who have inherited a genetic tendency for the disease, RA can be triggered by an infection. However, RA is not contagious — you can’t “catch it” from anyone.

Symptoms of Rheumatoid Arthritis
Although RA is often a chronic disease, the severity and duration of symptoms may come and go, resulting in periods of flare-ups or flares, alternating with periods when the symptoms fade or disappear, called remission.

Symptoms include:

  • Pain and stiffness lasting for more than 1 hour in the morning or after a long rest
  • Joint inflammation in the joints closest to the hand, such as wrist and fingers, although the neck, shoulders, elbows, hips, knees, ankles, and feet can also be affected
  • Symmetrical pattern of inflammation, meaning both sides of the body are usually affected at the same time
  • Fatigue, an occasional fever, and a general sense of not feeling well (called malaise)

Rheumatoid arthritis can cause joint inflammation, which can affect the ability to go about your daily activities. If left untreated, RA can worsen and destroy joints. After the onset of the disease, some of the effects of RA are as follows:

  • Tendons become inflamed and may tear
  • Swelling can severely damage or destroy ligaments that hold joints together.
  • Erosion of the cartilage and bones of the joint, causing pain and deformity.
  • Development of small lumps of tissue under the skin, called rheumatoid nodules.

If you have persistent discomfort and swelling in multiple joints on both sides of your body, see your doctor. Early diagnosis and treatment can help slow disease progression.

Your doctor should ask questions about your medical history and examine the joints that are bothering you. Your doctor will also decide if you need other tests to help confirm the diagnosis of RA and determine the extent and severity of joint damage. These may include:

Blood Tests

  • One of the tests looks for an antibody called rheumatoid factor. About 70% to 90% of people with RA have this antibody. However, it is also possible to have the rheumatoid factor in your blood and not have RA.
  • Another test measures your erythrocyte sedimentation rate, which will indicate the presence of an inflammatory process in your body. People with RA tend to have abnormally high sedimentation rates.


  • X-rays of all your joints can determine the extent of damage in the joints that are affected. A sequence of X-rays obtained over time can show the progression of RA.

Treatment Options for Arthritis
It’s important to understand that although there is no way to reverse the cartilage loss of osteoarthritis or rheumatoid arthritis, there are treatment options available to help you relieve the symptoms. These can include:

  • Maintain a Healthy Weight
  • Exercise, Rest and Sleep
  • Medications
  • Alternative therapies
  • Surgery

Your doctor may even suggest combining several treatment options to more effectively manage your arthritis symptoms.

Maintain a Healthy Weight
Being overweight increases the risk for developing OA. Losing weight is the easiest and simplest form of treatment to control arthritis symptoms and other health related problems.
Even a little weight loss can make a difference when it comes to reducing stress on your joints, especially the knees. For every pound you lose, you remove about 4 pounds of stress from your knees.

Aim to achieve a normal healthy weight. Any significant weight loss can lower your health risk and result in a decrease of inflammation of the joints, greater mobility of the joints and less pain.

Many of Dr. Bernstein Diet & Health Clinic patients find that painful arthritic symptoms are reduced or even disappear with weight loss. Swelling of the arthritic joints reduces with weight loss, which helps reduce pain and improve the range of movement of affected joints. Some patients have reduced or even eliminated their need for anti-arthritic medications. It is amazing how a loss of extra weight can relieve excruciating symptoms that they have been suffering over the years and improve the quality of life.

The Dr. Bernstein diet program is a medically supervised weight loss program which is a safe and effective method to lose excess weight. The Diet is designed for anyone who needs to lose weight to lead a healthy life. With the diet program, over 90% of our patients can stop the use of all arthritis medication when they reach their expected goal weight. The program includes a restricted diet, with vitamin and mineral supplementation and behavioural and life style modification.

Have you been advised to have hip or knee replacement surgery?
After losing a significant amount or weight, 70 or more pounds, most of our patients have been able to cancel replacement joint surgery because of significant relief of pain and increased movement. If you do require surgery, significant weight loss prior to surgery will improve your speed of recovery.

Our experience has shown that weight loss reduces joint inflammation and thus reduces swelling and pain and increase joint range of movement.


