Food Intolerance and Joint Symptoms — Historical Review and Present-day Application

Abstract

Summary It is becoming increasingly important that physiotherapists should have a knowledge of the possible involvement of food intolerance in some of the conditions which they are called upon to treat. This paper alerts the reader specifically to the connection between food intolerance and joint symptoms. There is a large amount of evidence relating to this and there are three very important factors to consider. 1. Why is the connection largely overlooked ? One reason is lack of awareness. The other is the fact that the history is misleading because in food intolerance, unlike other allergic reactions, the effect is delayed and skin prick tests are negative. It is therefore often incorrectly deduced that food is not involved. 2. What features suggest the connection ? An allergic background is a strong indication, and features of this are a history of allergic conditions, eg hay fever, urticaria, asthma; positive inhalant skin tests; known sensitivities; a family history of allergy; and multiple symptoms. 3. Which foods are involved ? This is entirely individual with different foods causing different symptoms in different people. Specific diets advocated for arthritis, therefore, will only be effective in some patients. The foods affecting each patient can be ascertained through elimination and challenge under medical supervision. The foods involved are usually those taken several times a day or at least several times a week, often particularly those which are liked most. Much work has been done in this field. There have been a number of trials, some blind or double blind, some placebo-controlled, some statistically significant and some with a combination of these factors. There have been reports by many writers of very large numbers of patients studied over long periods of time, and also many individual case histories of patients, whose joint symptoms have improved or resolved through food exclusion, worsening or recurring on repeated occasions on reingestion of the culprit foods. The evidence from these sources is overwhelming and very important. Although not all patients will respond to this approach, the findings have shown that very large numbers will. Some of the accumulated evidence, which has been emerging in different countries for more than sixty years, will be shown in an endeavour to illustrate the importance of food intolerance in joint symptoms. As more patients are treated successfully in this way, physiotherapy resources may be concentrated elsewhere. ‘The investigation required is simple, safe, and non-invasive, and it costs virtually nothing. All that is required is a co-operative patient with the will to persevere, careful instruction sheets, which already exist, and a doctor to monitor the experiment' (Williams, 1981).