Osteoarthritis Treatment With Homeopathy

In simplest terms, osteoarthritis is nothing but failure of joint pattern. It is certainly a degenerative joint disease, characterized by degeneration of articular cartilage and proliferation of new bone, cartilage, and connective tissue at the same time. Often secondary inflammatory changes are observed in the synovium.

 

Sadly the incidence of osteoarthritis seems to be on rise according to global surveys. The age onset of OA is reducing drastically over the period of last few years. Now the incidence is stated to start at the age of 30 years and by the age of 65, more than 80% people have degenerative changes in their joints. Older women are peculiarly affected more and certain geological variations are found too.

 

Causative and Risk Factors of Osteoarthirits-

 

(1) The primary etiology of OA is termed as idiopathic where no known cause can be determined.

 

(2) Secondary OA results due to some or the other systemic or local factors as below-

- intra-articular fracture

- trauma of any type

- occupational (elbows in pneumatic drill operators)

- Rheumatoid arthritis

- Gout

- Tabes dorsalis

- Diabetes mellitus

- Peripheral nerve lesions

- Metabolic diseases like Wilson's disease

- Hip dysplasia

- Paget's disease etc

 

(3) Sedentary habits, improper diet habits, sports injuries, absolute lack of exercise or overt exercise regimes, etc can be called as some of the modifiable risk factors of OA

 

Signs and Symptoms of OA-

1. In most cases, joints of spine, hands, knees, and hips are involved


2. At least initially, only one or a few joints are affected


3. Knee and hand involvement is peculiar


4. Characteristically the first few joints to be involved are distal and proximal interphalangeal joints, carpo-metacarpal joints of thumb, etc.


5. Gradual onset of symptoms


6. Intermittent pain and aching in joints typically is aggravated by movement of that joint and is better by resting it


7. With the advancement of the disease process, limited movement of joints is noticed. Initially this restriction of movement is attributed to pain and spasm of muscles but later capsular fibrosis, osteophyte formation, and remodeling of bone set in.


8. After minor sprains or twists, there are usually effusions into the joints when crepitus may be felt or even heard.


9. Associated muscular wasting is noted, because of which there is loss of muscle control over the joint, resulting in recurrent injury.


10. Due to hyperaemia of subchondral bone, there is usually nocturnal aching in bones


11. Deformities like Heberden's or Bouchard's node formation, and finally osteoarthritis deformans may set in.

How Homeopathy Can Help in the Patients of Osteoarthritis?

 

Homeopathy is not a magic. It is a full-proof science and art of applying the nature's principle while treating any disease with the natural drug substances aptly potentized to extract their curative properties. Therefore homeopathic principle is the most important one to be considered while treating any disease condition or the patient (more aptly).

 

The most important thing to remember while treating a case of OA homeopathically is that "Pay ample attention to characteristic symptoms of the disease and not to the common ones!"

 

It happens many times that a homeopath puts a common symptom of the disease as his priority while choosing the drug and as can be well judged, it leads to failure. Also paying good attention to the mental picture of the patient prior to catching the disease, during the disease process, and while on regime is one of the topmost priority while treating OA. You will observe that the "mind" is the organ that gives you good hint for appropriate remedial diagnosis in osteoarthritis patient.

 

Here we are listing top 10 remedies that may be of use during acute treatment phase of chronic osteoarthritis. Remember again that there is no alternative to constitutional therapy to be formulated individually for every patient, to help him find relief on all planes, while reducing his OA successfully.

 

Homeopathic Remedies for OA-

 

(1)Calcarea fluor-

- Indurated feeling of joints with stiffness

- Stony hardness of joints

- Nodal swelling in fingers that are hard on palpation

- Chronic synovitis and bursitis affecting hip and knee joint

- Sluggish temperament

- Coldness about wrists and ankles

- May be associated with varicose veins

- Pain usually begins on left side

- Worse in cold wet weather and while beginning to move

- Acute attack of pain in joint usually sets after a sprain

 

(2)Sticta-

- Stiff, rheumatic diathesis

- Rheumatism usually beginning in upper extremities

- Diagonal pains

- Soreness and stiffness in joints of neck extending to shoulders

- Old-maid's OA of knee

- Red spot on the affected joint

- Associated with restlessness of hands and feet and profuse sweats on hands

- Bursitis with cold moist limbs

- Incessant talking

- Worse by change in temperature, movement, night

- Better in open air

 