Contrary to what many people may think, exercise and staying active is not only good for your health, but it can also help relieve the symptoms of arthritis. In fact, people with arthritis who exercise tend to have less pain, more energy, improved sleep, and better day-to-day function. Staying active can help keep joints flexible and improve one’s ability to stay mobile.

Besides helping to ease arthritis symptoms, exercise can also:

  • Improve your mood
  • Strengthen your heart
  • Improve blood flow
  • Helps to maintain weight

Rest and Sleep.

Any exercise regimen should include adequate rest. It’s important to learn how to recognize the signs of overexertion, which can include fatigue and muscle weakness.

Getting proper sleep is also an important part of managing arthritis symptoms. If you find that joint pain is interfering with your ability to rest or sleep, talk to your doctor.

i. Over-the-counter medication
One way to manage arthritis symptoms is with an over-the-counter (OTC) medication. These can include:

  • Topical pain-relieving creams, rubs, and sprays
    These medications are applied directly to the skin over the joints to relieve pain.
  • Acetaminophen
    Acetominophen may be used to help relieve osteoarthritis pain. However, acetaminophen does not reduce inflammation.
  • Non-Steroidal Anti-Inflammatory Drugs (NSAIDs)
    Unlike acetaminophen, NSAIDs treat both arthritis pain and inflammation. NSAIDs such as ibuprofen and naproxen are often sold as over-the-counter medications. However, at higher doses, they are available by prescription by your doctor.

ii.Arthritis Prescription Medication
Prescription medications are an available treatment option to help manage arthritis symptoms.
Everyone responds differently to medications so only you and your doctor can decide which one is right for you.

iii. More Than Medication
Medications are an important part of managing arthritis symptoms. But medication alone may not be enough. Guidelines from both the American College of Rheumatology (ACR) and the Osteoarthritis Research Society International (OARSI) suggest taking an active approach that includes medication as well as lifestyle changes to more effectively manage arthritis symptoms.

Keep Fit

  • Follow a healthy diet. Maintain a healthy weight.
  • Find a balance between physical activities (like walking or water aerobics) and rest.

Keep Informed

  • Don’t be afraid to ask your doctor questions about arthritis or your treatment.
  • Use books, magazines, and online resources to learn more about arthritis and stay up to date on new developments in medicine and treatment options.

Keep Working with Your Doctor

  • Talk to your doctor about changes in your arthritis symptoms to help him or her determine the right treatment for you.
  • Always take your medication as your doctor prescribes.
  • Be sure to report any changes in your health or any side effects that you may experience. Your doctor needs that information to make sure that your treatment is the right one for you.

Alternative Therapies for Arthritis Symptoms
Studies have shown that some alternative therapies can help you manage arthritis symptoms. Don’t consider your approach to managing arthritis symptoms complete until you look into alternative therapies. Here are some ideas:
Meditation and Relaxation
Meditation and relaxation techniques can help reduce muscle tension and the stress that can accompany arthritis. In one study, RA patients who meditated 45 minutes a day reduced their stress by one third.
Yoga can be an effective way to increase physical activity. It can increase muscle strength, improve flexibility, and promote balance. It’s also associated with increased mental energy, positive feelings, and fewer body aches and pains.
Tai Chi
Tai chi is a slow-moving meditative exercise that originated in China. Many people practice tai chi to ease pain and stiffness, improve balance (which can help decrease the risk of falls), and improve overall health and well-being. It involves breathing deeply as you move your body slowly, gently, and with awareness.
Acupuncture has been practiced in China and other Asian countries for over 2,000 years. It involves stimulating nerves, muscles, and connective tissue in specific points on the body. It is thought to decrease pain by releasing the body’s natural chemicals that block pain. Acupuncture has been shown to provide pain relief and improve function for people with osteoarthritis of the knee.
Nutritional Supplements
Nutritional supplements, when taken correctly, may also be beneficial. However, some of these may interfere with other medicines you are taking, so before you try adding a supplement, talk to your doctor.
Massage Therapy
Massage can help increase blood flow and increase warmth to a stressed area, which may help relieve pain.

*Individual weight loss may vary. Call for details. Compliance with our program is required.