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Osteoarthritis (OA) is the most common type of joint disease in the United States. According to the Centers for Disease Control and Preventions (CDC), over 30 million people are affected, and the incidence is rising, along with an aging population. (1)
Approximately 37% of people over the age of 60 have radiographic evidence of OA of the knee, and up to 19% have symptomatic knee arthritis. (2)
OA is a degenerative disorder characterized by the progressive thinning and breakdown of the smooth cartilaginous tissue, which forms a cushion over the ends of the bones that meet inside the joint.
This “wear and tear” of the cartilage causes damage to the underlying bones, leading to pain, swelling, and deformity. The condition tends to get worse over time and leads to the destruction of the adjoining tendons and ligaments as well as inflammation of the joint lining.
OA can be extremely debilitating as it makes any kind of joint movement painfully difficult.
Although this kind of tissue degeneration can occur in any joint, it is more common in:
- Weight-bearing joints such as the knees, lower back, hips, and feet
- Overused joints such as the neck, hands, and fingers
Moreover, OA can affect people of all ages and gender. However, it is more prevalent in the elderly (50 years or above) and female populations.
What are the early signs of OA?
The earliest signs of OA are pain and stiffness in the affected joint(s). Later, swelling and deformity may emerge.
What are the causes of OA?
The exact causes of OA are poorly understood, but the risk factors are well known: (3)
- Age: The incidence of OA rises along with age.
- Gender: Women are affected more often than men.
- Genetics: Family members of affected individuals are more likely to develop OA.
- Obesity: Excess load on the joints increases the wear and tear and stresses the joints, especially the knees, hips, and spine. Persons with a BMI of >30 have seven times the risk of developing OA of the knees. (4)
- Trauma and injury: Previous events such as motor vehicle accidents or sports injuries increase the risk of OA in later years.
- Occupation: Certain repetitive activities required for workers in construction, firefighting, forestry, and agriculture increase the risk of OA, especially of the knees and spine.
- Inactivity: A sedentary lifestyle actually increases OA risk. Physical activity is generally protective of the joints, although some runners will experience OA of the knee and hip.
Which is the best test to diagnose osteoarthritis?
A physical examination by an experienced physician, such as a rheumatologist or orthopedist, is the best way to diagnose osteoarthritis.
An X-ray is helpful and can reveal cartilage loss, deformities, and calcifications and can confirm the physical exam findings. X-rays are very sensitive, which means they can identify changes in the joint and evidence of OA even in an asymptomatic patient.
What food items should be avoided when suffering from osteoarthritis?
Some foods are inflammatory; that is, they increase inflammation in the body and worsen the pain, swelling, and stiffness associated with arthritis.
Unfortunately, there is no single dietary approach that works for all. And to make matters more complicated, there is no accurate test to determine what foods are best avoided in any particular patient.
That said, there are some foods, such as those with added sugars, refined carbohydrates, fried and processed foods, which should be avoided in all cases.
Some experts recommend an “anti-inflammatory” diet, which emphasizes the intake of whole foods, rich in leafy green vegetables, fresh fruits, and monounsaturated oils, such as olive oils, wholes grains, legumes, and fish. This type of diet is essentially the Mediterranean Diet, which has been demonstrated in studies to improve arthritis symptoms. (7)
Others go a step further by specifically eliminating gluten, dairy, red meat, corn, and sometimes even eggs and soy-based products.
The only way for patients with arthritis to determine if any of these foods should be avoided or not is by simply trying their own elimination diet and see how they respond.
Which vitamin and mineral supplements should be taken when suffering from osteoarthritis?
Vitamin and nutritional supplements are often recommended for patients with OA, and many products are advertised, which can be confusing.
Some products have been shown in scientific studies to be helpful. Be careful about supplements offering cures and great claims without proper research studies.
Here are some supplements that may help improve OA symptoms:
- Glucosamine and chondroitin sulfate are the most commonly used nutraceutical and help about 50% of OA sufferers. They are quite safe and free of drug interactions. They contain building blocks for cartilage tissue and thus may reduce joint degeneration.
