Natural Remedies for Osteoarthritis

Arthritis affects nearly 21 million Americans and 200 million individuals globally. It is one of the most common health problems of the elderly and a significant problem for younger adults. Arthritis pain can come and go for many years. It may cause the joints of the fingers, hands, feet, wrists, knees, and hips to twist, bend, swell, and become stiff, greatly limiting the activities of its sufferers. Owing to the nature of this disease, osteoarthritis (OA) has been listed as one of the ten most crippling diseases in industrialized countries. It affects 70% of the population between the ages of 55 and 70.

Understanding Joints

Joints are the connections between bones; some are movable, and others are not.  Our movable joints were designed to permit low friction contact between bones. Their intricately engineered architecture supports weight and cushions force while providing smooth surfaces for easy gliding motion. The weight-bearing surfaces of joints are made of specialized molecules that have tree-like branches. These molecules allow water to be held there, much like a sponge, and making the surface smooth, slippery, and tough.

Cartilage lies at the end of each bone that is part of a movable joint and as a result is at the interface between bones within joints.  Cartilage contains neither blood vessels nor nerves, but gets its nourishment from a thick, viscous fluid (synovial fluid) which bathes the bones of most movable joints and reduces friction. Cartilage plays a crucial role in dispersing joint bearing forces, cushioning impacts, and minimizing friction within and between joints.¹

Cartilage itself has a rubbery consistency which provides for good shock absorbency and protects the bones at their movable unions. Chondrocytes are cells that responsible for healthy cartilage formation. Throughout life, normal cartilage is continually being renewed and replaced under the influence of growth factors. Unfortunately, cartilage does not heal well even after injury, thus making it susceptible to inflammation and deterioration. As it ages, it loses its ability to respond to the growth factors.

What Exactly Is Osteoarthritis?

Osteoarthritis (OA) results from an imbalance in the natural breakdown and repair processes that occur in cartilage. In this condition the damaged cartilage cannot repair itself as it normally would and the disrepair accumulates over time leading to joint deterioration. OA involves damage to the  synovial  membrane, the gradual loss of cartilage, and damage to the bone adjacent to the joint.

Loss of bone underneath the joint and narrowing of the joint space are also characteristics of the disease process. In some cases, pieces of bone or cartilage will break off and float in the joint space.  Because the supporting structures, tendons and ligaments, and the joint capsules are also damaged in OA, the joint becomes unstable. Bone spurs often form. In the later stages of osteoarthritis, muscle atrophy and joint contracture occur.

Signs and Symptoms:

• Joint pain, tenderness, or stiffness
• Swelling in the joint
• Limited range of motion
• Muscle wasting
• Partial dislocation
• Deformity

Risk Factors

Osteoarthritis results from environmental, lifestyle, and genetic interactions.

Obesity: Next to aging, obesity is the greatest risk factor since it places mechanical stress on weight-bearing joints such as the knees or hips. It also increases the risk in non-weight bearing joints via inflammation. Only 10 pounds of excess weight increase the pressure on the knees by 30-60 pounds at each step. Being overweight has been linked even to higher rates of hand OA in some studies. Overweight women have nearly 4 times the risk of knee OA; for overweight men the risk is 5 times greater.² Obesity is a strong independent risk factor for pain, especially in soft-tissue structures such as tendons.³ Excess weight is also significantly associated with an increased risk of rapid cartilage loss. For a one-unit increase in BMI, the odds of rapid cartilage loss increase by 11 percent.⁴

Trauma and Diseases: Very repetitive actions performed on a daily basis, as well as trauma, increases one’s risk. Neuropathy, as commonly seen in diabetics, is also a risk factor. In neuropathy the receptors and nerves involved in proprioceptive reflexes are diminished, consequently creating abnormal movement and positioning. As a result, mechanical stress is placed upon the weight-bearing joints. Not only does diabetes increases one’s risk for OA, but elevated cholesterol levels do also.

Drugs: The use of steroids stimulates the activity of enzymes which attack the cartilage and collagen of joints. Smoking and alcohol consumption increase the risk for OA.

Joint malalignment and muscle weakness also increase one’s risk for osteoarthritis. If you are at risk for OA, get evaluated periodically by a physical therapist. A competent chiropractor may help to correct any muscle imbalances and adjustable malalignment.

Reduce Your Risk Factors

Lose weight if overweight.

