Rheumatologist in Dubai Healthcare City

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Living with Arthritis in Dubai

Are you struggling with weight loss because of your arthritis? Do you feel like you can’t exercise as much as you would like, and diets just don’t seem to work for you? As a consultant rheumatologist and one of the founders of the Middle East Arthritis Foundation, Dr. Humeira Badsha is here to share some tips on how to lose weight sensibly, even with arthritis.

First of all, it’s important to know that 80 to 90% of weight loss is through diet, not exercise. Of course, exercise can help, and there are plenty of low-impact exercises like walking, swimming, and yoga that can be great for people with arthritis. However, getting your arthritis well-controlled with a rheumatologist is the first step.

When it comes to losing weight through diet, the secret is making long-term, healthy choices. It’s not just about eating fewer calories than you burn. Our bodies are regulated by several hormones that control appetite and weight, including Ghrelin, incretin, leptin, and insulin.

Insulin is one of the most important hormones to understand because it can make you gain weight, especially around the middle of your body. Every time you eat, your insulin levels spike, and certain foods can cause your insulin levels to spike even higher.

So how do you keep your insulin levels low? First of all, eat foods that are low glycemic index, which means they don’t spike your insulin levels as much as other foods. Avoid sugar, carbohydrates, fruit juices, coke, diet drinks, and artificial sweeteners like stevia. Instead, focus on healthy fats like avocados and nuts, proteins like chicken and fish, and lentils.

Also, try to limit your eating period within an eight-hour window. This is called intermittent fasting, and it can help keep your insulin levels low. Making these changes to your diet can help you lose weight sensibly, even with arthritis.

Remember, losing weight and keeping it off is a long-term journey, and healthy choices are the key. Don’t get discouraged if diets haven’t worked for you in the past. By making healthy choices and working with a rheumatologist to control your arthritis, you can achieve your weight loss goals.

salmon-fillets-arthritis

Eating healthily as old as a Greek legend – but there’s something very true today about what a sensible diet can do for painful RA

Table of contents

Arthritis is a devastating condition and does not discriminate in terms of age, gender or ethnic origin. Anyone can be a target. It causes constant pain, stiffness and swelling in the joints and surrounding tissues. Those places in the body where bones come together – the knees, wrists, fingers, toes, and hips. The two most common types of arthritis are osteoarthritis and rheumatoid arthritis.

Osteoarthritis develops in joints with overuse while rheumatoid arthritis is an auto-immune disease, which means your immune system attacks your joints.

There are however many foods that can ease inflammation and may help relieve pain. In fact, one survey found that a quarter of those with rheumatoid arthritis said that their diet significantly reduced the severity of their symptoms.

Whilst there’s a thumbs up to green leafy vegetables, what you should be avoiding are red meats, processed foods, fried foods, sugar, refined flour, gluten, dairy products and of course anything with alcohol in it. Some, however, would extol the benefits of red wine consumed in moderation because it contains the compound resveratrol, with its well-established anti-inflammatory effects.

Using probiotics

Then there’s probiotics, which are thought to promote health by giving a boost to the so called ‘good bacteria’ that live in the gut – microbiota. Probiotics are present in or added to foods like certain yogurts, kefir, sauerkraut, tempeh, kimchi and kombucha. Then of course there are probiotic dietary supplements available in liquid capsule, powder, tablet and other forms. The jury is still out however as to the extent that these man made formulas do actually benefit us long term, although there are an awful lot of companies making a fortune from flooding the consumer market with them.

They seem to work in three ways: by maintaining a balance between the ‘good’ and ‘bad’ bacteria in the body; reducing the bad, which cause infections and illnesses and by topping up the good bacteria that are lost often after illness or from a course of antibiotics.

“People with inflammatory arthritis have been shown to have inflammation of the intestinal tract, which results in increased intestinal permeability,” says nutritional expert Sonya Angelone at the US Academy of Nutrition and Dietetics. “Probiotics may be able to help decrease the inflammation associated with increased intestinal permeability,” she says.

Best foods for RA sufferers

Here’s the Top 10 of the best foods to include in your diet if you have rheumatoid arthritis…

Oily Fish

salmon-fillets-arthritis

Salmon, mackerel, sardines and trout are high in omega-3 fatty acids, which have been shown to have potent anti-inflammatory effects. Omega-3 supplements decrease joint pain intensity, morning stiffness, the number of painful joints and use of pain relievers in patients with rheumatoid arthritis.