(3)Ruta-

- Bruised sore aching in all bones

- Nodal osteoarthritis

- Paralytic rigidity of joints

- Weak paretic feeling in the mornings in hip, small of back, lower limbs etc

- Deep felt pains in long bones

- Osteoporotic changes in bones in elderly women with frequent bone fractures attributed to brittleness of bones

- Affections of wrists and ankles

- Feeling of heat on skin face etc

- Sometimes burning neuralgic pains about the joints

- Worse by over-exertion, sprains, cold wind

- Better by motion, lying on back and warmth

 

(4)Bryonia-

- Right-sided complaints

- Slowly advancing osteoarthritis

- Stitching pains in joints

- Irritable constitutions

- Inflammatory joint diseases affecting knee, shoulder, hips, etc

- Associated with absolute constipation, no desire

- Dry heat aggravates all complaints including joint pathology

- Congestive synovitis

- Worse by motion, stooping, exertion, morning

- Better by rest, cool open air, bandaging, damp days, lying on painful part

 

(5)Belladona-

- Acute inflammation of joints

- Marked redness and heat over the affected joint

- Congestive constrictive pain in joints

- Excessive restlessness with incessant talking

- Joint pains with spasms of muscles

- OA starting at young age

- Worse by heat, checked sweats, pressure, touch, movement

- Better by light covering, rest in bed

 

(6)Rhus tox-

- Paretic weakness in and around joints

- Recurrent sensation of dislocation of joints

- Sore, bruised or stiff pains about joints

- Swelling in joints with burning pains

- Principally left side is affected or the pain goes from left to right

- OA set after recurrent sprain of a joint or after overexertion

- Paralytic pains in elbows and knees

- Legs feel as if made of wood

- Wakes up with pain in limbs

- Edematous swelling of limbs

- Worse by wet, cold, beginning motion, rest, sprains, etc

- Better by continued motion, wrapping the joint, rubbing, and fomentation

 

(7)Rhododendron-

- Fibrous tissues are affected

- Small joints of hands are principally affected, also those of forearm and lower limbs

- Extreme sensitivity to windy stormy and wet weather

- Rapidly changing pains, zigzag variety

- Descending pains

- Confused stupid feeling prevails

- Affections of wrists

- Worse before storms, rough windy weather, night, rest

- Better by heat, in sun, motion, wrapping up

 

(8)Pulsatilla-

- Venous constitutions

- Swollen joints with dull aching

- Associated with numbness of extremities

- Acute periostitis

- Pains down the limbs alternate sides, with heaviness of legs

- Sticking pains in tibia with heaviness and cold sweat on legs

- Associated with foul foot sweat

- Chilly patient, yet averse to heat in any form

- Associated with digestive disturbances

- Worse by warmth, rest, beginning motion, evening, lying down, in bed

- Better by moving about slowly, cold, open air, after a good cry

 

(9)Ledum pal-

- Affection of small joints

- Tendons, ankles affected

- Left-sided affection of joints

- Ascending type of arthritis

- Purple, swollen (puffy) joints

- Shifting tearing pains

- Cold and edematous joints

- Gout

- OA resulting from recurrent sprains, especially of ankle joint

- Pain associated with coldness of joints

- Profuse night sweats

- Worse by injury, motion, night

- Better by cool air, cold bathing

 

(10)Actea spicata-

- Affection of small joints, especially wrist and finger joints

- Tingling pains with numbness and weakness

- Paralytic weakness in all joints

- OA set in old age, in people with debilitated states

- Swollen joints that cannot be moved

- Deformed joints

- Extremely sensitive joints to cold in any form

- Worse by cold, slight exertion, night, and touch

 

Auxiliary Line of Treatment-

 

In any case of osteoarthritis, one must suggest certain exercise regimen for early recovery. Rather, any regime without it is of no use in the long run. Also it is stressed that unless the pain is lessened, one should not exert the affected joint beyond certain limits. Therefore, seeking professional advice before you embark on any exercise regime is must!

