What Is the Worst Enemy for Arthritis?

If you have arthritis or are starting to worry about it, you have probably heard a lot of advice about what to avoid: too much sugar, too little exercise, the wrong shoes, stress. The advice is not wrong, but it usually misses the underlying story. There is one common thread connecting every commonly cited “worst enemy” for arthritis: chronic inflammation. At Solutions Regenerative Medicine in East Valley, Arizona, Dr. Mareshah Dunning, NMD, treats the inflammation in the joint directly and addresses the lifestyle and metabolic factors that keep feeding it.

What’s the Short Answer?

The single worst enemy for arthritis is chronic, low-grade inflammation. This is not a vague concept. It is a measurable biological state in which inflammatory cytokines (IL-1β, IL-6, TNF-α) and cartilage-degrading enzymes (MMPs, aggrecanases) remain active in the joint over months and years, breaking cartilage down faster than the body can rebuild it. A 2016 review in Nature Reviews Rheumatology makes the case that osteoarthritis is driven not by wear and tear alone but by chronic, low-grade inflammation that mediates cartilage breakdown, synovial inflammation, and joint pain across the entire joint as a whole (Robinson et al., 2016, PMID: 27539668). The lifestyle and metabolic factors discussed below are what feed and sustain that low-grade inflammatory state.

Almost every well-known driver of arthritis (sugar and refined carbohydrates, excess body weight, inactivity, repetitive stress, poor sleep, unmanaged stress, untreated metabolic and hormonal dysfunction) feeds or sustains this inflammatory state. So the more useful question is not “what is the worst enemy for arthritis,” but “what is keeping the inflammation going in my joint, and what can I actually do about it?”

What Drives the Inflammation That Worsens Arthritis?

Four lifestyle and metabolic factors drive the majority of inflammation that worsens arthritis. Most patients have at least two of them active at once.

1. A Pro-Inflammatory Diet

Refined sugar, ultra-processed foods, processed meats, vegetable oils high in omega-6, alcohol, and artificial additives reliably raise systemic inflammatory markers. Dr. Dunning’s Regenerative Health Diet is the framework she uses with patients: a whole-foods, anti-inflammatory pattern emphasizing high-quality protein for tissue repair, low-glycemic fruits and non-starchy vegetables, anti-inflammatory spices, glycosaminoglycan-rich foods like bone broth for connective tissue support, and the specific micronutrients (vitamins A, C, D, K plus copper, zinc, magnesium, sulfur, silica) that the body uses to synthesize collagen.

Diet is the most modifiable driver, and dietary support matters even more for patients pursuing regenerative injections, because the body needs the right building blocks to capitalize on the treatment.

2. Excess Body Weight

Body weight affects arthritis in two ways. Mechanically, every additional pound increases load across weight-bearing joints. Less commonly recognized, adipose tissue is metabolically active and secretes inflammatory adipokines (leptin, TNF-α, IL-6) that contribute to systemic and joint-level inflammation. Even modest weight loss can reduce both the mechanical and the inflammatory load.

3. Sedentary Patterns and Poor Movement Quality

Joints need controlled motion to stay healthy. Synovial fluid, the joint’s lubricant and nutrient delivery system, circulates with movement. Stabilizing muscles atrophy without use, and immobility tends to increase pro-inflammatory signaling in the joint capsule. The answer is not simply “more exercise.” It is the right kind of movement, often combined with correcting faulty movement patterns that are quietly overloading specific joints.

4. Unaddressed Metabolic and Hormonal Dysfunction

Insulin resistance, low vitamin D, gut inflammation, perimenopausal and menopausal estrogen changes in women, low testosterone in men, and thyroid dysfunction each independently raise systemic inflammation and change how joints heal and remodel. These factors rarely come up in a standard orthopedic appointment, but they materially shape the trajectory of arthritis over years.

Why Conventional Arthritis Care Often Misses the Real Driver

Standard arthritis care typically follows a predictable path: over-the-counter anti-inflammatories, corticosteroid injections, eventually joint replacement. Each has a legitimate place and can provide real relief. The limitation is that each treats the inflammation downstream rather than addressing what is driving it.

Anti-inflammatory medications and steroid injections reduce inflammation chemically but do not address the diet, weight, movement patterns, or metabolic factors feeding it. Once the medication wears off, the underlying drivers continue, and inflammation tends to return. A plan that addresses both the inflammation and the upstream drivers gives the joint a more durable path forward.

How Dr. Dunning Treats Arthritis at Two Levels

At Solutions Regenerative Medicine in East Valley, Arizona, Dr. Dunning treats arthritis on two fronts at once: the inflammation inside the joint and the drivers feeding it.

