What are the best ways to avoid, slow the progression or manage the symptoms of osteoarthritis? Which of the touted alternative methods are effective, and what’s new on the horizon?

The National Institutes of Health convene regular Twitter chats about topics of interest to Americans. Last month, the chat focused on arthritis. Harvard Medical School, the National Institute of Aging’s GoForLife program, the University of California’s BerkleyWellness.com and several doctors and researchers participated.

Here are the top takeaways for avoiding, slowing and managing the symptoms of osteoarthritis:

Is it Really Osteoarthritis?

Many older people assume that pain and stiffness are symptoms of wear and tear, confusing osteoarthritis with rheumatoid arthritis, which is an auto-immune disease. Click the image below, which explains the differences,  to see it full-size.

New Thinking on Osteoarthritis

• For a long time, doctors described osteoarthritis as the wearing away of cartilage. Now, they have a better understanding of it and say that the condition is also the result of changes in the bone under the cartilage and the joint lining, or synovium.
• The new thinking is leading to new, experimental treatments, among them the injection of stem cells into joints to regenerate tissue, and a drug called strontium ranelate that targets the bone.

Weight Control is a Number One Factor

• Carrying extra weight is a major risk factor for osteoarthritis. Losing weight – even just a few pounds – reduces stress on the joints and can ease pain and discomfort.
• Losing just one pound of body weight reduces the load on your knees by four pounds.
• The best way to avoid osteoarthritis from developing is by maintaining a healthy weight.
• The best way to maintain or lose weight is through regular weight bearing and aerobic exercise.

Exercise Is Super-Important, Too

• Exercise promotes the repair of cartilage.
• Strength exercises build muscle that helps to protect joints from stress. Click here to see some strength exercises.
• Flexibility exercises relieve stiffness and keep joints moving. Click here to see some flexibility exercises.
• Aerobic exercises help keep the blood flowing and can prevent or slow the progression of osteoarthritis. Click here to see some endurance exercises.
• Swimming and riding a stationary bicycle are great exercises since they don’t stress the joints.
• For knee arthritis, a simple, chair-based leg-straightening exercise strengthens thigh muscles, reducing symptoms in the knees. Click here to see the exercise.
• Tai Chi has been found to be effective for reducing the pain of osteoarthritis and increasing flexibility – especially in osteoarthritis of the knee. Read more here
• People who are experiencing arthritis pain tend to move less –  but walking is one of the best ways to relieve pain.

For a fact sheet that spells out how much physical activity is right for you, based on your arthritis condition, click here.

Diet Can Influence Osteoarthritis

No diet can cure osteoarthritis, but the right foods can help you to manage it.

• It’s a myth that nightshades – tomatoes, potatoes, eggplant, and other foods in  the nightshade family – exacerbate osteoarthritis.
• Omega-3 fatty acids help to reduce inflammation. The best sources are salmon, sardines and tuna. Other sources are flax seeds, olive oil, walnuts and to a lesser degree, green leafy vegetables.
• Omega-6 fatty acids can increase inflammation. Limit red meat and egg yolks, along with fried foods, fruit juices, sugary and baked goods, and other processed snack foods.

Some Supplements are Effective – Others Not so Much

• Turmeric could be as effective as ibuprofen in managing osteoarthritis pain and inflammation. A 2014 study showed that patients with significant pain from osteoarthritis found as much pain relief, along with reduced stiffness, from taking an extract of Curcuma domestica (turmeric) at 1500 mg a day as a control group that took ibuprofen.

• Research suggests that low levels of vitamin D can increase the risk of developing osteoarthritis. Doses of up to 4,000 IU a day are considered safe, and doctors says that foods and sunshine alone typically don’t provide enough, especially in the winter (read more about vitamin D on Senior Planet).
• Other research shows that in people with osteoarthritis and vitamin D deficiency , the disease gets worse three times faster than in people who have enough vitamin D in their blood.
• For knee osteoarthritis only, Glucosamine with chondroitin may decrease pain that’s moderate or sever – not mild pain. But these supplements haven’t been found to be effective for other forms of osteoarthritis. (Avoid Glucosamine if you’re allergic to shellfish. Talk to your doctor before taking Chondroitin if you are on an anticoagulant like Warfarin or anti-platelet drug like Aspirin.
• Clinical trials of DMSO and MSM have found no significant benefit.

Some OTC Meds Work Better Than Others

Researchers have studied which OTC and prescription meds work best for alleviating pain and other symptoms of OA. Research focused on knee osteoarthritis.

• Acetaminophen (eg, Tylenol) has been found in controlled studies to be scarcely more effective than a placebo. Celecoxib  (eg, Celebrex) was only a little bit more effective.
• Most effective for pain relief was diclofenac, followed by ibuprofen second, and naproxen third.
• Just as effective as these drugs were injections of placebos – for example, a saline solution (injections of corticosteroids were more effective). Researchers don’t know if the effect is psychological,or if injecting any fluid into the joint helps to relieve pain.

Other Therapies Are Worth Trying

• A review of studies suggests that mud pack therapy might be effective in reducing knee pain from osteoarthritis. Benefits might come from the mud’s warmth as it clings to the body or from the minerals in the substance itself. Read more her
• For knee osteoarthritis, preliminary research has shown Swedish massage – 60 minutes once a week – to be effective in reducing pain and stiffness. Read more here
• A small research study of acupuncture’s effectiveness in treating knee osteoarthritis didn’t show significant benefit, but some researchers say it’s still worth a try, since many patients have found that it helps relieve pain and inflammation. (Others say its effects are pure placebo.)
• Gentle massage helps to bring blood to sore areas.
• Heat and cold:  Warm baths, cold compresses or alternating heat and cold can help relieve pain.
• More than 200 smartphone apps claim to help patients relieve chronic pain. A 2012 systematic review of these apps found that almost none had been developed with the help of a healthcare professional and most lack evidence-based pain management features.

Read highlights from the #arthritistalk Twitter chat. Follow the link in each tweet to read more.

See the whole #arthritistalk Twitter chat.