What Are Surgery Options For Osteoarthritis Of The Knee

Conservative approaches to osteoarthritis of the knee include non-steroidal anti-inflammatory drugs, good quality forms of glucosamine and chondroitin, physical therapy, corticosteroid injections, viscosupplementation (injections of lubricant into the knee), and bracing.

For people who do not respond to these measures, there are more aggressive approaches available. The first is arthroscopy. This is a procedure where small telescope is inserted into the knee. Using specialized cutting instruments, damaged and diseased tissue is removed and flushed out of the knee. For many patients this affords relief.

If the arthritis damage is limited to one side of the knee, an osteotomy (removal of a wedge of bone to help the bones of the knee line up better) can be a very good option. This procedure is best done in patients under the age of 60 who are active and who do not have severe inflammatory changes. The only disadvantage is that because bone is removed, it may make subsequent knee replacement surgery more difficult because there is less bone to anchor the replacement in.

Resurfacing is a procedure where a thin layer of the femur (upper leg bone) and a thin layer of the tibia (lower leg bone) are removed. A layer of metal is applied to the femur and a layer of plastic is applied to the tibia. Sometimes the back of the patella (kneecap) is also resurfaced. This type of procedure is good for people who only have a moderate amount of damage and who have relatively good bone stock.

A relatively new procedure is paste grafting. Here, a hole is drilled in an area of arthritis to expose bleeding tissue. A paste consisting of crushed up bone and cartilage cells is then placed in the hole and the patient is not allowed to bear any weight on the repaired knee for several months. The paste is supposed to promote regeneration of cartilage. Preliminary data is encouraging.

Cartilage plug grafting is a procedure used when there is a single localized defect in the cartilage of the femur. A plug of cartilage is removed from the intercondylar notch of the knee (a non weight-bearing area). The plug is then placed into the cartilage defect in the femur. While this is good for localized defects, it is not useful for large defects due to osteoarthritis.

Autologous cartilage implantation is a procedure where a plug of cartilage is removed from the intercondylar notch of the knee (a non weight-bearing area). The plug is then used to provide cartilage cells which are grown in a laboratory. The patient then undergoes a second surgery where the cartilage defect in the weight-bearing part of the knee is carefully debrided (cleaned), then a patch is placed over this defect and cartilage cells grown from the first harvesting procedure are injected underneath the patch. Cartilage cells then grow over a period of several months. This procedure is good only for isolated cartilage defects and not for generalized osteoarthritis of the knee. Patients must not bear any weight on the leg for at least six months.

Synthetic cartilage plugs can also be inserted. The plug is made of synthetic biodegradable material that permits the patient's own cartilage cells to grow within the defect. This procedure is best used for younger patients (50 or younger) who have a localized defect. It takes several months for the plug to take hold.

Patients who have a damaged meniscus (cartilage cushion) due to arthritis can have a replacement meniscus donated from a cadaver source. These grafts can last about 4-5 years. The one danger is that the body may reject them.

Total knee replacement is a procedure where the end of the femur and the end of the tibia are removed and replaced with appliances consisting of metal capped with ceramic or plastic. Knee replacements last 12-15 years. A revision of this replacement may be required if the knee replacement is older than 15 years. Recent data indicates that a an exercise program instituted before surgery greatly enhances the chance of success.

Dealing With Osteoarthritis

What is osteoarthritis?

Osteoarthritis is perhaps the most common type of arthritis which affects most people. The condition is more prevalent among adults especially women. Also known as the wear and tear arthritis or degenerative arthritis, osteoarthritis involves a progressive degeneration or deterioration of a particular joint or group of joints. Weight-bearing joints such as those found in the arms, legs, back, and hips are the primary locations of damage. This is not to exclude osteoarthritis resulting from inflammation and injury in the smaller joints such as those in the fingers. The joints, particularly the cartilages in joints, are worn down as a result of everyday activities, strenuous activities, injury, fatigue, and dehydration. This degeneration of the joints could result to structural changes of the joints, joint effusion, bone spurs or bone overgrowths that result to osteophytes, and muscle and joint weakness.

People experience osteoarthritis differently and it is not yet well known why. The onset of arthritis may begin at an early age but usually it comes as a corollary of the ageing process. . The pain that characterizes osteoarthritis increases with more activity. Excess pounds also contribute more pain especially if a weight-bearing joint is the one involved.

What can be done?

