The Impact of Diet on Arthritis

Unfortunately arthritis does not yet have a cure, but there are some habits that you can practice to help alleviate the pain of arthritis symptoms. One question that patients frequently ask is, “Are there foods that can help? What foods should I avoid?” So far, there is no conclusive evidence that eating more or less of a particular food will affect symptoms or joint function. Throughout the ages, there have been many claims made on the influence of dietary habits on arthritis. Many of these claims are mostly anecdotal, though there are some reasonable theories.

Diet impacts many aspects of health, so it is possible that it can affect arthritis. Researchers are currently interested in the role of the microbiome in health and disease. The microbiome refers to the large population of microorganisms living within our bodies. We know that diet impacts the microorganisms in the intestinal tract and that these organisms may affect immune function. Because rheumatoid arthritis is an autoimmune condition, there is a possibility that changes in the microbiome can affect the activity and severity of rheumatoid arthritis.

Previously on this blog, I covered foods that can help arthritis pain, and this month I’m following up with some more healthy nutritional ideas for you to consider. One idea that is supported by medical evidence is weight control. Being overweight is a major risk factor for osteoarthritis, and weight loss can reduce the stress on joints. One study found that losing a pound of body weight reduces the load on your knees by four pounds. The best way to reach that healthy weight is to keep a healthy diet rich in vegetables and low in fat and to engage in regular  physical activity.

This blog was originally published on

Not Enough Pediatric Rheumatologists

A child who does not receive adequate treatment for a rheumatic condition may suffer dire lifelong consequences. Over 300,000 children have been diagnosed with rheumatic diseases, yet fewer than 400 pediatric rheumatologists practice in America. Rheumatologists who treat adults are doing their best to meet this care deficit, but they generally lack the expertise of pediatric specialists. The shortage persists amidst efforts to promote awareness of the need.


The structure of medical education may be a primary cause of the subspecialist shortage. The fellowships for pediatric rheumatology requires additional schooling. Because rheumatology is mainly an outpatient field, pediatrics residents do not normally have opportunities to see this field and develop an interest in it. Those residents who do observe pediatric rheumatology patients typically only see the sickest ones; they rarely study the spectrum of patients and how innovative therapies are reshaping the landscape of care for rheumatological diseases.


The American College of Rheumatology is striving to change this unfortunate scenario. In 2001, it initiated a residency program that pairs residents with mentors. The program has encouraged 73 percent of its students to pursue pediatric rheumatology training. Duke has set up a similar program that is turning more residents on to this subspecialty. Professors note that enabling the residents to survey the scope of inpatient and outpatient care has a significant impact.


These gains have not yet been enough to alleviate the shortage, which is expected to worsen. Meanwhile, more rheumatologists who specialize in adult care are forced to deal with pediatric patients. Pediatric specialists hope to increase awareness and provide counsel to these physicians.


The doctors who have not obtained specialized education to work with children face critical challenges with performing exams and prescribing medications for younger, smaller patients. Also, these adult rheumatologists often do not consider how differently children metabolize medications. The doctors need to consider the particular emotional needs of the sick children as well.


Most of the physicians who do treat children report dealing mainly with older teens. Although many of these adult rheumatologists are confident in diagnosing the most prevalent rheumatologic disease (JIA), many lack confidence in treating it. This trepidation could carry significant ramifications. Doctors must consider the impact of inflammatory conditions on a child’s growth when devising treatments. They need to understand how to take advantage of the limited chances to make progress with these patients during their formative years.


The Arthritis Foundation estimates that about one in four children receives proper care from a pediatric rheumatologist. Eight U.S. states have none of these specialists, and five states have only one. The average age of these doctors is over 50 years, so their retirement is critically imminent.


This stark reality shapes an increasing dilemma of access, but rheumatologists remain hopeful. They point to the host of resources that the ACR and disease foundations provide to educate care providers and families. Pediatric rheumatologists are also standing together and reaching out to promote awareness to future physicians.


Originally posted at

Rheumatoid vs Osteoarthritis: What’s the Difference?

Osteoarthritis (OA) and rheumatoid arthritis (RA) are both forms of inflammation of the joints but they are actually very different types of a broader condition called arthritis. There are many forms of arthritis, including gout, but RA and OA are two of the most common, affecting a combined 32 million people in the United States alone. Despite their similarities, the diseases have different causes and symptoms that can vary quite a bit in spite of some overlap.

What Is Osteoarthritis?

OA is a degenerative joint disease affecting the cartilage. Also known as wear-and-tear arthritis, it’s caused by a breakdown in cartilage of the joints that leads to pain and inflammation as bone rubs against bone without the protective cushion of the cartilage. OA may begin in a single joint and get progressively worse. This disease is most common among older adults with 70% of people over 70 showing some evidence of OA. It’s the most common form of arthritis.

What Is Rheumatoid Arthritis?

