Osteoarthritis: Taking Care of Degenerative Joints

Repairing Cartilage to Heal Joints

The word “arthritis” conjures up images of gnarled fingers and chronic pain.  But it actually means any joint inflammation.  There are over 200 known causes and types of arthritis.  People can get arthritis from any inflammation in their bodies, such as:

• Infections
• Psoriasis
• Deficiencies
• Toxins
• Crohn’s disease (inflammatory bowel disease)
• Degenerative joints
• Genetics
• Autoimmune diseases (rheumatoid arthritis)
• Metabolic issues (gout)
• Allergies
• And many others

However, we are going to focus on the most common type of arthritis: osteoarthritis, or degenerative joints.

Osteoarthritis

Have you ever seen bumps or knobs on people’s finger joints? Those nearest the fingernail are called Heberden’s Nodes. Enlargement of the middle joints are called Bouchard’s Nodes.

These boney swellings are an enlargement of the cartilage in the joint.  It feels like very hard rubber but generally isn’t painful.  Many things damage the cartilage:

• Injury
• Inflammation
• Lack of blood flow

Where there is any kind of injury and the cartilage is unable to repair itself correctly, the cartilage continues to enlarge as it attempts to repair. At this point, this knobby bony deformity is not damaged or inflamed, such as with most other types of arthritis. It is simply unable to repair itself. A very common early sign of osteoarthritis are these types of nodes.
People with osteoarthritis may experience the following symptoms:

• Enlarged cartilage
• Pain is often worse after exercise or pressure on the joint
• Grating or crackling like sand in the joint when moved
• Morning stiffness

However, these symptoms are usually only noticed later in the development of the disease.  Often there are no early symptoms, even though x-rays can show joint damage.  The reason for this is because the cartilage is degenerating for lack of nutrients, energy, or use. But since there are no pain nerves in cartilage you don’t feel it breaking down. When you do feel pain, it is because the cartilage has completely worn away and the bones are rubbing against each other. Bones have lots of pain nerves. That is when the worst symptoms of osteoarthritis start to manifest: pain, stiffness and swelling.

For this reason it is very important not to wait until you have lots of symptoms to take care of degenerative joints.  If your knee is not working properly, it can be helped early-on, but may require surgical replacement if you wait too long. 

Osteoarthritis Causes

There are many causes of broken down joints:

• Injury
• Poor circulation
• Medications
• Diabetes
• Obesity
• Deficiencies of nutrients
• Other chronic illnesses

Poor Circulation

Like every other tissue in the body, the joints need a constant supply of blood to bring in nutrients and take out waste products. Both the lack of nutrients and the buildup of waste prevent the cartilage from repairing, and allow the continual breakdown of the joints. Diseases like fibromyalgia often include arthritis because of poor circulation. Atherosclerosis, or hardening of the arteries, as well as any heart, lung, or circulation diseases, may prevent or slow down the blood flow enough to bring on degeneration.

Medications

NSAIDs such as ibuprofen, aspirin, and naproxen inhibit prostaglandins.

“Prostaglandins are a group of lipids made at sites of tissue damage or infection that are involved in dealing with injury and illness. They control processes such as inflammation, blood flow, the formation of blood clots and the induction of labour.”[1]

Prostaglandins are part of the body’s way of dealing with injury and illness. Essentially, while they may cause inflammation (redness, heat, swelling, and pain), they help heal bones and joints, as well as soft tissue.

Anti-inflammatory drugs reduce prostaglandin levels.

Thus people get knee pain, for example, and begin to take ibuprofen. This actually prevents their knee from healing.  The gradual loss of cartilage in the knee then leads to a knee replacement recommendation.  It makes one wonder how many knee replacements could be avoided if the knee was allowed to heal without NSAID treatment?

Also, it is common for people who suffer from arthritis to have shots or pills with cortisone drugs. These have the same effect. They cause the breakdown of connective tissue in the joints and prevent healing. This often leads to the need for joint replacement – or worse!

There are many other medications that can cause arthrosis, or breakdown of the joints. These are most commonly seen with artificial hormones, steroids, or cortisone. Blood pressure medications also affect the joints, especially the commonly-used diuretics. Any medication you are allergic to can cause pain and break down of the joints due to the inflammatory process.

Diabetes

Diabetes is a special case as a metabolic disease because so many people have it.  Over 10% of the United States has Type 2 Diabetes Mellitus, which pre-disposes them to osteoarthrosis.[2] Many type 2 diabetics are also obese, which is another independent risk factor for arthritis.

However, it was discovered that people get arthritis not just because of “wear and tear” on the joints. The joint cartilage also breaks down because blood sugar is high.  This is thought to be due to the sugar molecules attaching to the proteins and making them inactive, called Advanced Glycation End-products, or AGE.[3]

Obesity

It was once thought that being overweight only caused arthritis on weight-bearing joints due to the extra stress placed on them. However, arthritis risk in non-weight-bearing joints is also increased with obesity.[4]

The problem is metabolic, meaning the ability for the cells to generate energy. Ironically, in spite of all the extra energy available from fat stored in the body, there isn’t enough getting to the cells that need it the most!