Fish is also a good source of vitamin D, which can help prevent deficiency. Multiple studies have found that rheumatoid arthritis may be associated with low levels of vitamin D, which could contribute to symptoms.

Tumeric

spice root curcuma arthritis

Many rheumatoid arthritis suffers search for homeopathic options. One supplement that has been used to treat arthritis for millennia is turmeric, that golden-coloured spice commonly used in curries. Turmeric contains a chemical called curcumin, and scientists believe that this chemical may have anti-inflammatory properties.

Garlic

garlic arthritis

It’s packed with health benefits. It’s been proven that garlic and its components have been shown to have cancer-fighting properties. They also contain compounds that may lower the risk of heart disease and dementia. For RA patients, garlic has been shown to have an anti-inflammatory effect that may help decrease symptoms of arthritis. Other research further and has shown that garlic may enhance the function of certain immune cells to help strengthen the immune system.

Ginger

ginger and lemons arthritis

Besides giving a boost of flavour to teas, soups and sweets, ginger may also help ease the symptoms of arthritis. One study found that ginger and its components blocked the production of substances that promote inflammation in the body. Consuming ginger in fresh, powdered or dried form may reduce inflammation and aid in reducing symptoms of arthritis.

Broccoli

Broccoli Arthritis

It’s widely appreciated that broccoli is one of the healthiest foods out there. In fact, its strongly believed to be associated with reduced inflammation. Broccoli has been associated with reduced inflammation. It also contains sulforaphane, which may have anti-inflammatory properties, according to test-tube studies. More research is needed to look at the effects of broccoli in humans.

Walnuts

Walnuts Arthritis

Never say nuts to these. They’re nutrient-dense and just packed with compounds that can help reduce the inflammation associated with joint disease. Analysis has shown that eating walnuts is associated with reduced markers of inflammation. They’re also especially high in omega-3 fatty acids, which have been shown to decrease the symptoms of rheumatoid arthritis.

Berries

Wild Berries Arthritis

They have loads of antioxidants, vitamins and minerals, which may part account for their unique ability to decrease inflammation. For example, those having two servings of strawberries a week are 14 percent less likely to have an elevated level of inflammatory markers in the blood. Berries are rich in quercetin and rutin -two plant compounds that boast a huge number of benefits for your health.

Spinach and other Leafy Greens

Spinach leaves Arthritis

These are full of nutrients and some of their components are said to help decrease inflammation caused by arthritis. Several studies have found that a higher intake of fruit and vegetables is linked to lower levels of inflammation. Spinach, in particular, contains the antioxidant kaempferol which has been shown to decrease the effects of the inflammatory agents associated with rheumatoid arthritis.

Grapes

Grape Arthritis

Nutrient-dense, high in antioxidants and they also have anti-inflammatory properties. Resveratrol is an antioxidant present in the skin of grapes. In one study, resveratrol showed potential for helping prevent the thickening of the joints associated with arthritis by blocking the formation of rheumatoid arthritis cells. Grapes also contain a plant compound called proanthocyanidin. Its extract reduces inflammation related to RA.

Olive Oil

Olive Oil Arthritis

Well recognised for its anti-inflammatory properties, olive oil can have beneficial effect on arthritis symptoms. Rheumatoid arthritis patients who consumed either a fish oil or an olive oil capsule each day for 24 weeks showed a near 40 percent decrease in symptoms in the olive oil group and 55 percent in the fish oil group. In a study of over 300 olive oil consumption was associated with a lower risk of RA.

The bottom line is that, when it comes down to what you eat, the right diet can play a major role in rheumatoid arthritis severity and symptoms. Many of the above foodstuffs combine what has become popularly known as the Mediterranean diet.

For many years the Mediterranean diet has been proven to help prevent heart disease and some forms of cancer. Now it’s discovered that it may also reduce the pain and swelling of joints stricken with rheumatoid arthritis – although its relief benefits may not begin to show for six weeks from start, studies have shown.

Significant improvements

However, three months down the line significant improvements were reported by the majority of the 26 arthritic patients in the US who followed a well-supervised Mediterranean diet regime. The diet includes olive and canola oils as the primary dietary sources of fat, along with plenty of fish, poultry produce and legumes – peas and beans – say researchers. By way of comparison, no relief was reported by another group of 25 patients who followed a typical Western diet. In addition to being provided with meals, the patients on the Mediterranean diet also received nutritional counselling on how to cook more healthfully. By the end of the study, they’d lost an average of seven pounds.