- Fish oil and related omega-3 fatty acids have been shown to reduce joint inflammation and have been found useful in some studies. (8)(9)
- Curcumin, a turmeric extract, is a popular product and a well-researched natural anti-inflammatory agent. (10)(11)
- Undenatured collagen has also demonstrated benefits in clinical trials. (12)
- Other supplements that have shown some benefit in clinical studies include pycnogenol (maritime pine bark extract), avocado/soybean extracts (unsaponifiable), Boswellia (Indian frankincense), MSM and, SAMe. (13)(14)(15)(16)(17)
- Wobenzym, a mixture of enzymes developed in Germany, was found to be an effective natural anti-inflammatory nutraceutical. (18)
Is exercise helpful in treating osteoarthritis?
Absolutely! Maintaining range of motion in the joint, flexibility of the associated ligaments, and strong musculature is very important and an essential part of a complete treatment program.
High-impact exercises should be avoided, but walking, swimming, yoga, and limited resistance exercise are recommended. Physical therapy is often quite beneficial.
Experienced personal trainers can help develop specific exercise programs to enhance joint function.
Why does OA lead to fatigue?
The chronic pain of arthritis can be exhausting. The simple act of rising from a chair and climbing a flight of stairs can be painful and requires exaggerated effort by a person living with arthritis. When everyday activities become painful and require extra effort, fatigue tends to set in.
What are the repercussions of leaving OA untreated?
Untreated OA is a progressive condition that tends to worsen over time, especially in the absence of proper treatment.
The advancing joint deformity and pain associated with untreated OA can lead to disability, chronic pain, and the inability to walk and participate in desired activities.
In some cases, this may lead to severe joint damage that requires surgery, such as replacement of the knee or hip joint.
What is the difference between rheumatoid arthritis, arthritis, and osteoarthritis?
Rheumatoid arthritis (RA) is a systemic autoimmune condition in which joint damage results when the immune system attacks the tissues within the joint.
Less common than OA, it occurs in about 1% of the population and afflicts people at any age, even children. RA commonly affects multiple joints simultaneously.
Osteoarthritis is typically seen in older people and is mostly an aging phenomenon in which degeneration and cartilage damage of the joints take place, usually impacting a limited number of weight-bearing joints, such as the knees and hips. It can also affect the joints in the hands.
“Arthritis” is a broad term that refers to joint inflammation, but it does not specify what type of arthritis may be involved. There are many different types of arthritis, of which OA is the most common.
What are the important tips one should remember while coping with osteoarthritis?
- Stay active: Continued participation in daily physical activity and exercise is essential for maintaining joint function and flexibility. Protect the joints from injury with low-impact exercises and the use of protective gear when necessary.
- Eat right: A healthy diet is very important. Focus on whole foods, fresh vegetables and fruits, and lean protein sources. Avoid added sugars and processed or fried foods. Avoid calorie excess and try to manage your body weight to limit the excess load on the joints.
- Talk to your physician: It is crucial to obtain a correct diagnosis and treatment plan.
- Try supplementation: Carefully selected vitamin and nutritional supplements can often help promote joint health and support cartilage.
- Seek medical interventions for pain relief: In some instances, injections of medication directly into the affected joint may be helpful. This is usually performed by a rheumatologist or orthopedist.
Can OA be cured?
Not yet. Many treatments are available to help reduce the pain and swelling, and emerging regenerative medicine treatments hope to slow the disease progression. However, an actual cure continues to elude the scientific community.
For advanced knee and hip osteoarthritis, joint replacement surgery is often quite successful.
Is OA a genetic condition?
Yes, in part. There is clearly a hereditary component to OA, and it is estimated that over 50% of the risk of OA is due to genetic factors.
However, no single gene responsible for it has been identified. Instead, the genetic risks are due to multifactorial inheritance, which means that multiple genes are involved.
Numerous environmental factors, as discussed above, are important as well.
Why does the frequency of OA flare-ups increase during cold and damp months?
The joint tissues are sensitive to changes in barometric pressure, which can cause swelling and stiffness. This is why many people with arthritis can predict rain before the weatherman.
In colder environments, connective tissues that surround the joints, such as the ligaments and muscles, harden and lose flexibility. These actions irritate the joints and make them stiff.
Low temperatures also reduce blood flow to the joints, aggravating OA.