Early diagnosis is the first most effective combatant of osteoarthritis. With it, treatment may begin as soon as possible. Moreover, being able to diagnose the condition correctly from other similarly characterized forms of arthritis is very important for treatment to be successful.

What are the signs and symptoms of osteoarthritis?

It is very important to know and pay attention to any signs and symptoms of osteoarthritis so that your doctor can properly diagnose your condition as well as recommend a suitable treatment program for you. The onset of arthritis is often indicated by stiffness and soreness in one's joints especially after a prolonged time of sitting, after waking up, and inactivity. Excruciating pain in the hips, knees, and other muscle areas can also be taken as a symptom of osteoarthritis.

Tips in Dealing with Osteoarthritis

Osteoarthritis is a serious condition which affects the joints. Signs and symptoms must not be taken easily. It is always wise to have a check up with your doctor. Most importantly, osteoarthritis cannot personally be treated. Patients must not rely on self-knowledge and fast facts and must seek the guidance of a doctor or physician.

Furthermore, although pain relief is necessary, pain relievers only offer short-term relief. What is important and more successful in eliminating chronic pain from osteoarthritis is a long-term treatment program. This may involve the intake of medication such as NSAIDs or non-steroidal anti-inflammatory drugs and glucosamine. These help reduce pain and rehabilitate damaged joints. A change in lifestyle may also be a huge contributing factor to curing osteoarthritis. Your posture and your weight are some of the things that you should start being more aware of. A balanced and healthy diet provides you with your body's most needed nutrients and helps you maintain your weight. Regular exercise will help you manage your weight as well as strengthen your joints.

Recent studies have shown that a Glucosamine Chondroitin Therapy is more effective than pain killers such as Celebrex in reducing pain in those with moderate to severe pain caused by arthritis. One of the most popular brands is Syn-flex Liquid Glucosamine. Synflex offers a line of products to help those afflicted with osteoarthritis reduce if not eliminate the pain caused by degenerative cartilage. Syn-flex 1500 delivers 1500mg per ¼ oz. dose and has many synergistic ingredients to reduce inflammation and rebuild damaged cartilage. Synflex even has a pet variety in beef flavor for those who have pets suffering from this debilitating disease.

Osteoarthritis of Knee Diagnosis and The Healing Process

Among the most frequent joint diseases is osteoarthritis of knee. It occurs when the cartilage suffers gradual wear and tear. According to doctors, the cartilage is a cushion layer situated between the knee bones. Also called the degenerative joint disease, osteoarthritis could as well affect other body joints. When the cartilage deteriorates, the knee joint feels stiff and sore. In the last steps of the disease, the pain and discomfort is unbearable. Consequently, the sick person could hardly walk steadily or even try to move his or her knee freely. Since the cushion between two bones no longer exists after degeneration, any movement will cause friction. This is because the bones will grind against each other. The result is intolerable soreness and discomfort.

The causes of osteoarthritis are numerous. However, not all the cases of the disease are necessarily similar, in terms of severity and frequency. The following is a brief outline of the known causes:

• Chances of developing osteoarthritis are high if you have had a serious knee injury in the past

• Being overweight is a good cause of many diseases, including this one. This is because heavy weight pressurizes the joints, as you walk. Consequently, the cartilage layer will slowly wear away

• Some cases of degeneration joint disease is gender specific

• Aging is generally the main cause of weaker joints, which eventually result to osteoarthritis

Several knee diseases show up closely related symptoms. Therefore, if you diagnose your problem, you are likely to be very incorrect. The most recommended action to take is to visit your doctor. He or she is in a position to examine your knee expertly. If you have this disease, you will generally have the following symptoms:

• Knee join soreness, stiffness and unbearable discomfort

• You will find walking as a punishment. If the knee joint cannot withstand your body weight, you cannot move properly.

• The cartilage degeneration continues to occur, as you try to figure what is happening to your knees

It is very important that you always take your health seriously. If you notice the above signs, do not take chances. Visit your doctor right away. This is fastest method of preventing more damage to the knee joints. When the physician is performing diagnosis, he or she will ask you to talk about your knee pain. In short, he or she will find out how worse the soreness gets, if, you workout and then rest. The doctor is much more likely to examine the problem with leg movement. Do not fear the check up exercise.