Alpha-2-Macroglobulin (A2M): the targeted anti-inflammatory injection

Alpha-2-Macroglobulin (A2M) is the regenerative injection most directly aligned with the chronic-inflammation framework above. A2M is a large protein concentrated from a patient’s own blood that binds and clears the same inflammatory cytokines (IL-1β, IL-6, TNF-α) and cartilage-degrading enzymes (MMPs, aggrecanases) that drive arthritis progression. A 2023 study in the Journal of Orthopaedic Research demonstrated that A2M binds and neutralizes IL-1β in chondrocytes and blocks the downstream NF-κB pathway in a dose-dependent manner, reducing MMP levels and increasing cartilage-protective genes (Sun et al., 2023, PMID: 35451533). For patients whose arthritis is being driven primarily by ongoing inflammation rather than by acute structural injury, A2M is often Dr. Dunning’s first-choice regenerative tool, comparable to a corticosteroid injection for short-term inflammation control without the cartilage downsides of repeated steroids.

Additional joint-level tools when indicated

• Platelet-rich plasma (PRP), bone marrow aspirate concentrate (BMAC), or micronized fat for joints that need regenerative repair support, used after the inflammatory phase is calmed.
• Hyaluronic acid for joint lubrication and shock absorption, often as a supportive component of the plan.
• Corticosteroid injections where appropriate as a targeted, time-limited tool.
• Ultrasound or fluoroscopic image guidance for every injection, so the medication reaches the actual pain generator.

For the drivers feeding the inflammation

Comprehensive lab evaluation (inflammatory markers, metabolic markers, hormone panel, micronutrients) through her Foundations of Health approach to identify which drivers are active in your specific case.

• Dunning’s Regenerative Health Diet as the nutrition framework, tailored to your individual inflammatory and metabolic profile, with macronutrient targets (including elevated protein around 1 gram per pound of body weight for active healing) and any food sensitivities identified through testing.
• Targeted weight loss support when relevant, integrating nutrition, movement, and metabolic strategy.
• Movement pattern correction and physical medicine to address mechanical drivers of joint stress.
• Hormonal evaluation and treatment when indicated, including bioidentical hormone therapy for perimenopausal and menopausal women, testosterone optimization for men with documented low testosterone, and management of insulin resistance or thyroid involvement.
• Gut health and metabolic health work where labs point in that direction.

The two streams reinforce each other. The joint heals better when the inflammatory environment is calmer. The body sustains lower inflammation when the underlying drivers are addressed.

What Can You Actually Do About Arthritis Today?

Three steps make the biggest difference, and you can begin all three before your first consultation.

1. Start with the Regenerative Health Diet. Dr. Dunning’s Regenerative Health Diet is a whole-foods, anti-inflammatory framework that emphasizes high-quality protein for tissue repair, low-glycemic fruits and non-starchy vegetables, glycosaminoglycan-rich foods like bone broth, and the micronutrients the body uses to synthesize collagen. Reducing refined sugar, processed meats, ultra-processed foods, alcohol, and refined oils often produces a noticeable change in joint pain within weeks.
2. Move every day, with quality. Pain-tolerated walking, swimming, or cycling. The goal is not athletic performance; it is controlled load on the joint to keep synovial fluid moving and the stabilizing muscles strong. If a particular movement reliably aggravates the joint, that is a signal to have a movement pattern assessment done.
3. Get baseline labs. Inflammatory markers (such as hs-CRP), metabolic markers (HbA1c, fasting insulin), vitamin D, and a hormone panel (estrogen and progesterone for women, testosterone for men, plus thyroid in either case). These numbers tell you which drivers are active in your specific case.

Beyond these steps, a consultation identifies which drivers matter most in your case and combines targeted joint treatment with addressing them.

Why Choose Dr. Dunning at Solutions Regenerative Medicine?

Treating arthritis at both the joint level and the driver level requires a physician trained in both root-cause naturopathic medicine and interventional regenerative procedures. That is the scope Dr. Mareshah Dunning, NMD, trained for. She combines a naturopathic root-cause evaluation with the regenerative injection toolkit and image-guided technique. Fluoroscopy in particular is rarely used in regenerative medicine outside of providers trained as interventionalists. Her fluoroscopy training came from a residency under interventional anesthesiologist and general surgeon Dr. Klee Bethel, and her musculoskeletal ultrasound training was completed under Richard Kates, RMSKS, whose own mentors were RMSK pioneers Colin Rigney, DPT, and Wayne Smith, DPT. Solutions Regenerative Medicine serves East Valley, Arizona.