You have just delivered and a few days or weeks following that, you notice that you are stiff in the joints on waking up in the morning and cant seem to do your usual chores without feeling these aching pains in your joints. You notice also that the joints are swollen and red. As a new mom, as you are experiencing these pains and discomfort in several joints after delivery, it hampers your ability to take care of your baby.

The onset of these pains will really bring to the fore and drive home the fear and dread of chronic joint pains on you and worse still it exposes the risk of development of rheumatoid arthritis with its debilitating effect on the life of the sufferer the mom. And it is also a cause for worry as you age.

Postpartum arthritis is the swelling, pain and stiffness that occurs at any of the joints of the body leading to reduced range of movement and mobility in a recently delivered mom as a result of the impact of the pregnancy on the mother.

Causes

Preexisting joint pains in pregnancy

Some women have joint pains that predated the pregnancy like people with autoimmune arthritic conditions. As pregnancy occurs and switches off the immune system the pains regress only to recur again after pregnancy when the immune system of the mother switches back on again to its prepregnancy status.

Post pregnancy exacerbation

Following pregnancy the immune system can become overactive and can trigger off the development of autoimmune reactions in susceptible mothers that can lead to postpartum arthritis. In those that had a preexisting pain prior to pregnancy, delivery and this over activity of the immune system can worsen your pain.

The hormones of pregnancy

The hormones of pregnancy lead to softening of the cartilages and tissues around the joints and these softened joint cartilages lead to an increased mobility of these joints. These increased mobility makes the joints prone to swelling tenderness and stiffness during pregnancy and afterwards. This softening of joint cartilages is gradually restored as the woman delivers and the hormones return to prepregnancy levels but not without causing joint pains and stiffness to the mother before resolution.

Other causes

Age, Obesity, Sedentary lifestyle, Genetic composition, Inadequate diet or deficiencies in your diet can all contribute to postpartum arthritis.

Symptoms

The common symptoms of postpartum arthritis you should look out for are

Pain

The pain is classically located at the joints. It can be a single joint or it may affect multiple joints in the hand, legs, hip, and shoulders. The pain may be of acute and sudden onset or it may be a slow progressing one.

Swelling

The joints may in addition to the pain, be swollen as a result of the inflammatory response at the joints, they are warm to touch and tender with associated redness.

Immobility

The pain and stiffness leads to a reduction in the range of movement of the joint with its associated hampering of the normal day to day activities of the mom.

Management

As painful as it may sound, postpartum arthritis has no cure and you will benefit immensely from taking preventive measures. Instituting action early in the development of the ailment will help to reduce its progression to chronicity. Even the mild cases related to hormonal effects of pregnancy can lead to long term sequelae if not treated early.

Preventive strategies

After delivery, the immune system reacts aggressively to environmental influences on your body so preventive measures and life style modifications especially in your dietary habits will go a long way in curbing postpartum arthritis.

Control your weight – Obesity increases the pressure on the weight bearing joints of the body especially the hips, knees and ankles worsening arthritis so you should endeavor to lose weight – not that easy especially postpartum.

Exercise – Gentle exercise that doesn’t add undue strain to the joints is very good especially for people leading a sedentary life. Exercising also helps to take care of the stiffness of arthritis.

Eat a healthy diet – A diet rich in fruits and vegetables supplies the requisite nutrients that help in bone and cartilage remodeling and growth, fruits like tart cherries and strawberries contain anti inflammatory agents and anti oxidants beneficial to patients with arthritis.

Eat fish – Fish is rich in omega 3 fatty acids that have good anti inflammatory and anti oxidant properties. They convert the inflammatory cytokines and prostaglandins into anti inflammatory chemicals called resolvin that mediates anti inflammatory responses in arthritis.

Supplements – Vitamins C and D containing supplements are an essential part of the preventive strategies against postpartum arthritis

Avoid Alcohol, Smoking and Control your intake of sugars- These act as exacerbators of inflammatory activities in arthritis and controlling them reduces the symptoms of the condition.