Your doctor might squeeze the joint slightly, but he or she may recommend an instant X-ray of the knee. The X-ray shows the exact cause of the soreness and discomfort. As some of you already know, osteoarthritis of knee disease is broad. To find out if a patient has other types of this disease, the doctor might take a blood sample. The treatment procedure could differ from patient to patient. Nevertheless, doctors recommend therapies to alleviate the knee joint pains. Generally, he or she will ask you to do the following:

• After a walk or any form of knee exercises, you should always take your time to rest

• For twenty to thirty minutes, you could place an ice cube on the painful parts of the knee. Do this everyday to minimize inflammation. It will ease the pain too.

• Take a specific over the counter cure. Never decide personally the medicine to pick between ibuprofen and acetaminophen. The doctor should guide you

• For stronger muscles and joints, you need to focus on special exercise. You need to work with a practitioner, who understands osteoarthritis of knee disease very well.

• In severe cases, physicians prescribe surgery.

Acupuncture Can Help Osteoarthritis

Osteoarthritis is one of the most debilitating conditions which can affect the mobility and quality of life of its victims. Through time, there have been lots of anti-inflammatory drugs created to treat this condition however most of them bring adverse side effects to the patient. This leads people to turn to alternative medicines such as acupressure and acupuncture in treating osteoarthritis.

Undeniably, more and more people are shifting to traditional bodyworks in treating osteoarthritis primarily due to the absence of side effects. In fact, there have been a significant number of people who have turned to acupuncture in managing the chronic pain brought by this debilitating condition. So what is osteoarthritis and what role does acupuncture play in managing this condition? Let's find out.

Osteoarthritis and Its Nature

Also termed as degenerative arthritis, osteoarthritis is a condition primarily characterized by the functional or structural failure of the joints. It often involves one entire joint and affects the nearby ligaments, muscles, joint lining, joint cover and underlying joint. At times, it may involve the progressive cartilage loss in the body.

Osteoarthritis normally occurs as a result of cartilage degeneration but it can also be caused by heredity, aging, injury and disease. Cartilage is actually a protein substance which serves as the 'cushion' between the joints' bones.

Osteoarthritis is categorized into two, the primary and secondary osteoarthritis. Primary osteoarthritis normally occurs as a result of the aging of the joints. Through time, the loss of cartilage causes friction between the joints which may cause pain and mobility difficulty. Most cases of primary osteoarthritis are hereditary.

On the other hand, secondary osteoarthritis is normally triggered by other conditions or diseases including diabetes, gout, obesity and hormone disorder. Obesity can actually heighten the mechanical stresses between the joints which can negatively affect the cartilage. According to research, obesity is the second most significant risk factor for degenerative arthritis. Aging still emerges to be the most significant risk factor for such condition.

Symptoms of osteoarthritis actually vary from one person to another but the most common symptoms are pain, joint stiffness and difficulty in moving the joints. Most treatments for osteoarthritis are geared towards the reduction of joint pain and inflammation. Also, treatments are designed to maintain and improve joint functions.

Acupuncture- How It's Done and What Are Its Benefits

For more than 3000 years, acupuncture has been used to treat a wide range of illness because of its multiple relieving effects. However, extensive scientific studies were only conducted during the last 5 decades. Because of the growing popularity of traditional medicines such as acupressure and acupuncture, many western medical practitioners have developed the interest and curiosity about the mechanisms of how this method works and how it is able to provide pain relief to patients who suffer from osteoarthritis.

According to traditional Chinese medicine (TCM), illnesses are mainly a result of blockages or imbalance in the flow of life energy in the body. Through acupuncture, these imbalances and blockages can be corrected with the use of special and very thin needles.

Acupuncture holds into the premise that the body contains 12 major meridians, 8 secondary meridians and thousands of acupuncture points which when stimulated can bring satisfactory benefits to different organs of the body. This ancient bodywork involves the process of penetrating very thin needles into the skin and manipulating them to create electrical impulses.

Researches On Acupuncture And Pain Management

Through time, there have been lots of researches conducted to determine the effects of acupuncture in the treatment of osteoarthritis. According to research, acupuncture helps in stimulating the production of endorphins in the body. Endorphins serve as the body's natural pain killers thereby helping the victims of osteoarthritis to cope with pain.