Rheumatoid arthritis also affects the joints but it’s considered an autoimmune disease that causes chronic inflammation of the lining of the joint and sometimes organs as well. As an autoimmune disorder, RA happens when the body believes the soft lining of the joints is a threat and attacks it much like it would a virus. RA usually affects multiple joints in the body and an estimated 75% of people with RA are women. Unlike OA, which usually occurs in older people over 65, rheumatoid arthritis is usually diagnosed between 30 and 60. There is no known cause of RA.

Symptoms of RA vs OA

Both RA and OA cause joint pain although the type, duration, and even location of the pain can vary. As a general rule, osteoarthritis causes pain in an affected joint after repeated activity or use. It usually causes stiffness in the joints in the morning for 30 minutes or less with pain that worsens later in the day. After inactivity, the joints may become stiff or swollen. A hallmark of OA is the development of bone spurs, enlargements called Heberden’s or Bouchard’s nodes, and reduced range of motion.

Rheumatoid arthritis also causes joint swelling, pain, and stiffness. There may be warmth and redness around the joint as well as reduced range of motion. RA also causes morning joint stiffness but it usually lasts for more than 60 minutes. A hallmark of RA is symmetrical joint involvement. While OA may affect one knee, for example, RA would affect both.

Osteoarthritis usually affects weight-bearing joints like the knees, hip, and back along with smaller joints in the fingers. Rheumatoid arthritis typically affects joint pairs, usually smaller joints like the ankles or small joints in the hands and feet.


Originally posted at

Tai Chi as Fall Prevention

As you age, the ability to balance becomes more difficult, which is often why the elderly have frequent rates of falling. Without balance, you lose mobility, and your overall health suffers because the lack of balance leads to a lack of physical inactivity. This is why it’s so important to remain active at all age levels.


Any kind of physical activity is great and helps keep your body functioning well, but a recent study showed that there’s even a specific kind of exercise to aid with balance: Tai Chi.


Tai Chi, which is an ancient Chinese art, was originally used for self-defense purposes but has since developed into a form of exercise that has many benefits for reducing stress and improving balance. Although similar to yoga in that you move from pose to pose while breathing deeply, they are two entirely separate exercises and should not be confused for each other.


The research group found that the “Tai Ji Quan: Moving for Better Balance” intervention (Tai Ji Quan is another name for the practice) reduced falls by 58% when compared to just stretching. When compared with multimodal exercise intervention, fall rates reduced by 31%, according to Fuzhong Li, Ph.D., and colleagues in JAMA Internal Medicine.


The findings from Tai Ji Quan: Moving for Better Balance (TJQMBB) have a lot of practical application, the study reported. As an exercise that requires no equipment, is low-cost and does not require a particular amount of space, Tai Chi is accessible to groups of all incomes and abilities. It’s a simple way to improve lower-body strength and balance, as well as increase the amount of time you practice physical activity throughout the day.


This study, which focused on those ages 70 and up, also showed that it’s not too late to practice activities that reduce fall-related risks. As an added bonus, Tai Chi exercises the mind, too, which is another issue that seniors often face.


Of course, there is still much research to do, as the study covers a limited scope. Researchers share their study with the acknowledgment that they relied on the participants to report their falls, though they did review medical records and followed up monthly to ensure as much accuracy as possible. These results are also limited to participants who were able to travel to exercise classes and were primarily white, but overall, the study shows great promise in terms of giving the elderly an affordable option to help increase their balance abilities.


Originally published at on September 13, 2018

About Dr. Micha Abeles, Connecticut-Based Rheumatologist

Dr Micha Abeles

Dr. Micha Abeles, an accomplished rheumatologist in Meriden, Connecticut.

Throughout his career that spans more than four decades, Micha Abeles has not only attained board certification in rheumatology as well as internal medicine, but he has also acquired an impressive history of publications, papers, book chapters, and editorials. Many of these studies are still referenced today, and have set the groundwork for many other important discoveries in fibromyalgia, arthritis, lupus, and gout studies. He was instrumental in the clinical trials that eventually led to the development of two significant arthritis medications, Humira and Enbrel, and continues to serve as a dedicated physician to his patients as a private practitioner.

Micha Abeles began his career in medicine at the State University of New York at Buffalo (SUNY Buffalo) after completing his residency in internal medicine. From there, Micha enlisted in the United States Army has a major and chief of the outpatient department at the Fort Monroe U.S. Army base in Virginia. It was here that he received a commendation for his outstanding clinical skills, but also for his shining ability to maintain a positive morale on the base. He organized events such as chess and table pool competitions, which made a significant impact on the future of his career. Once leaving the army, Micha Abeles was given the opportunity to become a fellow of rheumatology at the University of Connecticut, thanks to his glowing recommendations. Although he didn’t know it at the time, this fellowship and eventual certification in rheumatology would soon shape the course of his career.

