N: Nails

To most people, the appearance of your nails reflects your attention to grooming, but to your doctor, your nails provide clues to what may be going on elsewhere in your body. Certain nail problems may be telltale signs of some arthritis-related conditions. For example, pitting of the nails may be a sign of psoriasis or reactive arthritis. Tiny red blood vessels under the nails could mean RA, lupus, ermatomyositis or scleroderma. Clubbing, a deformity of nails and ends of the fingers, could signal heart or lung disease or inflammatory bowel disease. Here's what else your nails can reveal:

  • Longitudinal striations: accentuated ridges in the nail surface
  • What it may mean: alopecia areata, vitiligo, atopic dermatitis, psoriasis
  • Onycholysis: separation of the nail from the nail bed
  • What it may mean: psoriasis, infection, hyperthyroidism, sarcoidosis, amyloidosis, connective tissue disorders
  • Splinter hemorrhages: reddish-brown lines of blood beneath the nails
  • What it may mean: lupus, RA or psoriasis
  • Koilonychia (“spoon nails”): abnormally thin nails that have become flat or concave in shape
  • What it may mean: iron deficiency

O: Omega-3 Oils

If you’re looking for a natural anti-inflammatory, look no further than fish and fish-oil supplements. For some time, doctors have known that fatty coldwater fish, including mackerel, salmon, tuna and sardines, are rich in omega-3 oils, which help reduce arthritis inflammation. Now they are starting to better understand why. In a study published in Nature, researchers describe how the body converts docosahexaenoic acid (DHA), an ingredient in omega-3 oils, into another chemical called Resolvin D2 and how that chemical reduces inflammation. The implications, they say, may be the development of new drugs for arthritis and other inflammatory diseases. In the meantime, doctors often recommend two or more servings of fish weekly for general health and supplementing with fish-oil capsules for inflammation. To treat arthritis-related conditions, use fish-oil capsules with at least 30 percent DHA. For lupus and psoriasis, take 2 grams (g) DHA three times a day; for Raynaud’s disease, 1g four times a day; for RA, up to 2.6g fish-oil (1.6 g DHA) twice a day.

P: Purines

While scientists have long debated the role of diet in many forms of arthritis, one form where there has been agreement is gout. A diet high in compounds called purines is known to raise blood levels of uric acid, which can deposit as crystals in the joints, causing excruciating pain. Limiting purines may add to the effectiveness of gout treatment prescribed by your doctor, says N. Lawrence Edwards, MD, a professor of medicine at the University of Florida. Foods to avoid: alcohol, anchovies, bacon, organ meats, shellfish, turkey and venison.

Q: Quadriceps

Recent research shows that having strong quadriceps – the muscles on the front of the thigh responsible for straightening the leg at the knee joint – helps protect against pain, stiffness and even the loss of cartilage from behind the knee in people with knee osteoarthritis (OA). But don’t strengthen your quads to the exclusion of other leg muscles. Quads that are too strong in relation to the hamstrings – the muscles on the back of the thigh – can throw off the balance of the knee, increasing the likelihood of injury.

R: Rash

The largest organ of the body, the skin often holds visible clues to a disease that’s lurking underneath.  A skin rash with spiking fevers help distinguish systemic JIA from other forms of the childhood disease. A skin rash of spots that rupture and leave sores is a sign of vasculitis. Arthritis treatments sometimes cause rashes too. If you notice new skin symptoms, bring them to the attention of your doctor, who can determine what’s causing them and how to treat them.

S: Steroid Injections

Developed more than 50 years ago, corticosteroids are still among the most effective drugs for arthritis inflammation – but when taken orally they can cause some nasty side effects, including brittle bones, weight gain, eye problems and high blood pressure. For many people, corticosteroid injections directly into the affected joint may be a better option. Corticosteroid injections might be right for you if you have just one or a few inflamed joints, cannot take oral medications or have painful joints without systemic inflammation (as with OA). Given too often, injections can cause problems, including damage to the cartilage, bones and surrounding tissues. For that reason, most doctors limit injections to three per joint per year.

T: Triggers

Many people can improve their symptoms by knowing and avoiding their triggers. For many people with lupus, exposure to ultraviolet light triggers a flare. For people with Raynaud’s phenomenon, reaching into the freezer or sitting too close to an air conditioner vent triggers painful blood vessel spasms in their hands. For a person with gout, indulging in certain foods or alcohol may trigger a painful flare. Keeping a diary can help you identify you own triggers to help you better manage your disease.