How Does Alcohol affect joint pain and stiffness?

Osteoarthritis and Rheumatoid Arthritis are the two most prevalent, and perhaps most severe, diseases that negatively affect the synovial joints in the body. These are complex disorders which seem to develop as a result of the interplay between a multitude of environmental and genetic factors.

Recently, new evidence has surfaced that suggests the existence of a possible interaction between lifestyle factors and genetic factors such as smoking and alcohol consumption in relation to arthritic disease. These findings are of extreme interest to the fields of biology and public health and further illustrate the importance of continuing to investigate the effect that lifestyle factors affect our bodies in unexpected ways.

Perhaps, the most interesting finding to come out of these studies is that alcohol consumption might not have the expected effects on joint health. Generally, alcohol is thought to influence inflammation in general and arthritic disease in particular; however, there is new evidence that alcohol is able to diminish the response to immunogens in humans. Even more surprising is the fact that alcohol can down-regulate the production of pro-inflammatory molecules via an innate influence on immunity.

How trustworthy is this data? How can alcohol consumption reduce the clinical signs of arthritis as well as joint degradation?

ARTHRITIC DISEASE

The progressive deterioration caused by the most common types of arthritic disease is the leading cause of disability in otherwise healthy adults over the age of 45.

All arthritic diseases are complex and chronic disorders that affect vast swathes of the adult population. When left untreated, these diseases cause persistent joint pain, inflammation, and irreversible joint damage.

INFLAMMATORY RESPONSE

Inflammation is the physiological response triggered by signals derived from tissue injury or infection. The inflammatory response is mediated by the individual’s innate immune system. The cells comprising the immune system, also known as macrophages, release pro-inflammatory cytokines and chemokines that stimulate neutrophil action to the affected site and increase vascular permeability to fluid and plasma proteins.

Acute inflammation works in tandem with other immune responses to eliminate the triggering agent and prevent further damage to the affected tissue as well as promote repair.

ALCOHOL AND INFLAMMATION

Inflammatory response with various degrees of chronicity has been associated with alcohol-related medical conditions in the past. By most accounts, alcohol acts as an etiological factor in the initiation and progression of many these types of situations. Especially relevant to this discussion is the fact that a significant number of individuals with alcohol-related diseases present a high level of circulating inflammatory particles called cytokines.

There are a few broad categories of alcohol-related sources of inflammation.

The first is a set of inducers derived from cells that have been damaged by alcohol.

The second is derived from gut micro-flora. One of particular importance is known as lipopolysaccharide which, as a result of metabolic processes, leads to the production of reactive oxygen species, known to stimulate the activation of a critical inflammation transcription factor.

The third is hypoxia, which is also known to induce an inflammatory response.

Therefore, it can be said that alcohol interferes with the body’s immune response. Even a single dose of alcohol can lead to a significant increase of serum cortisol levels which can further exacerbate the body’s inflammatory response.

How it then that some studies suggest alcohol can have beneficial effects in patients with the arthritic disease?

ALCOHOL AND JOINT PAIN

A recent study, researching the way that alcohol consumption affects patients with some type of arthritis resulted in some surprising revelations. In this study, patients who drank at least 10 alcoholic beverages each month reported up to 30 percent less inflammation and pain than patients who abstained from alcoholic drinks.

In a similar study, patients with confirmed cases of rheumatoid arthritis were compared to patients presenting no symptoms regarding alcohol consumption. The results of the study suggested that non-drinkers were four times more likely to develop the arthritic disease than individuals who partook in regular moderate alcohol consumption. Additionally, of the patients who presented symptoms, those who drank regularly reported less frequent and less severe bouts of joint pain and stiffness.

However, most medical professionals agree that the evidence is lacking and that further research needs to be done. As it stands, there are a few facts that suggest it is best to limit alcohol consumption when suffering from bouts of arthritic pain.

For example, the fact that alcohol exerts a diuretic influence on the body means that the more you drink, the more dehydrated your ligaments and cartilage tissue can become. Alcohol has been linked to many diseases and adverse conditions so it would be irresponsible to think of alcohol as a sort of therapeutic agent. Even if alcohol consumption improves your joint pain, you would be putting yourself at risk for other diseases by increasing your alcohol intake. Additionally, alcohol is known to interact heavily with a multitude of medications. Patients who have been prescribed Disease Modifying Anti Rheumatic drugs are advised not to drink alcohol because it actually increases the risk of liver toxicity and cirrhosis.

It is doubtful that, except for gout, alcohol consumption will cause the development of arthritic disease, and it is even possible that it can reduce the severity of most symptoms. However, it is also probably that by increasing alcohol consumption you also induce an increased inflammatory response.

When observed from a broader perspective and regarding inflammatory diseases, the established relationship between alcohol consumption and the progression of arthritic disease falls in line with what has long been known about its relationship to cardiovascular disease. In both cases, moderate dose-dependent alcohol consumption decreases the risk to develop and exacerbate the condition. Further study will be needed since no clear mechanism of action has been established as of yet, but the effects of alcohol consumption on inflammatory disease deserve more scrutiny.

REFERENCES:

• Voigt, Lynda F., et al. “Smoking, obesity, alcohol consumption, and the risk of rheumatoid arthritis.” Epidemiology (1994): 525-532.

• Hazes, J. M., et al. “Lifestyle and the risk of rheumatoid arthritis: cigarette smoking and alcohol consumption.” Annals of the rheumatic diseases 49.12 (1990): 980.

• Källberg, Henrik, et al. “Alcohol consumption is associated with decreased risk of rheumatoid arthritis: results from two Scandinavian case–control studies.” Annals of the rheumatic diseases 68.2 (2009): 222-227.

• Di Giuseppe, Daniela, et al. “Long term alcohol intake and risk of rheumatoid arthritis in women: a population based cohort study.” Bmj 345 (2012): e4230.

• Latash, Mark L., and Vladimir M. Zatsiorsky. “Joint stiffness: Myth or reality?.” Human movement science 12.6 (1993): 653-692.