Post-fellowship, Micha Abeles became the Associate Director of the UConn Multipurpose Arthritis Center. This federally-funded grant allowed him to conduct numerous clinical trials sponsored by many pharmaceutical companies across the country. These studies brought attention and funds back to the university, as well as gave Dr. Abeles firsthand experience in running these trials before beginning his own original research.

It was in 1990 that Micha Abeles became the co-author to a fibromyalgia criteria paper, and it was at this time, for the first time, that fibromyalgia had truly been defined by medical professionals. This study then led to additional research. So many, in fact, that Dr. Abeles and his co-authors eventually produced thirty-seven publications, book chapters, and national presentations about fibromyalgia.

Currently, Dr. Abeles has become interested in antibody testing — one of his most recent publications showed that anti-nuclear antibodies (ANAs) were difficult to interpret, and that contradictory findings that were very common in laboratories made them even more challenging to understand. Micha Abeles has also co-authored several of the first papers that explained the use of methotrexate in rheumatoid arthritis and in eosinophilic fasciitis.

To stay up to date in rheumatology, Micha Abeles is a member of the American College of Rheumatology, which is a professional organization that globally represents rheumatologists and rheumatology health professionals, and also sits on the Connecticut Rheumatology Association Board of Directors.

When Dr. Abeles isn’t seeing patients or working on a new trial, he can be found reading up on the latest studies in arthritis, lupus, and the United States healthcare system.


Originally posted on Medium

A Brief Background of Fencing

As a sport, fencing has been around as the art of sword dueling and self-defense since at least around the 1400s and finds its origin story in Spain. Fencing evolved from a military exercise to a sport in the 1700s as spearheaded by Domenico Angelo at his academy, Angelo’s School of Arms. There, Angelo’s family penned all the works on proper footwork, posture, attacks, and defenses in every blade to teach the aristocracy the fashionable new sport.

Today’s versions of fencing are every bit as passionate without quite as much blood, though. The International Fencing Federation (IFE) requires all fencers to dom multiple layers of protective clothing and equipment to ensure safety. In addition to the every stylish knickers, jackets, and masks, fencers are also required to wear a glove, plastron (underarm protector), breastplate, and lame to conduct electricity and determine touches.

Olympic fencing recognizes three blades, each of which has different historical purpose and thus different rules of play. Fencing has appeared at the Olympics starting in 1896 with the inclusion of the sabre, followed by the foil and lastly the epee.

The “starter” blade is the foil, a slender square blade with a compressible tip. Historically, foil fights were to the death, and as such, the “target area” for foil is only the area from waist to neck and inside the shoulders, and only a touch with the point of the blade scores a point. The rules for scoring a touch in foil are many and complex, but most of them boil down to who had the “right of way” to score.

The Epee is a much larger, heavier blade with a guard covering the hand and a compressible tip much like the foils. However, whereas a foil fight was to the death, Epee fights are only to first blood, and as such, the entire body, from the crown of the head to the soles of the shoes, is target area. Epee disregards the tedium of foil’s rules and awards a point to any touch, sometimes to both fencers in the match.

Lastly, the Sabre is the same weight as the foil but employs a slashing technique, as the whole blade is wired to score a touch, not just the tip. For sabre, any area from the waist up is considered target area. This blade is conducive to the quickest movements by the fencers, although similar “right of way” rules to foil apply.

Fencing is a great sport for players of any age. It requires agility, precision, and lightning-fast thinking. Because it’s not a contact sport, anyone can participate, whether you’re a college-aged pro or a grandparent beginner.

Micha Abeles was an all-Ivy League fencer while he was a student at Cornell University. While completing his MD at the State University of New York at Buffalo School of Medicine and Biomedical Sciences, Micha coached the school’s fencing team.

Millennials are Already Getting Arthritis

The Centers for Disease Control and Prevention determined that 54 million adults are diagnosed with arthritis, and not all of them are elderly as you would typically imagine. About 8 million millennials have been diagnosed with arthritis as well!

So what’s the cause of millennials getting diagnosed with this condition? It’s a combination of technology usage and excessive workouts that put too much use on their joints.

How Fibromyalgia Affects Your Sleep

Fibromyalgia is a rheumatic disease that causes muscle pain, stiffness, and fatigue. People with fibromyalgia commonly experience sleep problems, and a good night’s sleep is hard to come by for people who suffer from it. The pain makes sleeping difficult, and sleep deprivation makes the pain even worse. If you have fibromyalgia, here’s the scientific explanation of how and why the disease affects your sleep.

This blog post was originally featured on Micha Abeles’ website,

What Can Trigger a Raynaud’s Attack?

For those who have Raynaud’s disease, you may find that the blood vessels to your fingers and toes tend to overreact to certain situations by limiting blood flow — turning your fingers white or blue! The attack may only last a few minutes, but it leaves your extremities numb and throbbing.

This rheumatic phenomenon has doctors scratching their heads since there’s no known cause. However, there triggers out there that you can avoid to a few things make sure you don’t have an attack.

See the original post on Micha Abeles’ blog here