Osteoarthritis: Signs, Symptoms, Supplements and Suggestions
Based on excerpts from the Wikipedia page
“Osteoarthritis”
Edited (with Introduction) by Dr. Don Rose, Writer,
Life Alert
--
One of our website’s other articles discusses
the benefits of a
Mediterranean diet for those with a specific variant of arthritis (rheumatoid arthritis
(RA), a painful disease of the joints). The article below discusses the most common
form of the disease, osteoarthritis (OA) -- which, like RA, afflicts many
seniors. The article also lists some supplements
that may, in some cases, be helpful in preventing or mitigating OA, and provides
suggestions for beneficial lifestyle changes. --Don Rose
--
Introduction
Osteoarthritis (OA), also known as degenerative
arthritis or degenerative joint disease -- and sometimes referred to as "arthrosis"
or "osteoarthrosis" or even "wear and tear” -- is a condition in which low-grade
inflammation results in pain in the joints, caused by wearing of the cartilage that
covers and acts as a cushion inside joints. As the bone surfaces become less protected
by cartilage, the patient experiences pain upon weight bearing, including walking
and standing. Due to decreased movement because of the pain, regional muscles may
atrophy, and ligaments may become more lax.
OA is the most common form of arthritis. The word is derived
from the Greek word "osteo", meaning "of the bone", "arthro", meaning "joint", and
"itis", meaning inflammation, although many sufferers have little or no inflammation.
OA affects
nearly 21 million people in the United States, accounting for 25% of visits to primary
care physicians, and half of all NSAID (Non-Steroidal Anti-Inflammatory Drugs) prescriptions. It is estimated that 80% of the population will have radiographic
evidence of OA by age 65, although only 60% of those will be symptomatic (Green
2001).
There is no cure for OA, as it is impossible
for the cartilage to grow back. However, if OA is caused by cartilage damage --
for example, as a result of an injury -- Autologous Chondrocyte Implantation may
be a possible treatment.
Signs and symptoms
The main symptom of OA is chronic pain, causing
loss of mobility and often stiffness. "Pain" is generally described as a sharp ache,
or a burning sensation in the associated muscles and tendons. OA can cause a crackling
noise (called "crepitus") when the affected joint is moved or touched, and patients
may experience muscle spasm and contractions in the tendons. Occasionally, the joints
may also be filled with fluid. Humid weather increases the pain in many patients.
OA commonly affects the hands, feet, spine, and the large weight-bearing joints,
such as the hips and knees, although in theory, any joint in the body can be affected.
As OA progresses, the affected joints appear larger, are stiff and painful, and
usually feel worse the more they are used throughout the day, thus distinguishing
it from
rheumatoid arthritis.
In smaller joints, such as at the fingers,
hard bony enlargements may form, and though they are not necessarily painful, they
do limit the movement of the fingers significantly. OA at the toes leads to the
formation of bunions, rendering them red or swollen.
Causes
OA often affects multiple members of the same
family, suggesting that there is hereditary susceptibility to this condition. A
number of studies have shown that there is a greater prevalence of the disease between
siblings and especially monozygotic twins, indicating a hereditary basis. Up to
60% of OA cases are thought to result from genetic factors. Researchers are also
investigating the possibility of allergies, infections, or fungi as a cause.
Types
OA may be divided into two types:
Primary osteoarthritis
This type of OA is caused by aging. As a person
ages, the water content of the cartilage decreases, and the protein composition
in it degenerates, thus degenerating the cartilage through repetitive use or misuse.
Inflammation can also occur, and stimulate new bone outgrowths, called "spurs" (osteophyte),
to form around the joints. Sufferers find their every movement so painful and debilitating
that it can also affect them emotionally and psychologically.
Secondary osteoarthritis
This type of OA is caused by other conditions
or diseases, such as:
-
Congenital disorders.
For example:
-
Congenital hip luxation.
-
Abnormally-formed
joints (e.g. hip dysplasia). People with such joints are more vulnerable to OA,
as added stress is specifically placed on the joints whenever they move.
-
Cracking joints.
Some say evidence is weak that this has a connection to OA.
-
Diabetes.
-
Inflammatory diseases and all chronic forms of arthritis
(e.g. gout and
rheumatoid arthritis). In gout, uric acid crystals cause the cartilage
to degenerate at a faster pace.
-
Injury to joints,
as a result of an accident.
-
Hormonal disorders.
-
Ligamentous deterioration
or instability.
-
Obesity. Obesity puts
added weight on the joints, especially the knees.
-
Osteopetrosis (High
bone density).
-
Sports injuries, from
exercise, athletic activity or work. For example, certain sports, such as weightlifting,
running, or even football, put undue pressure on the knee joints. Injuries resulting
in broken ligaments can lead to instability of the joint, and over time, wear of
the cartilage and eventually osteoarthritis.
-
Surgery to the joint
structures.
Diagnosis
Diagnosis is normally done through x-rays.
This is possible because loss of cartilage, subchondral ("below cartilage") sclerosis,
subchondral cysts, the narrowing of the joint space between adjacent bones, and
bone spur formation (osteophytes) show up clearly in x-rays. Plain films, however,
often do not correlate with the findings of a physical examination in the early
stages of the disease.
