Therapeutic nutrition for arthrosis, arthritis and gout: what are the differences?

Along with diseases of the cardiovascular system throughout the world, joint diseases hold the palm. Many of them are chronic and often lead to disability. Orthopedists and rheumatologists prefer conservative methods, and diet plays an important role in therapy. Nutrients directly affect how intense the inflammatory process will be in tissues. What nutritional recommendations do doctors give for arthrosis, arthritis, gout?

Nutrition is part of conservative therapy for joint pathologies

Subtleties of therapeutic nutrition for gout

In gout, the metabolism of purine bases is disrupted. The disease is manifested by damage to the joints and internal organs, the cause of which is the deposition of uric acid salts.

Gout can be primary, which is also called idiopathic, and secondary, when the disease is caused by medication. Excessive amounts of uric acid are formed due to the fact that a person consumes a lot of foods that contain purine bases. The second option is that these substances are synthesized in the body in increased quantities. In this case, the kidneys cannot cope with excretion.

Before the advent of drug treatment, diet therapy was perhaps the only effective way to influence the course of the disease. Its main principles are:

• it is necessary to limit the consumption of meat and fish, since they contain a lot of purine bases;
• milk and cereals are introduced into the diet, which contain a minimum amount of these bases;
• the person is advised to drink plenty of fluids;
• If you are overweight, you need to get rid of it.

Types of gonarthrosis of the knee joint 2 degrees and aspects of treatment

Pathology of 2nd degree of severity can be secondary or primary. More often, a secondary form of the disease is detected, that is, when gonarthrosis becomes a consequence of certain knee injuries, advanced arthritis and certain pathological conditions of the body, for example, of an endocrine nature (diabetes mellitus, thyroid disease, etc.). The primary form is characterized by the causeless occurrence of degenerative processes in the cartilage of the knee, which is rarely observed.

Symmetrical damage to the joints, the joint space is completely absent.

In turn, the primary and secondary disease can be concentrated either in only one knee or simultaneously in both the right and left joints. In orthopedics, damage to one side is usually called unilateral, and damage to two joints of the same type is called bilateral. Bilateral degenerative joint damage at stage 2 or more is much more difficult to tolerate, since two legs suffer from serious articular deformities at once. Bilateral arthrosis, according to its etiology, predominantly belongs to the idiopathic (primary) form, while the unilateral lesion is almost always secondary.

Regardless of the type of gonarthrosis in grade 2, treatment first involves the use of conservative methods, and in the absence of a therapeutic effect, surgical methods. Non-surgical technologies give positive results only with 1-2 degrees of arthrosis of the knee joint, and even then, unfortunately, not always. It is worth noting that the non-surgical approach does not involve curing the disease itself (all arthrosis is incurable), but:

• competent prevention of further cartilage destruction using medications and physical means;
• symptomatic action against painful symptoms through painkillers;
• maintaining the muscular-ligamentous system with the help of exercise therapy, which will to a certain extent help improve movements.

From the complete absence of destruction to its last stage.

Conservative therapy is advisable at the initial stage; in the middle phase of development of gonarthrosis, the level of its productivity decreases significantly, but there is hope for improving well-being. In the last phase, non-surgical methods do not work at all. You must understand if you suddenly decide to fight an incurable illness of grade 2-3 in severe manifestations yourself using folk remedies or some vaunted unconventional method, the modified configuration of the joint and the destroyed areas have been and will remain. It is simply impossible to achieve this physiologically. If everything were so simple, then there would not be such a large number of disabled people, and such unimaginable numbers would not have to perform difficult operations such as endoprosthetics every day.

By the way, sometimes they give disability already at the 2nd stage of gonarthrosis with persistent and severe functional disorders, rapidly progressing processes of degeneration and dystrophy of articular cartilage. When the disease reaches its final stage, the patient is clearly declared incapacitated. In these cases, there can be no question of any gentle treatment tactics; here it is recommended to remove the non-viable joint with the subsequent installation of an artificial joint. Only prosthetics can, at advanced stages, restore the lost locomotor-support functionality of a limb for many years (15-30 years).

The disease is not life-threatening, but it can cause severe, constant pain.

Do you want to live with your joint and not experience painful symptoms associated with physical failure, endless terrible pain, and the inability to walk without the use of crutches and outside help? Then contact an orthopedic doctor or rheumatologist in a timely manner!

