Joint Degeneration, Osteoarthritis

If you have noticed that your knees, ankles, wrists, shoulders, or other joints have started to creak you could be affected by a degenerative arthritis known as, osteoarthritis.  The word osteoarthritis breaks down into three words; “osteo” meaning bone, and “arthro” meaning joint, and “itis” meaning inflammation.  This is the most common type of arthritis and is often referred to as “wear and tear” arthritis. Osteoarthritis typically affects people over the age of 45 and worsens with continued use of the joint. It can also affect much younger generations as well.

Our joints provide movement, stability, flexibility, and protection to our musculoskeletal system. Cartilage is a white, flexible connective tissue that coats the ends of the bone and allows for fluid motion of the joint.  Synovium tissue lines the joint capsule and secretes the lubrication needed. Your knee or elbow bends back and forth like a hinge, with proper lubrication and oil, the hinge will move freely.  Joint inflammation is one of our body’s natural defence mechanisms to provide protection to an area that is healing.  Chronic, or long term, inflammation will cause abnormal tissue and bone changes and an eventual breakdown of the cartilage in the joint. The inflammation will lead to redness or warmth, swelling, pain, and a loss of mobility in the joint.  Left untreated, the inflammation can cause a positive feedback loop, bringing more inflammation and degenerative changes as time progresses.

Stages of Osteoarthritis
There are four progressive stages of osteoarthritis:

Stage 0: Normal – there is no radiographic evidence of arthritic changes or loss of joint space. Mobility is good and there is no pain.
Stage One: Minor – Beginning phase of wear and tear begins in the joint capsule. There may be a mild decrease in joint space as the cartilage wears down and the bone may start to have subtle changes as it adapts to the added pressures inside the joint. There may or may not be pain in this stage.
Stage Two: Mild – The joint space is noticeably decreased and the cartilage is starting to wear down. Bone spurs may be developing. Increased pain and a loss of mobility are present.
Stage Three: Moderate – There is obvious erosion of the cartilage and joint capsule. Bone spurs may have developed and be pronounced. The joint is inflamed and pain can be moderate to severe especially after activity. There is significant loss of joint space.
Stage Four: Severe – The cartilage has completely worn away, there is a severe loss of joint space, and the joint may be bone-on-bone. Bone spurring may be present and significant. The bone’s physical appearance may be changing due to the added pressures. Severe pain and loss of mobility is associated with this stage, especially with activity or standing for long periods of time. Knee pain may not subside when resting and may be worse in the mornings.

Symptoms
For stages one through four, symptoms will vary but may include:

• Pain in the joint after activity and repeated use
• Pain, swelling and stiffness after long periods of inactivity
• Continuous joint pain even at rest
• Throbbing, stabbing, or burning pain in the joint

The degree of symptoms will vary greatly. Some people become completely debilitated, while others may experience few symptoms even though they may be in a later stage of osteoarthritis.  There can be periods of intense pain, followed by periods of no pain.

Causes of Osteoarthritis
Osteoarthritis is not a systemic condition like rheumatoid arthritis can be and does not spread throughout the body. Instead it will only affect joints where the deterioration has occurred.  The most common joints affected are the knees, hips, shoulders, wrist and hands, spine, and feet. In the spine pain can be both in the cervical (neck) and lumbar (lower back).

Causes include:

• Repetitive activities at work and at home
• Poor posture and ergonomics
• Trauma to a joint, running on hard surfaces - power walking is far better for joint health, injury etc
• Inflammatory foods – sugar, gluten, wheat/grains, dairy, fizzy drinks
• Inactivity (“use it or lose it” principle)
• Genetic factors
• Joint and spinal misalignment

Prevention and Healing your joints naturally using a functional medicine approach

If you want to heal naturally, a great place to start is using a functional medicine approach asking the question of “what is the cause?” This root cause analysis can help you dig deeper into why the inflammation is in the joint to begin with, why it is worsening, and how to start mobilising the body to remove the inflammation.

1.    Movement is crucial - Physical fitness is important in restoring mobility to the joint. Even light exercise is important to maintain proper muscle tone and weight bearing on the bones and joints. A good place to start is with light aerobic activity, such as an elliptical machine or water exercises. Graduate to longer aerobic activity and then mix with circuit training, weight resistance and active stretching techniques.

2.    Diet – Your joints are as healthy as the food you are eating. Highly inflammatory food groups will cause more inflammation in the joints and lead to further degeneration. Remove ALL inflammatory food groups immediately and start rebuilding the joint through a clean, anti-inflammatory diet. The following are few great things to add in: Bone Broth and Collagen – the base building material of cartilage. Collagen is essential for helping restore joint health and healing any intestinal permeability (Leaky Gut). Essential Fatty Acids are Key! Eat healthy fat foods such as wild-caught salmon, walnuts, flax seeds, hemp seeds, coconut/olive/avocado oils.
These omega-3 fatty acids contain primarily EPA and DHA, which have been shown in studies to help maintain bone health and flexibility. Antioxidant Rich Foods – Cruciferous vegetables such as broccoli, kale, collards, bok choy, and spinach, along with low sugar fruits such as organic blueberries, strawberries, blackberries, and raspberries help reduce the free radicals caused by degenerative changes.

3.    Supplementation Collagen or gelatin –  supports rapid repair of tissue, bone, hair, skin, and nails.  Helps to keep your cartilage healthy and joints smooth. Glucosamine and Chondroitin sulfate – provides the joints with the building blocks they need to help repair the natural wear on cartilage.  Protects the cartilage and attracts fluids that give the tissue its shock absorbing quality. Glucoflam from untrained is great. MSM – Because of MSM’s sulfur content, it is used by the body to maintain normal connective tissues. MSM may have anti-inflammatory activities, chemopreventive properties, anti-atherosclerotic action, and free radical scavenging activity. Turmeric, Cayenne, Cinnamon, Ginger – these herbs provide many great health benefits but can be very useful for their anti-inflammatory properties in the joints as can Devils Claw, Salix and others. Cinnamon also helps control insulin which can have an indirect effect on joint health through blood sugar control. Hylauronic and Stem Cell injections – Minimally invasive, non-steroidal, injections can be done to quickly lessen the pain, increase mobility, and regenerate cartilage, bone and tissue in the joint.

4.    Rehabilitation Exercises – When joint pain is caused by poor spinal and hip alignment, muscle imbalance, or poor core stabilisation, Chiropractic, osteopathic and physio adjustments and Paul Chek exercise rehabilitation may be used to correct the alignment concerns and strengthen your surrounding muscles along with improving flexibility of the joints.

We all have the potential to lead an active, healthy, happy life free from chronic disease and disabling symptoms, we just need the health insights to learn how!