According to research, most acupuncture points are located near the nerves. When these nerves are stimulated, it creates a feeling of fullness or dull aches in the muscles. The stimulation of the muscles, triggers the transmission of signals to the central nervous system, which is composed of the spinal cord and the brain, to produce endorphins. These are hormones which the body produces in times of stress or pain. Together with other neurotransmitters, endorphins help in blocking the transmission of pain signals to the brain. In effect, patients are able to experience less pain.

The Symptoms Of Osteoarthritis And Osteoarthritis Pain Relief Remedies

The symptoms of osteoarthritis vary, as do treatment options. Osteoarthritis pain relief is the goal of most treatment plans, although preventing further deterioration of the cartilage protecting the joints is also a primary concern. Here we have an overview of the symptoms of osteoarthritis, as well as nutritional options for osteoarthritis pain relief.

It is important to note that joint pain should be evaluated by a physician. Joint pain and progressive stiffness, without the presence of fever probably indicates the onset of osteoarthritis, but joint pain is also found in other forms of arthritis and in other diseases, so professional evaluation is advisable.

The symptoms of osteoarthritis can range from daily and disabling to minor and intermittent. Some patients may experience years of pain free intervals, while others spend years searching for effective osteoarthritis pain relief.

The most common symptom is pain in a joint after repetitive use. For example, a person who has been hiking for years may suddenly experience pain in one knee that is not related to a fall, sprain or other injury. Examination by X-ray may show deterioration of the cartilage that prevents the joints from grinding against each other.

Joint pain typically worsens as the day wears on. Long periods of inactivity, such as taking a car trip or sitting through a movie can lead to stiffness and pain.

If the cartilage cushions are completely lost, there can be pain associated with any activity or even at rest.

Symptoms of osteoarthritis in the weight bearing joints (knees, hips and ankles) sometimes include limping or outward curvature of the knees (bow legged). When other measures do not provide osteoarthritis pain relief or if the cartilage in the knees or hips deteriorates to the point of joint dysfunction, surgery to "replace" the affected joint is sometimes necessary. The most common reason for "total knee replacement" in the United States is osteoarthritis.

Symptoms of osteoarthritis in the spine include neck and lower back pain. Bony spurs may form along the spine irritating the nerves and causing severe pain or numbness and tingling.

Bunions are symptoms of osteoarthritis in the joint at the base of the big toe. If the joints of the fingers are affected, they may become enlarged and spurs may form. If the disease progresses, it can be difficult to perform simple tasks, like buttoning a shirt.

Recent surveys have shown that acetaminophen (Tylenol) is the most commonly used over the counter medication for osteoarthritis pain relief. Interestingly, acetaminophen is not an anti-inflammatory, and it is inflammation in the joints that causes the pain. In addition, many people are unaware that excessive regular use of acetaminophen can lead to liver damage. Other prescription and non-prescription pain relievers can have serious side effects, as well.

Clinical research has shown that regular daily supplements containing omega-3 fatty acids and an extract from the New Zealand green lipped mussel can provide effective osteoarthritis pain relief, without any detrimental side effects.

The University of Maryland's Medical Website states:

"Similarly, New Zealand green lipped mussel ( Perna canaliculus ), another potential source of omega-3 fatty acids, has been shown to reduce joint stiffness and pain, increase grip strength, and enhance walking pace in a small group of people with osteoarthritis."

Omega 3 occurs naturally in the diet, but most people do not obtain the proper balance of omega 3 to omega 6 fats through diet alone. The immune system uses omega 6 fats to create compounds that increase inflammation, while omega 3 is used to make compounds that decrease inflammation.

In addition to providing osteoarthritis pain relief, omega 3 fatty acids may prevent further deterioration of the cartilage cushions. Laboratory research has shown that omega 3s inhibit the activity of enzymes that destroy cartilage.

Long considered a natural part of the aging process, it now appears likely that symptoms of osteoarthritis may be avoidable. Although heredity may be a factor, maintaining a healthy weight, participating in regular moderate physical activity and increasing intake of omega 3 fatty acids, reduces the risk of developing the disease.

Osteoarthritis of the Knee - Why Does Hydrotherapy Help?