Nutrient Deficiencies

In spite of all the variety of foods we have access to today, many are deficient in key nutrients that especially affect the joints. Sulfur is required to create joint cartilage. Sulfur is abundant in the Earth, and in foods, but there are very few usable forms for the body. For example, many of these usable forms of sulfur are lost with time after a vegetable is picked. The sulfur compounds that we need are lost over time, evaporating into the atmosphere. The fresher the vegetables, the more nutrients they have. Other vital nutrients include magnesium and potassium.

• A sulfur deficiency can lead to the initial stages of arthritis.
• Magnesium helps maintain joint cartilage.
• Potassium in the body proves to have a strong anti-pain effect.

These nutrients are essential for joint health, and general health. Sometimes the problem is balance. For example, we often get too much sodium and calcium at the expense of potassium and magnesium.

Inflammation, or Degeneration?

The process of osteoarthritis is more a problem of degeneration than it is inflammation. Inflammation often comes late in the disease.  Sometimes people will injure a joint that doesn’t heal well, which is often due to deficiencies of nutrients.  Thus, the anti-inflammatory agents are not often the best choice. They can only relieve part of the symptoms and will not prevent further breakdown of the joints.

Osteoarthritis Treatment

Treatment is, of course, determined by the underlying cause.  If you have diabetes, then you must deal with it first so you can begin to heal the joints.  If you are taking pain medication that prevents healing, these must be stopped. Overall, there are three things that improve joint function and reverse loss of cartilage:

1. Glucosamine and MSM[5]
2. Weight loss[6]
3. Exercising the muscles of that joint.[7]

For example, in the case of knee degeneration the best chance of improving knee cartilage are as follows:

• Losing 30 pounds
• Building the quadriceps muscles of the thighs
• Taking glucosamine

Beyond that, there are other issues that must be considered, such as the cause of the problem.  If you identify with one of the problems above, then you must resolve that issue in order to start the healing process.

Food and Diet

One common issue we find among our patients is food sensitivities.  Many people have digestion and absorption problems because of their diet. This leads to both inflammation and nutrient deficiencies.  Treatment won’t work unless these underlying food sensitivities are addressed, as well.

The easiest way to understand your food sensitivities is with an elimination diet.  You must eliminate everything and just drink bone broth (recipe here) for a couple of weeks. It is okay to add leafy green vegetables (like green salads). Then add in one food at a time to see what causes a reaction.  Avoid the foods that produce any kind of reaction.

Those who are unable to do the elimination diet can benefit from a starter elimination diet:

• Gluten-free
• Dairy-free
• Sugar-free (includes all sweeteners, even artificial sweeteners, juices, or any processed foods)

We find this works in more than half of those who try it for at least 8 weeks.

Pain

What can be done about the pain if we can’t use drugs? Devil’s Claw is an African herb that has been extensively tested for osteoarthritis.[8] The advantage is that it not only relieves pain better than NSAIDs, but also allows the joints to heal. Other herbs include Turmeric and Boswellia. These should be used according to the directions on the label depending on their form and strength.

Recommendations

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  Avoid NSAID drugs
• Devil’s Claw, Boswellia or Turmeric (Curcumin) for symptoms according to the label
• Lose weight if you are overweight
• Avoid sugar or anything sweet
• Avoid all foods you are sensitive to or use one of the elimination diets
• Exercise regularly
• Repair intestines for better nutrient absorption
• MSM – 500 mg three times per day for 6 months
• Glucosamine – 500 mg three times per day for 6 months
• Magnesium – 400 mg per day
• Try acupuncture to get the chi flowing (as well as the blood)

In the past we thought that osteoarthritis could only be managed with medications or surgery.  But now we know we can actually reverse the process of joint degeneration.  If people would use these principles to re-build their cartilage, then most knee replacements could be prevented.   Don’t wait until there is no cartilage left.

Ignoring osteoarthritis until it is too late is extremely painful and debilitating. At that stage, it is very difficult to reverse, heal, or even arrest.

But the large majority of osteoarthritis can be prevented and eliminated. Healthy joints are as easy as proper nutrition, avoiding inflammation, getting regular exercise, and avoiding medications.

If you liked this article, then you’ll love these:

• 8 Healing Remedies to Repair Joints
• Natural Relief for Joint Pain
• Food for Joint Pain

 

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Dr. Scott D. Saunders, M.D. is a practicing physician, specializing in preventative health care, who utilizes eclectic health care for the whole family, including conventional, orthomolecular and natural medicine. He is also the medical director of The Integrative Medical Center of Santa Barbara in Lompoc, CA. He went to UCLA medical school and is board certified in family medicine. View natural remedies with Dr. Saunders at: http://drsaundersmd.com

Sources:
[1] http://www.yourhormones.info/hormones/prostaglandins.aspx
[2] http://www.medscape.com/viewarticle/745724
[3] http://www.ncbi.nlm.nih.gov/pubmed/22168993
[4] http://www.ncbi.nlm.nih.gov/pubmed/18836239
[5] http://www.ncbi.nlm.nih.gov/pubmed/11548224
[6] http://www.webmd.com/osteoarthritis/managing-oa-pain-10/weight-loss
[7] http://www.ncbi.nlm.nih.gov/pubmed/19116936
[8] https://umm.edu/health/medical/altmed/herb/devils-claw