Arthritis

I’m having a debate with my rheumatologist, and I’d like some input from anyone similarly situated. Here’s my situation. I’m 51; I’ve been lifting since I was a teenager (although not consistently for that entire period); I’ve been pretty consistent for the last 12 years or so. I have had arthritis in my right hip joint for about 18 years; it was diagnosed about 15 years ago. Until recently, the pain was under control with medication, but in the last year or so, I find that I wake up with pain in my hip after sleeping for 3-4 hours. I have to get up and walk around for 5 or 10 minutes to get the joint warmed up and lubricated. Then I’m okay to sleep for another 3-4 hours.

I went to the rheumatologist last week, and he switched me from Vioxx to Celebrex (both maximal doses) to see if that helped. He made some general remarks about aging, the progress of the disease, and eventual hip replacement, and then said, “Let’s get an x-ray.” Well, the good news is that he was astounded when he put that x-ray beside one from 1988 – there was almost no change. I attribute that to two things, lots of exercise so as not to lose range of motion (I can still squat to rock bottom) and use of glucosamine, chondroitin, and MSM – not that the Doc would approve of those supplements, though, so I don’t discuss those with him.

So we went back to his office, and he stated the obvious, “Your symptoms are inconsistent with both your range of motion and your x-ray. In fact, your range of motion is inconstent with your x-ray. Most people your age with your hip joint would be walking with a cane. Let’s try to figure this out, but in the meantime, stop squatting.” I finally convinced him that in fact, squats were not stressing my hip joint, and got his grudging approval to continue. In my opinion, this is a use-it-or-lose it situation – the reason that I can still squat is that I just kept doing it, and if I stop I will be one of those people walking with a cane.

So here’s my question, is there anyone else out there with arthritis in the hip who can tell me their own experience with this? Do you squat? How deep? How is it working – more pain, less pain, no difference? How about developing pain while remaining in one position (i.e., mostly while asleep, but also sometimes when driving long distances – there’s a limit on how I can shift my hip around while still keeping my foot on the accelerator), but being more or less pain-free as long as the joint remains in use? If you have experienced this, what therapies or medications have your tried? Did they work? Are you using any of the supplements that I use? Do you use other supplements? I am also a martial artist, so I am usually pretty well stretched out, but I’d also like to hear stretching suggestions.

Thanks in advance.

Porkchop

I have what was at first thought to be osteoarthritis in my right hip and knee. Later, I was told I may (or may not) have Ankylosing Spondylitis.

Either way, the pain in my hip and knee was excruciating. Walking was a major challenge and most leg work was out of the question.

I was on Clebrex, the Vioxx. Neither did much. I got a little relief after a few months on Glucosamine.

About 2 years ago, I found what worked the absolute best. It was fish oil! After hearing about John Berardi’s recommendations of 6 grams of EPA/DHA per day, I amped up my dosages. (Originally I did it to begin a phase of massive eating). A month or so later, I was pain free. An extremely beneficial side-effect!!! I had lost my insurance months before the fish oil, so I was off vioxx for 2 months and off glucosamine for over a month before taking it. This is how I knew it wasn’t anything else that did it.

I did Ian King’s “Limping” workouts last year and got PR’s on both my Squats and Deadlift. I started getting some pain again in the hip around late December last year and took a couple months off the fish oil, thinking I may have gotten too used to it. About Feb. I started it up again and the pain once again went away.

I too was told to lay off Squats and Deadlifts or I’d be sporting a plastic hip someday. (I’ve also been told that masturbation makes you blind). Either way, I still squat and occassionaly deadlift…and still have 20/20 vision.

Thanks. That sounds really interesting. Do you have any suggestions regarding brand names and sources?

That is the experience of many people I know. The scan says they are cripples, the doc scratches his head and wonders how they can move at all, and they continue working out with ease. Any good brand name will do. Me and those I know do very well with the Walmart house brands of glucosamine and Omega-3.

I started out using two Tbsp./day of cod liver oil. Tasted like hell, but it worked. Now I just use Members Mark fish oil from Sam’s Club or similar. Works the same. Just be sure to use it consistently. I take 12 caps a day, but you may require more, depending on your size.

This sounds like osteoarthritis so I am curious as to why you’re seeing a rheumatologist? I have not been very pleased with the mainstream medical treatment of arthritic related conditions. Anti-inflammatory drugs will in fact end up accelerating the loss of cartilage although they do provide temprary relief of the pain. There are many beneficial supplements you just have to find the right combination that works for you. Glucosamine, Chrondroitin, MSM, SamE, Gelatin, and fish oils can all have benficial effects. Make sure you stay very well hydrated and eat at least a moderate carbohydrate diet. Low carb diets promote cellular dehydration which is not good for arthritis. Also explore different dietary options. Many people find relief just from avoiding grains, dairy, chemical additives, processed carbohydrates and foods from the nightshade family (tomatoes, potatoes, eggplant, peppers, tobacco) And to answer your question on squatting…If you’ve been doing it this long with no ill effects then I don’t see any reason to stop.

Here’s a very good, very cheap link: www.ourhealthcoop.com. Fish oil for almost nothing, and as far as I’ve been able to determine, good quality.


Also, I say this a lot on the Forum, but you need to get another doctor’s opinion (if not another doctor altogether).

I’m 46. I have arthritis in my knee. Actually I’m looking at a knee replacement. Had injections of Synvisc 2 yrs. ago. Helped quite a bit. Also the cleaner the diet the less pain I have. I continue to squat. Reps low. Form as perfect as possible. I also go to a doctor that specializes in arthritis. He’s big on all the supplements. He insists that you use them.
Good luck.