If stage 1-2 is diagnosed, you still have a chance to get by with supportive conservative therapy. Follow purely professional recommendations, expertly compiled by a specialist especially for you, taking into account your diagnosis and individual characteristics of the body.

What is the difference between nutrition during an exacerbation and outside of an acute exacerbation of gout?

During an exacerbation, a person is recommended to take mainly liquid food - lactic acid drinks (kefir, fermented baked milk, yogurt), milk, homemade compotes, juices, simple liquid porridges and vegetable soups. It is necessary to completely abandon meat and fish products. Hunger and moisture deficiency are contraindicated: it is important to drink at least 2 liters of liquid, especially mineral waters with an alkaline composition.

When an acute attack of gout subsides, you can eat 100-150 g of boiled meat no more than twice a week, and on other days you can gradually add dairy products to your diet (lactic acid products are preferred), cereals, eggs, fruits and vegetables.

If gout flares up, you need to stick to a strict liquid diet for at least 1-2 weeks.

Menu for the week

Proper nutrition plays a very important role in joint arthrosis. When arthrosis worsens, it is necessary to switch to a more strict diet. Here's what a sample diet menu for a week looks like:

• Mon. Morning - cottage cheese, bread, tea with milk. Snack – nuts, fruits. Lunch – salad, vegetable soup, buckwheat porridge with chicken. Afternoon snack – jelly with cookies. Dinner – baked fish with rice;
• Tue. Breakfast - oatmeal with dried apricots, cocoa, cookies. Snack – yogurt, fruit. Lunch – chicken broth soup, boiled veal. Afternoon snack – compote, banana. Dinner – boiled rabbit meat, salad;
• Wed. Morning – omelet and cocoa. Snack – fruit jelly. Lunch – vegetable salad, fish soup and boiled fish. Afternoon snack – kefir with cookies. Dinner – fish aspic, vinaigrette, fresh or dried fruit compote;
• Thurs. Breakfast – 2 soft-boiled eggs, bread, cocoa. Snack – compote with cookies. Lunch – beetroot soup, steamed meatballs with boiled rice. Afternoon snack – milk jelly. Dinner – rabbit soufflé, banana;
• Fri. Morning – cottage cheese with kefir. Snack – soft-boiled eggs, fruit salad. Lunch – noodle soup, chicken cutlets with vegetable salad. Afternoon snack – fruit jelly. Dinner – buckwheat porridge, apple juice;
• Sat. Breakfast – cottage cheese casserole, green tea. Snack – apples. Lunch – vegetable soup, baked veal with a side dish of buckwheat, compote. Afternoon snack – fruit salad, jelly. Dinner – baked fish with vegetables, mint tea;
• Sun. Morning – buckwheat porridge, toast, cocoa. Snack – omelet. Lunch – fish soup, baked beef, vegetable salad, jelly. Afternoon snack – apples, fruit jelly. Dinner – cabbage rolls with carrots, low-fat kefir.

On a note!

Meals for arthrosis of the joints should be fractional - eat five meals a day instead of three meals a day. Dinner should take place at least three hours before bedtime.

Breakfasts for proper nutrition for arthrosis

• Nutrition for arthritis of the joints - what can you eat and what can you not?

Outside of an exacerbation of an attack, a person is recommended to:

• limit the intake of proteins and refractory fats into the body;
• reduce salt consumption to 5-7 g, including that contained in foods;
• increase the volume of seasonal vegetables, fruits and dairy products;
• exclude from the diet foods that contain purines that are hazardous to health in large quantities: meat extracts, beef innards, small shrimp, sardines and mackerel, legumes;
• reduce the intake of meat, fish, legumes - peas, beans, lentils;
• practice fasting days;
• If you are overweight, give up sugar and baked goods.

For gout, the meat of young animals, which contains a lot of purines, is especially contraindicated.

What nutrition is indicated for arthrosis?

A comprehensive treatment regimen for osteoarthritis always includes nutritional recommendations. A thoughtfully designed diet allows you to avoid excess weight and provides the body with the necessary supply of vitamins and minerals. Antioxidants are of particular importance for joints, namely vitamins A and E, omega-3 fatty acids. Also, in order for the body to produce chondroitin and glucosamine, a person must receive sufficient amounts of vitamin C and manganese.