Avoid injury to the joints – Any injury to the joint worsens the prognosis for arthritis as it destroys the cartilage as it wears it away, the joint space reduces and the synovial fluid regresses with the joint surfaces that are now directly abutting each other knocking against each other leading to stiffness and pain

Natural remedies

Some natural remedies with anti inflammatory properties have an effect on mild forms of arthritis and can be used in conjunction with other measures to treat arthritis.

A word of caution though needs to be exercised here as regards natural remedies and you must consult your doctor before using natural remedies for your treatment to avoid adverse drug interactions.

There are so many remedies available but the most studied ones which have good promise are as follows:

Turmeric/ Curcumin – Curcumin is the main active product of turmeric. It has anti inflammatory characteristics and it reduces swelling and pain by blocking enzymes and cytokines that lead to destruction of cartilages. It is available as spices, tea or as an oral supplement.

Avocado-Soybeans Unsaponifiables (ASU) – According to the Arthritic foundation, this natural remedy blocks pro inflammatory mediators in the joints, prevents synovial cell degeneration and helps in the growth and regeneration of connective tissue thereby improving the symptoms of arthritis and reducing the use of orthodox medications.

Ginger – Ginger has been known for ages to have anti inflammatory properties and studies have revealed it to have effects similar to NSAIDs and Cox-2 inhibitors and some studies suggest it could one day replace the NSAIDs in pharmaceutical preparations. It can be used in so many varieties for treatment of the many forms of arthritis.

Boswellia (Indian frankincense) – The active ingredient of Boswellia serrata called Boswellic acid is extracted from the gum of Boswellia tree. It has anti inflammatory and analgesic properties. It also prevents cartilage loss and inhibit autoimmune processes. An extract of it known as loxin 5 has been noted to improve pain and stiffness in osteoarthritis.

Cats claw (Uncaria Tumentosa) – This herb is from the root and bark of a tropical vine that grows in central and south America. It is an anti-inflammatory agent that suppresses the tumor necrosis factor (TNF) according to the arthritic foundation. There are side effects associated with usage of cats claw that you should be aware of and discuss this with your doctor before commencing treatment with cats claw

Medications

Medications are used to treat arthritis and they are of different forms and act at different levels of the arthritic process ranging from pain killers or those that affect pain and inflammation to those that act on the immune system. You need to consult your doctor for the appropriate therapy for your condition.

Pain killers – These act solely to reduce your pain and has no effect on the inflammatory process. They range from the locally acting acetaminophen to the centrally acting opiod drugs.

Non steroidal anti inflammatory drugs (NSAIDs) – NSAIDs act to relieve pain and reduce inflammation at the joints. They come in various forms like tablets, injections, gels and sprays. Examples are the over the counter (OTC) ibuprofen and diclofenac

counter irritants – Some menthol containing gels and creams also have capsaicin and when rubbed over the joint pain interferes with transmission of pain stimuli from the joint.

Disease Modifying Anti rheumatic Drugs (DMARDs) – These drugs act on the immune system preventing it from attacking your joints, one of the causal factors in postpartum arthritis

Biologic response modifiers – These are involved in the immune response and act usually in conjunction with DMARDs. They target specific proteins involved in immune reactions. Tumor necrosis factor (TNF) is one example.

Corticosteroids – They reduce inflammation and affect the immune system,

Physical therapy

Occasionally there may be need to involve physiotherapists in the care of postpartum arthritis. They help you to exercise the joints, extend the range of motion in the joints and reduce the spasm that occurs in the muscle as s result of the arthritis

Surgery

This is the last resort and is infrequently used. Common procedures are

• Joint repair
  

• Joint replacement
  

• Joint fusion

When you have postpartum arthritis, taking care of your baby becomes next to impossible as the pain, swelling, tenderness and debilitating nature of this condition can only be imagined. A knowledge of the condition will assist you in being able to understand what is needed to be able to live a postpartum lifestyle that is free of pain.

No single therapy resolves the problem of postpartum arthritis and most mothers do benefit from a combination of therapies and preventive measures for the resolution of their arthritis.

Natural remedies are gaining popularity in the treatment of arthritis and further studies have highlighted their usefulness and effectiveness in the management of arthritis but medications still remain the mainstay of treatment with surgery being reserved as the last resort.

Dr mawa

To your postpartum health and freedom

mypostnatalmanagement.com