Meanwhile, those on a diet richer in dairy foods and red meat – typical in Europe and Scandinavia, as well as in the States of course – also received prepared meals but no counselling. They lost no weight and reported no measurable relief of symptoms. None of the study participants in either group had previously encountered the Mediterranean, or even a vegetarian-based, diet.

Benefits typical among Greeks

Their findings, published in the Annals of Rheumatic Diseases, clearly identify that arthritis relief may result from this eating plan, so typical among the inhabitants of many of the Greek isles. Meanwhile, University of Buffalo researchers found that mice fed high doses of fish oil and vitamin E had reduced levels of a specific protein that causes joint swelling and pain. Greek investigative scientists themselves found that a similar Mediterranean diet reduced the onset of rheumatoid arthritis by nearly three-fold – that’s compared with those who ate less olive oil and fewer fruits and vegetables.

So, it seems, the ingredients in these key cooking oils may be the key to pain relief. In addition to being good sources of heart-healthy fats, olive and canola oils are rich in oleic acid and vitamin E. Like vitamin E, oleic acid has an anti-inflammatory effect and is thought to reduce inflammatory protein levels.

Reduced disease risk

The fish eaten by the study participants in Greece didn’t have the same high levels of omega-3 and omega-6 fatty acids found in cold-water fish such as salmon, mackerel, and others associated with a reduced risk of heart disease and other conditions. Importantly, however, the nutrients in these oils may have a similar anti-inflammatory effect. And like green leaf veg, they’re also good sources of other antioxidant phytochemicals believed to reduce inflammation and inhibit tissue damage. The other foods in the diet research – legumes, poultry and cereals – are low in fat, which may further reduce inflammation.

The upshot of these dietary interventions show that a Mediterranean diet suppresses disease activity in patients who have stable and modestly active rheumatoid arthritis. Therefore, by eating a Mediterranean diet for three months, patients with RA can obtain better physical function and increase their activity. In theory, even a minor good effect that is persistent and accumulates over time is welcome. So why not try it? You may have nothing to lose but your waistline!

Physiotherapy for Fibromyalgia Dubai

If you deal with the aches and pains of fibromyalgia, the thought of beginning an exercise program may make you cringe. In the long run, however, it can do you a world of good. Consider this: Physical therapy has helped many fibromyalgia patients get active and manage their fibromyalgia pain at the same time.

Anne Reicherter, PT, DPT, PhD, a licensed physical therapist and associate professor in the department of physical therapy in the School of Medicine of the University of Maryland in Baltimore, says physical therapy can help fibromyalgia patients “manage their daily living with less pain and generally make life more enjoyable.” She explains that people with fibromyalgia pain are often caught in a vicious cycle: Pain and fatigue prevent them from being active and exercising, but inactivity can trigger more pain and fatigue.

Another benefit of proper exercise? It’s one way to help you get restful, restorative sleep every night. And good sleep benefits fibromyalgia patients, as sleep disturbances are a common fibromyalgia symptom. Working with a physical therapist can help you get the exercise you need for a good night’s rest. Reicherter says physical therapy can also eventually reduce the need for pain medication, and possibly even surgery.

Fibromyalgia patients may find it hard to start an exercise program on their own because they fear it will make their symptoms worse. By having a physical therapist tailor a gentle, yet effective program with your particular pain and fatigue levels in mind, you can eliminate the hard part — getting started. And a recent study found that fibromyalgia patients who participated in an exercise program designed for their specific needs showed improvements in their mood, functioning, and physical abilities even six months after the program ended.

Physical Therapy Options for Fibromyalgia Relief

Increasing flexibility and strengthening muscles through a maintainable exercise routine are two important ways physical therapists reduce fibromyalgia pain and make life more manageable. Options include:

  • Stretching. By increasing flexibility through stretching, tight, stiff muscles loosen up, providing fibromyalgia relief. Your physical therapist can instruct you on the proper way to stretch muscles, tendons, and ligaments. The National Pain Foundation recommends keeping the number of repetitions low — 5 to 10. Holding a stretch for 30 to 60 seconds is good for large muscle groups, with possibly only one to two reps necessary.
  • Aerobic exercise. Low-speed and low-impact activities are best, says Reicherter. Stationary bicycles and elliptical machines are usually less stressful on the joints.
  • Aqua therapy. Swimming and other water exercises are excellent for fibromyalgia patients. Says Reicherter, “The buoyancy of the water can lessen stress on muscles and joints and improve flexibility.” A heated pool may be especially beneficial because the heat can soothe sore muscles.

