Osteoarthritis

Osteoarthritis (OA) is so common that sometimes it’s called arthritis for short, even though there are other types of arthritis as well.  80% of the US population over 65 years old struggle with OA.

OA is associated with the breakdown of cartilage, which is there to cushion bones at the joints, and it’s considered an unavoidable consequence of getting older, for the most part.  Symptoms include pain and stiffness in the joint, especially for the first 30 minutes after waking.  There may also be a rubbing, grating, or cracking sound.

You’re move likely to develop OA from anything that stresses your joints. A big one is carrying extra weight.  Others are trauma, overuse, hypermobility of the joint (which can also cause damage), or the presence of irritants, like gout crystals or (surprise, surprise) excess sugar in your diet.

As you might expect, most traditional treatments focus on the symptoms (pain killers and anti-inflammatory meds), but a number of MD/DOs are now recommending exercise in order to maintain joint and overall movement, physical therapy (for the same reason), braces (particularly for hypermobility cases), and even two well-known “joint” supplements, glucosamine and chondroitin.  These are building blocks for collagen fibers, and so help repair the breakdown of cartilage.  I’ve read that glucosamine can increase blood glucose, blood pressure, and CPK (muscle enzymes) if taken concurrently with statin drugs to lower cholesterol (such as Lipitor), though I have yet to see this clinically.  Note that you should avoid chondroitin if you have a shellfish allergy.

In severe cases, traditional treatment involves surgical removal of torn and damaged cartilage; surgical realignment of a bone to relieve stress, fusion of vertebra for OA of the spine, or replacement with an artificial joint.

As in the traditional medical world, the appropriate naturopathic treatment will depend on the severity of the case.

I’ll always start by removing refined sugar and adding fish oils.  Fish oils are anti-inflammatory, and they actually work via a similar mechanism to aspirin, naproxen and ibuprofen, but without suppression.  (For those who care: ibuprofen and similar medications block the production of a certain inflammatory substance in the body called prostaglandins, while fish oil will simply shift the body’s ratio in favor of a different, anti-inflammatory prostaglandin.)  In milder cases of OA, most patients will experience significant improvement in a month or so, just with this.  (But if you try this at home, let me warn you that you must a) READ LABELS, because there’s sugar hidden in just about everything, and you’ve really got to avoid all of it for this to work, and b) get a high quality fish oil – they’re not all created equal.)

Depending on the patient, certain foods may aggravate the condition as well, especially if there are any food sensitivities involved.  I also strongly agree with my MD/DO colleagues that non-weight-bearing exercise is incredibly important, as is weight loss, range of motion exercises, and in certain cases, occupational or physical therapy.

In addition to an excellent fish oil, I also frequently prescribe a number of botanicals and supplements as building blocks for cartilage, including but not limited to glucosamine and chondroitin, as well as other anti-inflammatory measures if the situation requires it.  Some of these include hydrotherapy techniques to increase local blood flow to the joint.

For more severe cases that aren’t quite to the point of surgery, I often refer for acupuncture or prolotherapy.   The latter involves an injection into the joint space of dextrose, saline, and a few other components depending on the practitioner, designed to create a local “irritation” in order to induce the body to build new cartilage.

In short: it doesn’t have to be “all downhill from here.”  Let’s reverse the process! Call for an appointment.