Joint Pains
 (Arthralgia)

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Patients commonly report aches in the joints following cancer therapies. Fortunately this is most often mild and usually wears off within a few weeks. This is a particular problem with some chemotherapy agents including the taxanes (taxol and taxotere). Hormone therapies, in the longer term are also associated with joints pains. About 12% of patients who have taken tamoxifen have joint pains but this increases to around 55% among patients with breast cancer taking the aromatase inhibitors drugs. Some biological agents can also contribute to joint pains such as herceptin.

How can you help?

Joints are often regarded as a barometer of our health. Excluding specific medical arthritic conditions, arthalgia or joint discomfort, it is often associated with changes in our general sense of well being. They are thought to be particularly sensitive to ingested toxins although the precise mechanism for this is unknown. One theory is that the dietary toxins get caught in the micro vessels of the joints. A good example of this is gout where excess uric acid, often caused by dietary excess gets trapped in the joint. 

Other dietary toxin also may cause irritation in the joint itself but in addition to the direct damage they cause, the body’s immune system can make it worse. Defence cells and proteins attach to the toxins forming large complexes which can then clot in the small joints, particularly those of the fingers and toes. The immune attack on the toxins, then further causes collateral damage to delicate joint tissues. A diet low in man made chemicals is therefore certainly well worth a try. Washing fruit and vegetables is a good step but many consider organic food if joint pains persist. Avoiding processed food or commercially packaged snack or sweets with reduce the intake of preservative, colourings and flavouring. Fizzy sugary drinks are also often packed with food additives and, although often difficult through lack of choice could be replaced by more health drinks such as purdy’s, fresh juices or if all else fails water!

Joints, by the nature of their mechanism, endure a great deal of wear and tear. Extra strain is put on them by excessive weight or bad posture. Being overweight is associated with arthralgia and later arthritis in the major weight bearing joints such as the hips, knees & back – needless to say if overweight, it would be a good idea to slim down.

Posture is a more complex issue. Most of us do not even know we are slouching until someone points it out or we see a video or photograph of ourselves. Bad posture particularly leads to neck, lower back and shoulder pains. Patients are either more vulnerable to a long standing bad posture after chemotherapy or with its associated fatigue can develop bad habits especially if there has also been some weight gain. Simply being aware of a deterioration on posture is a good start as most of us know what to do – the old adage is relevant – walk tall, chin in, shoulders back, stomach in. It may be worth a strong course of physiotherapy or osteopathy. If you have a good gym nearby a session with a personal trainer may well be money well spent.

Exercise may seem incongruous if joint pains have already set in, but particularly if combined with stretching is a fantastic way to help immediate pain and prevent further relapse. 

Try a simple experiment yourself - stretch an arm out horizontally in front of you with the palm of your hand facing the floor. Then move the hand upwards bending the wrist. Compare this with someone older then younger than yourself. The younger will  be able to move the wrists upwards with a much greater movement. In fact, most elderly people cannot move the wrist up at all. 

After chemotherapy or prolonged recovery from surgery the normal problems we all experience with aging seems to be exacerbated so extra effort needs to be made. Try to follow these simple instructions:

• get the joints moving - unless there is extensive joint discomfort there is usually an exercise which is possible to get the ball rolling; walking dancing, swimming or even machines in the gym.
  

• exercise with a friend - exercising with a friend or other members of a support group would be a good start. Most patients after treatments will often be told by their relative – I wish I could do more to help – well here is their opportunity
  

•  join a walking group, gym or dance class together, squeeze on the training shoes and off you go 
  

• stretch after exercise - stretching may be a little more difficult at the beginning, even if previously healthy there may be  a degree of re-training required either alone or in a group; it is well worth putting aside 10 minutes every day for stretching in a fairly regimented programme which ensures all the joints are stretched; start from the head down moving the joints into the fullest range possible without causing pain; develop a system which works but try to include the neck, shoulders back hips, knees, hands and feet. 
  

• try yoga or pilates class - if time and local facilities allow consider joining a yoga or pilates class – you don’t have to be contortionist to participate; a good class should have levels for everyone.
  

• find a personal trainer -  if you lack time or a suitable local class a personal trainer coming to the house for a few weeks will provide motivation, exercise and stretching guidance all in one! (a complete list of national personal trainers, gyms exercise, aerobic, dance, yoga and pilates classes can be found on in the exercise section. 

Diet and arthritis The is strong evidence that lifestyle factors such as stopping smoking, health fats, a healthy gut and reular polyphenol intake can reduce the onset and serverity of joint pains - read more