TOP 10 products that must be present in the diet for arthrosis:

1. Fresh vegetables.
2. Seasonal fruits.
3. Greenery.
4. Lean fish.
5. Whole grains.
6. Dairy products with low fat content.
7. Various nuts.
8. Low-fat butter.
9. High quality olive oil.
10. Jelly.

With arthrosis, it is important to get enough vitamin C so that chondroitin and glucosamine are produced

Recommended Products

To eliminate the deficiency of water-soluble vitamins and essential microelements, nutritionists recommend including fresh herbs, vegetables, berries, and fruits in the diet. These are cauliflower, cucumbers, dill, potatoes, celery, carrots, pumpkin, zucchini. The most useful fruits and berries are apples and sweet and sour pears, oranges, apricots, plums, watermelon, black and red currants. The daily menu should also include the following products:

• low-fat cheeses, kefir, Varenets, cottage cheese, fermented baked milk, yogurt - the main sources of calcium necessary for strengthening bones;
• dried apricots, prunes, pumpkin seeds, cashews, hazelnuts - nuts and dried fruits containing almost all the microelements necessary for tissue regeneration;
• pasta, bran bread, whole grain bread, the chemical composition of which contains many complex carbohydrates and proteins;
• jam, marshmallows, marshmallows - confectionery products with the lowest content of easily digestible carbohydrates;
• rabbit, chicken breast, turkey, beef - lean meat with low calorie content and a lot of healthy proteins.

Fatty fish (salmon, herring, smelt), olive, flaxseed, and corn oils contain a lot of polyunsaturated fatty acids and fat-soluble vitamins A, D, E. These bioactive organic compounds are necessary to improve the condition of the blood vessels that supply the knee joint.

What is recommended for osteoporosis?

With osteoporosis, bone density decreases and the risk of bone fracture increases. The cause of the disease is insufficient intake of calcium and vitamin D into the body, consumption of alcohol in large quantities, medications of the glucocorticoid group, as well as the postmenopausal period.

Diet therapy for osteoporosis involves the following rules:

• taking calcium, which reduces the progression of the disease (the main source is milk and dairy products);
• consumption of foods with a high content of the microelement magnesium, which also promotes better absorption of calcium by the body (foods such as sesame, almonds, hazelnuts, watermelon, sunflower seeds, oatmeal contain it);
• taking vitamin D (fatty fish, caviar, liver of various origins, milk fats, eggs);
• Postmenopausal women are recommended soy-based products that have an estrogen-like effect;
• It is important to reduce your salt and coffee intake.

In osteoporosis, calcium comes first

Brief description of the disease

Cartilage tissue, which is affected by severe chronic pathogenesis, is an elastic, fairly strong, elastic and smooth formation. Cartilage covers all surfaces of articulating bones: femur, tibia, patella. Thanks to the unique coating, unhindered, smooth, silent interaction of the ends of the articular bones occurs, causing the joint to move. Hyaline cartilage also serves as a shock absorber and stabilizer of movement. Due to lack of nutrition caused by negative pathological external or internal causes, it begins to gradually break down and, as a result, thin out and die.

As gonarthrosis progresses, the bone surfaces forming the knee joint become exposed and the space (articular space) between them narrows. As a result, spiky bone growths and cystic formations grow at the ends of the interacting bones, and critical deformation of the joint develops, which entails serious movement disorders. The flexion-extension potential of the lower limb in this section becomes limited, and with each stage the amplitude of movements progressively decreases. As a result, a person is unable to move normally and perform various types of physical activity, even the simplest. Stiffness of the knee is always accompanied by painful sensations, which at the initial stage of the pathology are not very disturbing, but starting from stage 2, they rapidly gain momentum in intensity.

Since hyaline cartilage does not have its own blood-vascular network, the destroyed areas are no longer restored. In a word, degenerative-dystrophic pathogenesis is irreversible in nature, and therefore it is impossible to completely cure it. But it can still be stopped in the early stages or significantly slowed down using conservative methods, preventing gonarthrosis from completely ruining a person’s quality of life. Advanced pathogenesis is treated exclusively through surgery to replace the joint with an endoprosthesis. That is why experts urge people to contact them in a timely manner: at the earliest manifestation of discomfort in the form of morning stiffness or local pain after long physical activity.

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Nutrition secrets for rheumatoid arthritis

Rheumatoid arthritis is thought to be caused by autoimmune disorders. With this disease, it is important to establish a daily routine and nutrition, and most importantly, to ensure sufficient intake of protein and amino acids into the body.