As previously mentioned, obesity is the major lifestyle risk factor for the development and progression of OA in weight bearing joints. Excess weight not only puts extra mechanical stress on the cartilage of our weight-bearing joints, but extra fat cells create a whole arsenal of pro-inflammatory chemicals that damage joints.⁵ At one time osteoarthritis was considered just “wear and tear” arthritis. We now know that inflammation plays a pivotal role in the symptoms and progression of the disease. Furthermore, inflammation produces actual detrimental, biochemical changes which cause damage to the cartilage. Even a small amount of weight loss (10%) reduces the risk of developing knee OA. Weight loss also reduces the pain of arthritis and can restore the function and quality of life in osteoarthritis patients.⁶

Engage in Frequent Bouts of Mild Exercise

Scientists discovered that exercise intervention in people with arthritis did not just reduce their pain, it also lowered their levels of pro-inflammatory compounds. Additionally, in this study, exercise also increased the body’s natural cannabis-like endocannabinoids. Interestingly, the way exercise resulted in these changes was by altering the gut microbes.⁷

Strengthen the muscles surrounding your joints.

Strong muscles create stability for weak joints and protect them from further damage. Weak muscles in the quadriceps and hamstrings increase the risk for osteoarthritis in the knees. The joint capsule is comparable to a bag which surrounds the joint. Cartilage itself has no blood supply and to a certain extent functions as a sponge. It is dependent on regular weight bearing exercises to squeeze or pump nutrients in and out, thus promoting health and repair. Low impact and water exercises are excellent if you already have osteoarthritis. Walking lubricates the joints.

Exercise can alleviate OA at a molecular level. Exercise relieves the pathological changes of OA by several mechanisms. It inhibits the deterioration of extracellular matrix and reduces inflammation of the affective joints.⁸  Consistent exercise can delay the progression of osteoarthritis. However,  high-intensity exercise may lead to the occurrence and development of OA.

Maintain flexibility.

Many of us engage in work that requires repetitive movement. If you type, for example, extend your fingers and wrist every hour. It is also beneficial to stand for a few minutes during the hour and move all joints in range of motion exercises as it will help to prevent joint capsule contractures. It is essential that you stand and walk for five minutes to help prevent knee OA. If that is not possible, invest in an under-the-desk glider. Stretches, properly done, and appropriate resistance exercises can help OA.

Protect your joints from injury.

Wear seat belts while riding in a vehicle and proper protective gear during sport events. If you have been seriously injured during a sport, why add insult to injury by participating in an activity that substantially increases your risk for more injury?

Enjoy a Plant-Based Diet

One study suggests that a whole-foods, plant-based diet significantly improves self-assessed measures of functional status among osteoarthritis patients.((Clinton, Chelsea M et al. “Whole-foods, plant-based diet alleviates the symptoms of osteoarthritis.” Arthritis vol. 2015 (2015): 708152. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4359818/ )

Meat, liberal consumption of sugar, and fried foods encourage inflammation. Some pain and inflammation of arthritis are specifically related to arachidonic acid. This fat comes largely from animal fat: meat, butter, cheese, and milk. Interestingly enough, excessive corn, safflower, sesame, sunflower, and other vegetable oils can also contribute to excess arachidonic acid in the tissues. Thus, too much of these fats not only specifically promotes inflammation in joints but also contributes to inflammation in other parts of the body.

Anti-Arthritis Power Foods:

A diet consisting of fruits, vegetables, whole grains, and nuts provides an arsenal of anti-inflammatory phytochemicals which quell inflammation. To be more specific, lutein and zeaxanthin, found in green vegetables, are correlated with a lower risk of cartilage defects. ⁹ Celery contains more than a dozen anti-inflammatory and analgesic compounds.

Salad Greens

Fresh  dark salad greens contain an anti-arthritis factor (Wulzen’s) factor. Skip the raw milk ads as a source for the Wulzen’s factor. There are 100,000-300,000 dead germs per one cubic cc of pasteurized Grade A refrigerated milk. This stimulates the immune system, and while the immune system is busy clearing out the dead germs, it has less energy to fight live germs. One glass of Grade A pasteurized, refrigerated milk is deemed acceptable although it contains nearly 2,500 coliform bacteria. The live and dead bacteria count in raw milk would therefore be even higher!

Red Grapes, Pineapples, and Blueberries

Red grapes and blueberries contain resveratrol and other anti-inflammatory compounds.These compounds  target several inflammatory agents and cartilage destroying compounds involved in OA.¹⁰¹¹  Bromelain from fresh pineapple might help OA. Pomegranate fruit, if consumed regularly, may help to slow cartilage deterioration in OA.¹²

Plant-Based Omega 3 Fats

A high fat diet worsens arthritis. Some fats, however, are protective. Vegetarian diets, especially those including chia, flax, walnuts, modest amounts of soy, and fresh green vegetables especially, are significantly beneficial. These foods contain their own pure “omega -3” fat, free of cholesterol. They decrease formation of aggressive pro-inflammatory chemicals which increase joint pathology and promote the formation of the milder and anti-inflammatory prostaglandins. Omega-3 fats stimulate the building up of cartilage while inhibiting some of its destruction, thus promoting the alleviation of OA symptoms.¹³ Use a small amount of  cold-pressed extra virgin olive oil on your salads instead of your regular salad dressing. Or better yet, eat a few green ripe olives. The oleocanthals in olives are combatants against inflammation.

