What Is Osteoarthritis?
Of more than one hundred types of arthritis, osteoarthritis is by far the most common. Osteoarthritis refers specifically to a breakdown of the cartilage pad in at least one joint, such as the fingers, knees, or elbows. It also can affect the neck, hips, and lower back, even resulting in a decrease in height. These pads, known as articular cartilage, cushion the impact and lubricate the movement of bones in a joint. When articular cartilage is thin or completely gone, bones grind directly against each other. Signs of osteoarthritis include inflammation, swelling, pain, stiffness, and difficulty moving one or more joints. Nearly every person over age sixty has some degree of osteoarthritis, though the disease progresses at different rates from person to person.
For the most part, osteoarthritis is a disease of wear and tear; the more you use your joints, the more you lose them. Overuse, such as in athletics, and athletic injuries can accelerate the breakdown of articular cartilage. Sometimes immune cells inflaming tendons can spread out and affect a nearby joint.
Being overweight, even by as few as ten pounds, also can increase the risk of osteoarthritis. One reason is that the extra weight puts more stress on joints. Another is that fat cells secrete large amounts of proinflammatory interleukin-6 and C-reactive protein, which increase inflammation throughout the body.
An often overlooked cause is that relatively few people nowadays consume cartilage, which contains the building blocks of our own joints. In the past it was common to make soups using chicken or beef bones, with cartilage (and other nutrients, such as calcium) dissolving in the broth. Cartilage attached to the bones releases glucosamine and chondroitin, two important building blocks of our own cartilage. It is very possible that people would have less need for glucosamine and chondroitin supplements if they had regularly consumed homemade soups.
The omega-3 fatty acids found in fish oils inhibit some of the enzymes involved in breaking down articular cartilage, so eating less fish also may increase the risk of developing osteoarthritis. Allergylike food sensitivities also may influence symptoms of osteoarthritis. Exposure to allergens often varies, and this could explain why many arthritics feel better or worse from day to day.
How Common Is Osteoarthritis?
About three times as many women as men have osteoarthritis, and about one in every fourteen people (21 million in the United States) suffer mild to crippling symptoms. That number is expected to rise to 30 million by 2020. Overall, one in seven people has some form of arthritis, 40 million in the United States. That number is expected to increase to one in six by 2020.
Nutrients That Can Help
For osteoarthritis, supplements of glucosamine and chondroitin, about 1,200 to 1,500 mg of each daily, have been shown to reduce pain and inflammation.
One excellent study found that glucosamine supplements can help rebuild articular cartilage, and chondroitin appears to have some anti-inflammatory properties. (For more details, review chapter 10.) Vitamin C is needed for the formation of collagen and cartilage, as are manganese and sulfur. A minimum of 500 mg of vitamin C may be needed.
Additional sulfur, also essential for cartilage formation, can be obtained in glucosamine sulfate, chondroitin sulfate, or methylsulfonylmethane (MSM), and small amounts of manganese can be obtained in a multimineral supplement.
What Else Might Help?
A variety of other nutrients, herbs, and habits also may reduce inflammation and pain associated with osteoarthritis. The least expensive change is to drink more water. According to Hugh D. Riordan, M.D., of the Center for the Improvement of Human Functioning International, Wichita, Kansas, poor hydration is a common problem. Sufficient water intake helps cushion cells and tissues.
Vitamin D may indirectly reduce the risk of osteoporosis, according to research by Timothy E. McAlindon, D.M., a medical doctor and rheumatologist at Boston University Medical Center. Vitamin D is necessary for normal bone development, and low levels may affect bone structure and stability underneath the cartilage pads in joints.
Another study, by Margaret A. Flynn, Ph.D., professor emeritus at the University of Missouri, Columbia, found that supplemental vitamin B12 and folic acid could improve hand-grip strength in men and women with osteoarthritis of the hands.
The herb ginger also may be helpful. A study in Arthritis & Rheumatism found that patients taking a ginger extract benefited from moderate improvements in knee pain. The study confirmed ginger’s use as an antiinflammatory agent in Chinese medicine, dating back more than twenty five hundred years.
Two topical treatments also can help. Several studies have found that creams containing capsaicin, the pungent component of hot peppers, can reduce the pain of osteoarthritis. Capsaicin blocks the transmission of pain chemicals to the brain. The effect appears to be strictly symptomatic, but other than a local sensation of heat, it is far safer than acetaminophen and other nonsteroidal anti-inflammatory drugs. Creams containing the herb arnica also may relieve joint pain.
Lastly, mild movement therapies such as walking, yoga, and swimming may improve flexibility and reduce pain. It is very important, however, not to overdo such exercises because they may further break down articular cartilage.