For arthritis, the following nutritional rules are fundamentally important:

• limit the amount of fat in the diet, but so that the body receives animal - twice as much as vegetable;
• reduce the amount of easily digestible carbohydrates in the diet, in particular sugar and sweets;
• reduce table salt consumption to 3-4 g per day;
• Among vitamins, antioxidants come to the fore;
• strong meat and fish broths, it is better not to eat smoked meats;
• It is recommended to eat fractionally – ideally up to 6 times a day;
• if a person is overweight, cereals and pasta are replaced with raw or boiled vegetables, sugar is completely eliminated, and the amount of bread and bakery products is reduced to 100 g per day.

For arthritis, doctors strongly recommend giving up a number of foods. You will see the 10 most dangerous for joints in the video below:

Do not underestimate the importance of proper nutrition for joint diseases. The main thing is to correctly determine your priorities, since they will be different in the treatment of ankle arthrosis, knee arthritis or gout.

Bilateral gonarthrosis of the knee joint 2 degrees

Bilateral gonarthrosis is a degenerative-dystrophic pathology that affects the knee joints of both lower extremities. Experts recognize such a crisis as particularly difficult because it can lead to disability in a short period of time. The disease predominantly occurs in old age, although there are exceptions. The genesis of the disease is mainly idiopathic: arthrosis begins to develop spontaneously against the background of the patient’s good health status. As a rule, the severity of defects in the structures of the right and left knee joints is different, that is, one of the knees is slightly more damaged. Features of the stages of deforming osteoarthritis of bilateral localization are the same as those of unilateral localization:

• Stage 1 is the initial stage of the onset of unfavorable pathogenesis at the molecular level, when there are no deformations yet, the cartilage is just beginning to experience a nutritional deficiency, there are single small osteophytes, barely noticeable bone compactions appear, the joint gap is usually within normal limits;
• Stage 2 is a moderately severe gonarthrosis, characterized by a sharp deterioration in the condition of the joint, namely, a significant enlargement of bone spines, a significant narrowing of the interarticular space (by 50% or more), a discrepancy in the correct ratio of the articular surfaces, distortion of the shape of the epiphyses of the articular bones;
• Stage 3 is the final formation, accompanied by the complete disappearance of the gap between the articular surfaces, the formation of fluid cysts, large-scale osteophytic growths, critical bone deformations, the complete absence of viable tissues of hyaline cartilage, and, as a consequence, fatal blocking of the knee.

Stages of the disease on X-ray images.

If in phase 2 it is not possible to stop the progressive disease, as you understand, the knee joint will completely stop functioning. The problem is complicated by the fact that both joints are sick, so treatment cannot be delayed even for a moment! After all, the knee that hurts more will simply force you to put more stress on the opposite leg. The stronger limb will rapidly lose ground from irrationally increased loads, and limited work of the other leg will lead to critical dystonus of the periarticular muscles and continued destruction of the corresponding joint.

The probability of losing two vital joints at the same time is very high. The sooner you start treatment, the better for you. We emphasize that bilateral arthrosis of the knee joints is a serious problem that requires adequate multi-complex treatment. Conservative treatment measures are selected by purely professional doctors, strictly on an individual basis. They are based on techniques such as:

• Exercise therapy and physiotherapy;
• massage treatments;
• intra-articular administration of drugs;
• diet for losing weight and providing the body with important microelements and vitamins;
• wearing special orthopedic products;
• sanatorium treatment.

Unfortunately, as practice shows, intra-articular injections do not produce any effect.

The treatment process is long and lifelong. Unfortunately, no doctor will give you a 100% guarantee that the disease will respond to non-traumatic therapy. But at least you will do everything correctly, as required by orthopedic standards, and, perhaps, you will be able to achieve stable remission of the disease for several years. By not seeking qualified help and acting on your own, you are consciously signing your own death sentence to bilateral endoprosthetics, which will need to be performed very soon.

There are, of course, other surgical methods, for example, osteotomy (correction of the curved axis of the knee) and arthrodesis (artificial creation of ankylosis of the joint). But it is worth recognizing that these are already relics of the past; they are practically not used due to significant surgical aggression towards anatomical structures and the body as a whole, as well as due to low effectiveness and a high percentage of severe complications. In terms of manufacturability and effect, neither athrodesis nor osteotomy can come close to replacing knee joints with an endoprosthesis.

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