With or without other techniques -- such as
MRI (magnetic resonance imaging), arthrocentesis and arthroscopy -- a careful study
of the duration, location, and character of the joint symptoms, and the appearance
of the joints themselves, will help the doctor to determine whether his patient
suffers from OA.
OA and Supplements
Supplements which may be useful for treating
OA include:
-
Antioxidants, including
Vitamins C and
E in both foods and supplements, provide
pain relief from OA. (McAlindon TE, et al, 1996).
-
Chondroitin sulphate improves symptoms of OA,
and delays its progression (Poolsup N et al, 2005).
-
Collagen hydrolysate (a gelatin product)
may also prove beneficial in the relief of OA symptoms, as substantiated in a German
study by Beuker F. et. al. and Seeligmuller et. al. In their 6-month placebo-controlled
study of 100 elderly patients, the verum group showed
significant improvement in joint mobility.
-
Ginger (rhizome) extract
- has improved
knee symptoms moderately (Altman RD, 1991).
-
Glucosamine: A molecule derived
from glucosamine is used by the body to make some of the components of cartilage
and synovial fluid. Supplemental glucosamine may improve symptoms of OA and delay its progression
(Poolsup N et al, 2005). However, a recent large study suggests that glucosamine
is not effective in treating OA of the knee (McAlindon et al 2004).
-
Methylsulfonylmethane
(MSM):
A small study by Kim et al. suggested that MSM significantly reduced pain and improved physical
functioning in OA patients without major adverse events (Kim et al). The authors
cautioned that although this short pilot study did not address the long-term safety
and usefulness of MSM, they suggest that physicians should consider its use for
certain osteoarthritis patients.
-
S-adenosyl methionine: small scale studies
have shown it to be
as effective as NSAIDs in reducing pain, although it takes about four weeks
for the effect to take place.
-
Selenium deficiency has been
correlated with a higher risk and severity of OA, therefore selenium supplementation
may reduce this risk.
-
Vitamins B9 (folate) and
B12 (cobalamin)
taken in large doses significantly reduced OA
hand pain, presumably by reducing systemic inflammation (Flynn MA 1994).
-
Vitamin D deficiency has
been reported in patients with OA; supplementation with
Vitamin D3 is recommended for
pain relief (Arabelovic, 2005).
Lifestyle changes
Other nutritional changes shown to aid in the treatment
of OA include elevated saturated fat intake (Wilhelmi G, 1993) and elevated body
fat (Christensen R, 2005). Reducing sugar, processed foods, and fatty foods (despite
the apparent contradiction) have helped many. According to Dr. John McDoughall,
a low-fat
vegetarian diet can reduce arthritis symptoms. A macrobiotic diet has been known
to reduce symptoms as well.
Lifestyle change may be needed for effective
symptomatic relief, especially for knee OA (De Filippis L, 2004). No matter what
the severity, or where the OA lies, conservative measures such as weight control,
appropriate rest and exercise, and the use of mechanical support devices are usually
beneficial to sufferers. In the case of OA of the knees, knee braces, a cane, or
a walker can be a helpful aid for walking and support. Regular exercise, if possible,
in the form of walking or swimming, is encouraged.
Applying local heat before exercise, and cold
packs after, can help relieve pain and inflammation, as do relaxation techniques.
References
Altman RD
, Marcussen
KC. Arthritis Rheum. 2001 Nov; 44(11):2531-8.
Arabelovic S, McAlindon TE. Curr Rheumatol
Rep. 2005 Mar; 7(1):29-35.
Christensen R. Osteoarthritis Cartilage. 2005
Jan; 13(1):20-7.
Curtis CL et al. Proc Nutr Soc. 2002 Aug; 61(3):381-9.
De Filippis L et al. Reumatismo. 2004 Jul-Sep;
56(3):169-84.
Flynn MA, Irvin W, Krause G. J Am Coll Nutr.
1994 Aug; 13(4):351-6.
Green GA.
Understanding
NSAIDS: from aspirin to COX-2. Clin Cornerstone 2001; 3:50-59. PMID 11464731.
McAlindon T, Formica M, LaValley M, Lehmer
M, Kabbara K. Effectiveness of glucosamine for symptoms of knee osteoarthritis:
Results from an internet-based randomized double-blind controlled trial. Am J Med
2004; 117:643-9. PMID 15501201.
McAlindon TE, Jacques P, Zhang Y, et al. Do
antioxidant micronutrients protect against the development and progression of knee
osteoarthritis? Arthritis Rheum 1996; 39:648-656.
Mooney V. Spinal arthritis complete treatment
guide. Spine-health.com, May 25, 2005.
Wilhemi G. Z Rheumatol. 1993 May-Jun; 52(3):174-9.
This article is based on the Wikipedia webpage
titled “Osteoarthritis”. The information provided here is, to the best of
our knowledge, reliable and accurate. However, while
Life Alert
always strives to provide true, precise and consistent information, we cannot guarantee
100 percent accuracy. Readers are encouraged to review the original article, and
use any resource links provided to gather more information before drawing conclusions
and making decisions.
Dr. Don Rose writes books, papers and articles
on computers, the Internet, AI, science and technology, and issues related to seniors.
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