More Ways to Relieve Fibromyalgia Pain

Transcutaneous electrical nerve stimulation (TENS) stimulates nerve fibers and can decrease fibromyalgia pain. Reicherter says TENS helps:

  • Block pain signals to the spinal cord
  • Release the body’s own natural pain-killing chemicals
  • Improve local circulation and gently contract muscles for healing and relaxation

Dry needling: Treatment of fibromyalgia using dry needling targets muscles with trigger points and helps to relax muscles that are causing the pain. Research suggests dry needling has an affect on the pain signals that come from the brain.

Manual therapy: Trigger point release and manipulation of spine has also been considered beneficial

Some fibromyalgia patients say they feel worse after starting therapy, but Reicherter says this should not happen if you are getting good therapy and are going slowly. Overdoing exercise or activities after you start to feel better can make you feel worse. Reicherter also points out that exercise soreness is different from fibromyalgia pain. Once you get used to the exercise, you should start reaping its benefits: less pain every day.

Fibromyalgia and Sleep – What You Need To Know

For patients with fibromyalgia, sleep apnea could become a problem. With a wealth of recent research suggesting that those with fibromyalgia are more likely to develop an obstructive breathing problem, known as sleep disordered breathing, or experience nonrestorative sleep, researchers have been looking at the links between these two conditions.

Fibromyalgia is a long-term disorder that causes widespread, chronic pain throughout the body, leading to fatigue, low mood and increased sensitivity to pain. There is, as of yet, no cure for fibromyalgia. Many clinicians report that fatigue and poor sleep have become more prominent than pain in their patients with fibromyalgia. But how do you know if sleep apnea is related to how you’re feeling?

What is sleep apnea?

Sleep apnea is the partial or complete collapse of the airways while you are sleeping because of muscles in your throat relaxing. Apnea just means that the flow of air into and out of your lungs stops for more than 10 seconds, but when this happens many times throughout the night, you can expect to snore more, wake frequently and find it difficult to enter sleeping phases necessary for full sleep health.

Can sleep apnea cause chronic fatigue syndrome?

The most recent studies show evidence that up to 60% of patients with chronic fatigue syndrome have sleep apnea, but there are no definitive links between having sleep apnea and developing CFS or fibromyalgia. The effect of sleep apnea, including fatigue and lack of sleep, may contribute to a feeling of chronic fatigue, but this is not inherently linked to the condition of CFS itself.

Does sleep apnea have any relationship with fibromyalgia?

Yes, it does. Think about how not getting a good night’s sleep disrupts your day. You may find yourself feeling more moody, less active, more drowsy and less able to function. Combined with the pain from fibromyalgia, not getting good rest can increase sensitivity to pain, increase mood issues and lead to exhaustion. Studies have shown that fibromyalgia has a profound relationship with sleep apnea, leading patients to suffer more through the combination of these two conditions.

Can chronic fatigue syndrome and fibromyalgia run in families?

As with many conditions, CFS and Fibromyalgia show some evidence that they run in families. If you have a family history, you might be more prone to developing them, but there are environmental factors at play too.

Is sleep apnea a valid medical condition?

Yes, it is. Sleep apnea is a serious medical condition in which you stop breathing, possibly hundreds of times throughout one night. This lack of oxygen to the brain and body has a damaging effect on your health and pre-existing conditions. Untreated sleep apnea might not be able to kill you, but the effects of it can be detrimental; including developing heart disease, high blood pressure and diabetes.

If you have sleep apnea, how do you feel during the day?

Not getting restorative sleep has a big impact on your daily functioning. Some types of sleep apnea mean you might notice that you have a dry mouth, headache or low mood. You’ll be tired, sometimes exhausted despite sleeping, or suffer from insomnia.

Can losing weight cure sleep apnea?

Some sleep studies have found that larger necks or higher BMIs can predispose people to sleep apnea and other sleep disorders. Combined with treatment of fibromyalgia your clinician may suggest losing weight as part of developing a healthier lifestyle. It has been shown that exercise and diet play a big part in many chronic pain conditions including fibromyalgia and rheumatoid arthritis. Increasing your quality of life is always the goal, so weight loss might be an option for you.

As with many chronic pain conditions, sleep is vitally important to recover from the pain and fatigue of everyday living. Cognitive behavioural therapies, mindfulness and medication, alongside lifestyle changes are all beneficial to regaining an optimum quality of life, and treating each condition as it presents is important.

If you suffer from fibromyalgia, sleep apnea or another chronic condition, it’s important to keep in touch with your clinician, updating them on your symptoms, sleeping patterns and overall functioning, so they can help you as much as possible.

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