“After hearing about John Berardi’s recommendations of 6 grams of EPA/DHA per day, I amped up my dosages.” I picked up some 1000 mg caps yesterday at GNC and am starting out with 2 caps twice a day. For clarification, though, the EPA/DHA content in the GNC caps adds up to about 540 mg. For dosages, do you target 6000 mg of fish oil, or sufficient fish oil caps so that the EPA/DHA content aggregates 6000 mg, which would be about 11-12 caps a day vice 6 caps a day.? If so, over how long a period did you ramp up to your maximum/optimum dose? In my previous experiences with fish oil, I found that there were some digestive consequences to taking too much too fast. That’s why I’m starting out at what I think is a fairly low dose. Thanks, Porkchop.

“This sounds like osteoarthritis so I am curious as to why you’re seeing a rheumatologist?” It is osteoarthritis; my rheumatologist, at least, treats all degenerative joint disorders, not just rheumatoid arthritis. “I have not been very pleased with the mainstream medical treatment of arthritic related conditions. Anti-inflammatory drugs will in fact end up accelerating the loss of cartilage although they do provide temprary relief of the pain.” Well, I’ve heard that, too, but the X-ray shows that I have as much cartilage on the weight-bearing portion of the joint as I had 14 years ago. There is some additional narrowing on the outer edge of the socket and more sclerosis showing all around the socket, but the space between the head of the femur and the socket is as wide as it ever was. I can’t be too displeased with the guy, even if he did tell me way back when that he didn’t see any reason to take glucosamine. “There are many beneficial supplements you just have to find the right combination that works for you. Glucosamine, Chrondroitin, MSM, SamE, Gelatin, and fish oils can all have benficial effects.” I’ve been using glucosamine and chondroitin for a good 10 years and MSM for at least 6. Arguably, that’s what maintained the cartilage in a steady state for all this time. At RXR7’s suggestion I’m starting on fish oil. I may add SAMe later. What is the theory on the beneficial effect of gelatin? “Make sure you stay very well hydrated and eat at least a moderate carbohydrate diet. Low carb diets promote cellular dehydration which is not good for arthritis. Also explore different dietary options. Many people find relief just from avoiding grains, dairy, chemical additives, processed carbohydrates and foods from the nightshade family (tomatoes, potatoes, eggplant, peppers, tobacco)” Yeah, hydration is always an issue; unless I am constantly vigilant, it is easy to get behind on water intake. What is the theory behind avoiding foods from the nightshade family? Taking tomatoes and peppers out of my diet would leave a significant hole, and probably have me out searching for supplemental sources of lycopene. “And to answer your question on squatting…If you’ve been doing it this long with no ill effects then I don’t see any reason to stop.” Thanks for your encouragement, I won’t. Porkchop

Response to all - That website that Char-Dog mentioned “our health co-op” is incredible. They sell Wild Salmon Oil as cheap as I have ever seen it. Seem to have a good community focus too!

I have a story similar to yours. I had a nasty case of colitis in 1996. I had to take prednisone for 1.5 yrs. At the max dose of 60 mg. I would not recommend this stuff to anyone, maybe an enemy of course. Anways, one day I woke up and could not move my hip. At all. No ROM. I went to the doc, got some work done, turns out the prednisone started to cause bone death in my hip. Which was a symptom of taken long enough. I had fluid build up in my hip joint. They drained it and now it is more stiff than the other but better overall. The thing with doctors is, they deal with illness when it occurs, not the prevention of it. So realistically, what does your doc know about squatting anyways? I have seen plenty of MD’s that are overweight and unhealthy, so much for practice what you preach.

The nightshade vegetables contain a substance (solanine I think is the name) that promotes inflammation in the body and for some people they even seem to cause arthritis all on their own. It’s been a couple of years but I did read about a 250 page book on nightshades and arthritis. Most of the information as well as the name of the book escape me however I played around with the recommendations and did and do find the nightshade family definitely aggravates my joints. Unfortunately I love tomato sauce too much to give all of them up :).

RXR7 to Porkchop

I was going for 6 grams of EPA/DHA per day. Yes, that means in excess of 12 caps a day. If there is a gastrointestinal problem you may wish to slowly work your way up. You may even find you won’t need that much. Fish oil seems to have a cumulative effect, so it’s benefits aren’t realized right away. Anyway, 6 grams of EPA/DHA is a good target to shoot for, or is at least the starting point I used.

You may wish to try working up to 2 caps per meal (provided you eat 6 meals a day). I don’t carry fish oil on my person 24 hrs a day, so I generally take 6 in the mid-morning and 6 later on in the day or before bed. Best of luck! I hope it is as beneficial for you as it has been for me. Keep me posted.

RXR7, interesting situation here. I started on Celebrex (as a substitute for Vioxx) about 9 days ago, I started fish oil caps on Monday. Last night, I slept though the night and woke up with no pain in my hip for the first time in months. One night doesn’t necessarily resolve the issue, but it looks as if there is some possibility that either the Celebrex is kicking in or that fish oil works faster and at lower dosages than you experienced. If this continues, I may play around a little with drugs, supplements, and dosages to see what is essential to stay painfree and what isn’t. I may or may not ramp up my consumption of fish oil as time goes on. In the meantime, things seem to be looking up. I’ll keep you posted. I really appreciate the helpful advice I’m getting from you and Kelly Baggett.

An update for you who replied so helpfully. I don’t know whether it’s the Celebrex or the fish oil, but I’ve had three painfree nights now. The other variable is that I didn’t squat this week, since my leg regimen this week and for the following three weeks has me doing step-ups and lunges, but I don’t think that’s significant, since not squatting hasn’t really made a difference before. The addition of fish oil and the switch to Celebrex is working so I’m going to stay on this regimen. Thanks for your suggestions. Porkchop