Dr. Andrea Flemmer: Self-help for osteoarthritis

Dr. Andrea Flemmer: Self-help for osteoarthritis

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Dr. Andrea Flemmer: The best measures for at home

Osteoarthritis means joint wear. This widespread disease affects eight million people in Germany alone. The older a person gets, the higher the risk: 70 percent of those over the age of 70 suffer from it, according to the author. Osteoarthritis does not always hurt, and, according to Flemmer, this has a lot to do with personal behavior.

The author writes from the perspective of a nutritionist and biologist and publishes advice on medicine, nutrition and environmental protection. It presents measures for self-help against the consequences of osteoarthritis. This includes the right form of sport, a diet suitable for osteoarthritis, and conventional non-drug therapies such as relieving pain from heat, herbal medicines and exercise. Not every method works for every person, since people, like arthrosis, are very different.


In the first chapter, Flemmer explains how joints work and how they wear out. This means that no movement is possible without a joint, and the joint lubrication ensures that the joints remain flexible. Joints cushion hard movements, with the help of the articular cartilage, a smooth, elastic coating and joints provide support by their structures allowing certain movements and preventing others.

Joint types

The shape of a joint, its structures, the muscles, ligaments and capsules define the scope of the joint.

The ball joint is the most flexible - with a spherical joint head and a joint socket, as well as three movement axes for six different directions. This includes the hip joint as well as the shoulder joint.

An egg joint, on the other hand, has the shape of an ellipse with a concave joint head and a convex joint socket. It has two axes of motion for bending and stretching movements from one side to the other. To do this, count the wrist.

Then there is the saddle joint with two similar articular surfaces, whose shape is reminiscent of a saddle, but they are offset from one another. It has two hinge axes. One of these joints is the thumb saddle joint. The thumb is connected to the hand by the saddle joint.

However, a hinge joint has only one axis and can only be moved back and forth. An articulated head in the form of a roller lies in an articulated channel. For example, the elbow joint is a hinge joint.

Finally there is the pivot joint, which also only works uniaxially, but here as a rotary movement. You can only move the radio-ulnar joint on the elbow in and out - with the arm extended.

Joint structure

Each joint consists of the joint head and socket, joint surfaces, cartilage, joint gap and joint capsule. Cartilage covers the articular surfaces. The joint capsule itself forms a sheath of connective tissue. It encloses the entire joint and protects it airtight from the outside. This creates the joint cavity on the inside and a thin gap separates the joint surfaces.

The articular cartilage is as resilient as it is elastic, it protects the bones, is millimeter-thin and sits on the bone ends as a sliding layer, explains Flemmer. It prevents the bones from rubbing against each other. Cartilage cells and collagen fibers are the substance.

With a healthy joint, the cartilage surfaces do not touch, but the joint lubrication fills the gap between the cartilage surfaces. The inner skin of the joint capsule produces this joint lubrication, enables smooth sliding and also supplies the cartilage with nutrients.

The arthrotic joint

According to Flemmer, a worn joint is the result of wear. There are different phases of this disease.

In the beginning there is damage to the articular cartilage. This can be very small, but is spreading. The cartilage is getting thinner and rougher, wear out more and more. The cartilage surfaces rubbed against each other, particles detached and the rubbing intensified. This then characterizes the first stage of osteoarthritis.

In the second stage, the ankle was no longer smooth and the movement of the joint was impaired.

In the third stage, the adjacent bones are affected, now there is pain and the affected can only move the joint to a limited extent, the joint becomes inflamed.

In the fourth stage there was no more cartilage. The surrounding bones change, as does the joint mucosa, joint capsule and adjacent muscles. Now the entire joint could break. Without countermeasures, severe pain and inability to move the joint are the result.

How does arthrosis develop?

According to Flemmer, doctors see arthrosis primarily as a kind of chronic inflammatory disease. The inflammation leads to the breakdown of the cartilage and the pain. The cause is injuries or infections.

If a joint is damaged, Flemmer says, risk factors promote further wear. This includes over- as well as incorrect loading of the joint due to overweight or incorrect posture. The normal wear of the cartilage is, however, also a side effect of aging. Poor postures such as X or O legs would put a strain on the knee joints in the long run. Here the weight works either only on the inner side or only on the outer side. The lateral joint structures are less stable, which means that osteoarthritis can form more easily here.

