Arthritis affects nearly 21 million Americans. 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.
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, but make 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. Cartilage itself has a rubbery consistency which provides for good shock absorbency and protects the bones at their movable unions. 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 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 the gradual loss of cartilage. 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.
Signs and Symptoms:
- Joint pain, tenderness, or stiffness
- Swelling in the joint
- Limited range of motion
- Muscle wasting
- Partial dislocation
Osteoarthritis results from environmental, lifestyle, and genetic interactions.
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.1 Obesity is a strong independent risk factor for pain, especially in soft-tissue structures such as tendons.2 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.3
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.
The use of steroids stimulates the activity of enzymes which attack the cartilage and collagen of joints.
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.4 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.5
Strengthen the muscles surrounding your joints.
Strong muscles create stability for weak joints and protect them from further damage. Weak muscles in the quadriceps 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.
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.
Protect your joints from injury.
Wear seat belts while riding in a vehicle and proper protective gear during sports. 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.6 Celery contains more than a dozen anti-inflammatory and analgesic compounds.
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. It targets several inflammatory agents and cartilage destroying compounds involved in OA.78 Bromelain from fresh pineapple might help OA. Pomegranate fruit, if consumed regularly, may help to slow cartilage deterioration in OA.9
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.10 Use virgin olive oil on your salads instead of your regular salad dressing. 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.11
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.12 Insufficient sunlight exposure and deficient serum vitamin D levels are both associated with decreased knee cartilage loss as assessed by radiograph or MRI.13 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.
Engage in Frequent Bouts of Mild Exercise!
Scientists discovered that exercise intervention in people with arthritis did not just reduce their pain and lowered the 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.14
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 cells have a functioning body clock which switches genes that control tissue function on and off. 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.15
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.16
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.17
Curcumin in Turmeric
It possesses powerful anti-inflammatory and analgesic properties. Curcumin protects the weight-bearing surface of joint and cartilage cells from breakdown.18 It 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.
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.19 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.20 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.
Disclaimer: The information in this article is helpful and is educational. It is not the author’s or authors’ or Wildwood Health Institute’s intent to substitute the blog article for diagnosis, counseling, or treatment by a qualified health professional.
Copyright through December 2023. All rights reserved by Wildwood Sanitarium, Inc.
- Role of Body Weight in Osteoarthritis – Arthritis Information
www.hopkinsarthritis.org › Patient Corner › Managing Your Arthritis
Mar 27, 2012↩
- Weight Loss May Prevent, Treat Osteoarthritis in Obese Patients …
www.thefreelibrary.com › Business › PR Newswire › March 8, 2013↩
- Roemer, Risk Factors for MRI-detected Rapid Cartilage Loss of the Tibio-femoral Joint over a 30-month Period: the MOST Study. Radiology, July 2009 r↩
- Conde, Javier, et al. Adipokines and osteoarthritis: novel molecules involved in the Pathogenesis and Progression of Disease, Arthritis, Volume 2011 (2011), Article ID 203901↩
- Konce, RC, et al, Obesity and Osteoarthritis: More Than Just Wear and Tear. Journal of the American Academy of Orthopaedic Surgeons, 2013; 21 (3): 161 DOI:↩
- 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. ((Wang, Yuanyuan et al. “Effect of antioxidants on knee cartilage and bone in healthy, middle-aged subjects: a cross-sectional study.” Arthritis research & therapy vol. 9,4 (2007) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2206367/↩
- Basu A, Schell J, Scofield RH . Dietary fruits and arthritis. Food Funct. 2018;9(1):70–77.↩
- Mobasheri, Ali, et al, Scientific Evidence and Rationale for the Development of Curcumin and Resveratrol as Nutraceutricals for Joint Health, Int J Mol Sci., 2012; 13(4): 4204-4232↩
- Balbir-Gurman A, et l. Consumption of pomegranate decreases serum oxidative stress and reduces disease activity in patients with active rheumatoid arthritis: a pilot study. Isr Med Assoc J. 2011 Aug;13(8):474-9.↩
- Dzelska-Olezak, M., Antiinflammatory therapy in osteoarthritis including omega 3 and omega 6 fatty acids, Pol Merkur Lekarski. 2012 May;32(191):329-34↩
- Bubbles up knee osteoarthritis; especially in men. ScienceDaily. Retrieved August 22, 2013, from http://www.sciencedaily.com/releases/2012/11/121111153527.htm↩
- Wang, Y., et al, The Effect of Nutritional Supplements on Osteoarthritis, Alternative Medicine Review, vol 9(3), 2004, p.275↩
- Ding,C. Serum levels of vitamin D, sunlight exposure, and knee cartilage loss in older adults: the Tasmanian older adult cohort study. Arthritis Rheum. 2009, May60(5):1381-9↩
- Amita Vijay, et al. The anti-inflammatory effect of bacterial short chain fatty acids is partially mediated by endocannabinoids. Gut Microbes, 2021; 13 (1) DOI: 10.1080/19490976.2021.1997559 ↩
- Gossan, N, et al., The circadian clock in chondrocytes regulates genes controlling key aspects of cartilage homeostasis. Arthritis and Rheumatism, 2013.Sep;65(9):2334-45 https://pubmed.ncbi.nlm.nih.gov/23896777/↩
- Clark, J.M., Arthritis: Don’t let Joint Pain Slow Your Journey, www.newstartclub.com↩
- Wang, Y., et al, The Effect of Nutritional Supplements on Osteoarthritis, Alternative Medicine Review, vol 9(3), 2004, p.275↩
- Henrotin, Y, et al., Biological actions of curcumin on articular chondrocytes, osteoarthris, Cartilage, 2010 Feb; 18(2):141-9↩
- Schwager, J., Rose hip and its constituent galactolipids confer cartilage protection by modulating cytokine, and chemokine expression. BMC Complement Altern Med. 2011 Nov 3;11:105.↩
- Poulsen, E. Patient education with or without manual therapy compared to a control group in patients with osteoarthritis of the hip. A proof-of-principle three-arm parallel group randomized clinical trial. Osteoarthritis Cartilage. 2013↩