Skip the Soft Drinks

Sugary soft drinks accelerate the progression of osteoarthritis. After controlling for other factors that may contribute to knee OA, researchers from three universities found that men who consumed more soft drinks per week had worse knee OA progression. The joint space became narrower by an average of 0.29 millimeters in men who drank no soft drinks to 0.59 millimeters in men who drank more than five soft drinks a week.¹⁴

Get Enough Vitamin D

The active form of vitamin D stimulates the synthesis of cartilage-protecting molecules and is an important anti-inflammatory hormone inside the body. Low levels of vitamin D are associated with loss of muscle mass and muscle weakness (a risk factor for OA). Moderate vitamin D deficiency independently predicts knee and hip pain. Radiological studies show that low levels of active vitamin D are associated with progression of OA. In fact, if one is deficient in this vitamin, he has three times the risk for developing OA.¹⁵ Insufficient sunlight exposure and deficient serum vitamin D levels are both associated with decreased knee cartilage loss as assessed by radiograph or MRI.¹⁶ Elderly and dark-skinned individuals, obese persons, and those using sunscreen may not get enough vitamin D from exposing their skin to the sun. Have your vitamin D level checked.

A 2023 meta-analysis of vitamin D for osteoarthritis revealed that vitamin D may help certain aspects of knee OA. The meta-analysis evaluated the effects of vitamin D supplementation in patients with knee osteoarthritis, with 3,077 patients included. The results showed that vitamin D administration had a statistically significant impact on the amount of synovial fluid. It had larger fluid volume in individuals taking vitamin D compared to placebo. Additionally, the meta-analysis showed that vitamin D improves joint pain and function and increases the tibial cartilage volume.Supplementing with vitamin D, however, showed no positive impact on bone marrow lesions, joint space width or joint stiffness, (Visual Analog Scale, VAS) and tibial cartilage.¹⁷

It should not be overlooked that regular exposure to sunshine, as well as vitamin D, are both associated with decreased knee cartilage loss (assessed by radiograph or MRI).¹⁸

Sleep Tight!

Sleep reduces inflammation within our body; sleep debt increases it. The pituitary gland releases growth hormone during deep sleep. Growth hormone goes to each cell, including those in your joints and bones. By improving protein synthesis, it helps to repair the body.

Cultivate a Regular Schedule

Cartilage, synovium, bone and skeletal muscle are reported to have regular rhythms for maintaining joint health. They have a functioning body clock which switches genes that control tissue function on and off.  Disturbed circadian rhythms compromise the health of our joints, accelerates the progression of osteoarthritis, and worsen symptoms.¹⁹ Scientists believe imposing a rhythm by regularly scheduled exercise, restricted meal times, or by targeting the joint itself with scheduled warming and cooling of the joint, could have a significant impact on the future management of joint diseases. With further study, it could relieve sufferers’ symptoms.²⁰

Stay Hydrated

Water composes sixty-five to eighty percent of cartilage and functions as a shock absorber in the cartilage, also providing lubrication. Water is the essential for the nutrition of the cartilage. It helps oxygen to penetrate the cartilage. Dehydrated joint cells become oxygen-deprived and acidic; consequently, cartilage cells die.²¹ Certain forever chemicals in water seem to be linked to increase risk of osteoarthritis in women.²² For this reason, a reliable water filter like Zero Water, that removes most of the forever chemicals in our drinking water, would be a good investment.

Supplements

A modest intake of 120-200 mg of ascorbic acid is associated with a three-fold lower risk of OA progression. Vitamin C stimulates collagen synthesis as well as production of molecules which protect the cartilage in the joint surfaces.²³

Curcumin in Turmeric

It possesses powerful anti-inflammatory and analgesic properties.  Curcumin protects the weight-bearing surface of joint and cartilage cells from breakdown.²⁴  Studies show that curcumin significantly decreased the levels of inflammatory markers, such as IL-β, IL-6, and TNF-α, in human articular chondrocytes.²⁵

Curcumin is sensitive to light exposure and is not easily absorbed, but there are vegetarian supplements in which phosphatidylcholine (a lecithin) is added to improve its absorption. Turmeric can interfere with certain medications, so consult with your pharmacist or doctor before using it medicinally. Nano formulations of curcumin are better absorbed.

Like turmeric, rose hips tea inhibits the Cox-2 enzymes involved in inflammation. Rosehips tea contains phytochemicals that decrease some of the catabolic activities involved in joint deterioration related to OA.²⁶ Diallyl disulphide, a compound found in garlic, represses the activity of proteases which cause degradation in the matrix of the cartilage.

Maintain Good Posture

Good posture protects the joints in your neck, back, hips and knees. Within it, gravity will make sure that your slump shows up as joint problems.²⁷ If you have posture problems, or if one leg is shorter than the other, consult a physical medicine specialist or a physical therapist for exercises and other modalities which will help your problem.

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