According to Flemmer, extreme and competitive athletes often overload their joints and / or put a one-sided load on them, thus also promoting wear.

Accidents are another risk. Every third patient and a third of all patients suffer from osteoarthritis as a result of an accident. For example, the stability of the knee joint is damaged by injuries to the meniscus and cruciate ligament and this promotes early wear.

Not only extreme sports, but also the opposite caused arthrosis - lack of movement. This leads to the fact that not enough fluid is formed in the joints, the articular cartilage loses its elasticity and is not adequately supplied with nutrients.

Disorders of the hormone and metabolism also played a role in osteoarthritis, as well as various underlying diseases such as gout, diabetes mellitus, a dysfunctional thyroid gland, or the decline in female sex hormones.

As different as the causes may be, the symptoms were very similar.


The cartilage tissue has no nerves, so there would be no pain at the beginning of osteoarthritis. The more the cartilage is damaged, the more the pain increases. The start-up pain is typical. When the joint was resting, the first movements would hurt particularly. The warmed up joints hurt less, but the pain comes back when the load increases. This phase could last for years.

As the process progressed, muscle tension and restrictions in movement were added, and the joint became stiffer. Now very painful inflammations could also occur, the joint swell and deform.

The symptoms included:

  • Start-up pain,
  • Stiffness of the joint in the morning,
  • Crunch in the joint,
  • Stress pain,
  • later rest pain,
  • tense muscles and tendons,
  • restricted mobility,
  • Conservation,
  • Joint inflammation,
  • Joint effusion,
  • Joint swelling
  • and muscle weakness.

What to do?

The self-help section of the book is divided into six sections: relieving the joints, physiotherapy, nutrition, exercise, herbal medicine and natural remedies. Flemmer emphasizes that the advice relates to osteoarthritis, not to other diseases of the joint.

According to the author, measures to relieve the joint include stabilizing bandages, for joints on the legs or back, orthopedic shoe inserts and shoes with soft soles and buffered heels, as well as the use of a walking stick.

Physiotherapy such as coordination and balance training and strength training as part of movement therapy are necessary. Thus, osteoarthritis patients should in no way take care of their joints, but rather perform exercises that serve to build muscle and coordinate.

Occupational therapy helps to use aids correctly and to be able to act in everyday life. Heat therapy stimulates blood circulation and thus ensures that nutrients get to the joint head better. Peat packs or hot envelopes are suitable for this. Treatment with heat is not appropriate for acute inflammation. Cold therapy can block the pain pathways for a short time and thus alleviate the pain.

Medicines for pain are pure pain relievers, agents that relieve pain and inhibit inflammation, and also pure anti-inflammatories. Flemmer mentions ibuprofen, aspirin, paracetamol and diclofenac as examples.

According to the author, healthy eating against the consequences of osteoarthritis includes plenty of fruits and vegetables from many different types (especially broccoli, onions, garlic and leek), fatty fish such as salmon, mackerel or herring, and linseed, rapeseed and walnut oil and whole grain products.

You should reduce sugar, unhealthy fats, fast food and ready meals. You should also drink enough, low-sugar drinks. To reduce chronic inflammation, according to Flemmer, vitamins A, C and E, copper, selenium, zinc and omega-3 fatty acids are part of the diet.

Medicinal plants that help with osteoarthritis are nettle, devil's claw, willow bark, ginger, comfrey, cayenne pepper, hay flower, mustard seeds, rosemary, rose hip or lemon grass.

According to Flemmer, sports that make sense for osteoarthritis include Nordic walking, cycling, dancing, playing golf, hiking, cross trainers, swimming, water sports and moderate strength training. Running and mountaineering are unsuitable.


"I help myself" does what it promises. Readers who are struggling with the consequences of osteoarthritis get a clear overview of what you can do yourself - and that's a lot. If Flemmer uses technical terms, she explains them, and even someone who has no idea about joints, joint wear and countermeasures understands what it is all about after reading the adviser. The measures that Flemmer presents can all be planned and implemented in everyday life without any problems and without prior knowledge. (Dr. Utz Anhalt)

Author and source information

Video: Understanding Arthritis (December 2022).