The main difficulty facing arthritis sufferers is that they are told exercise will help but exercise very often increases their pain. Our natural instinct to avoid pain makes us more likely to do less activity, resulting in weaker muscles that don't support our joints.

To break out of this cycle you need to exercise these supporting muscles to make them stronger. The pay-off is less pain but the road is not easily travelled. The most difficult part is getting started. There needs to be a bit of 'trial and error' - gently testing various exercises until you stumble across one that lets you fatigue the muscles without aggravating your knee pain. The best way to do this is to seek the advice of a physical therapist. If the co-pay remains too expensive, there is no reason why you can't have a go yourself. You will need to do your research and find as much information as you can on the subject. There are also some inexpensive books covering this subject.

Why the pool?

Osteoarthritis is primarily a disease of weight-bearing joints. Being in water helps you eliminate or greatly reduce the load on your joints. This allows some exercises to be pain-free in water that would otherwise aggravate you knees.

Purpose built hydrotherapy pools are heated. Heat helps combat stiffness in joints (but remember it can aggravate some inflammatory conditions). The combination of gentle exercise and heat can help lower pain levels. Remember though - just because you don't have access to a heated pool doesn't mean you can't benefit from this type of exercise. Any body of water takes weight off your joints.

The pool also allows you to start very gently. A common reason for people giving up on exercise is that they start too fast, too soon. This causes a flare up and the natural response is "I'm not doing that again......I could not walk for days"

Start in chest high water and walk some laps. If this doesn't bother your knees before or after, add some shallow squats. No two knees are the same so its up to you to learn about your knees and take control of  your arthritis.

Arthritis Treatment: How to Treat Osteoarthritis of the Thumb

One of the most common areas for the development of osteoarthritis (OA) is the base of the thumb.

This joint is called the carpo-metacarpophalangeal joint. It consists of a bone in the wrist called the trapezium that forms a shallow groove or saddle in which the base of the metacarpal bone (thumb bone) rests. Each of these bones is covered with a layer of hyaline cartilage.

This joint is particularly prone to developing OA because of its extreme mobility (one of the most mobile joints in the body) as well as the forces it must withstand during the course of a day's activity.

It has been estimated that the force multiplier effect is about 12 times the actual force applied by the thumb. Over a long period of time this causes the cartilage to undergo wear and tear. This wear and tear is complicated by the presence of local inflammation which accelerates the destruction of cartilage.

Prior injuries to the joint or to the ligaments supporting the joint also can make it more prone to developing OA.

OA at this site is more common in women than men. (Callinan N. Arthritis Self-Management.2011; 12: 8-15)

The diagnosis is made clinically and supported by x-rays. There is poor correlation between symptoms and extent of disease.

While early management consisting of medication, hand therapy, joint protection and exercises can be of assistance, the course of the disease in this location is inexorably downhill.

Thermal modalities such as ice or heat may help. One method of delivering heat is a paraffin (hot wax) bath.

Hand stretching and strengthening exercises under the supervision of a hand therapist may offer temporary respite.

Splints can also offer a modicum of relief.

Non-steroidal anti-inflammatory drugs (NSAIDS) or oral analgesics can help in milder cases. However, their effectiveness is limited by their potential toxicities. Topical NSAIDS may be helpful and cause less overall toxicity.

Patients may require injections with either corticosteroids or viscosupplements. These injections should be done using ultrasound guidance and be followed by at least three days of splinting to rest the joint. No more than three corticosteroid injections should be administered per calendar year.

Arthroscopic debridement followed by viscosupplementation has been demonstrated to be of some benefit. (Wei N, et al. J Clin Rheum. 2002; 8: 125-129).

End stage disease will require surgery.

A hand surgeon will use a tendon from the forearm to act as a spacer inside the joint. Less commonly, the joint may require fusion.

Arthritis: The Cause of Joint Replacement Surgery

When searching for the main causes of joint replacement surgery, different types of arthritis come up time and again. If it's Osteoarthritis or Rheumatoid arthritis, these main types of arthritis are the leading causes for joint replacement surgery, mainly hip, knee or wrist.

Joint replacement surgery is performed when all other treatments have failed to help the patient and the pain has become intolerable, or he can no longer function normally on a daily basis. Patients reach this situation when the cartilage, which serves as a protective cushioning between two or more bones, becomes damaged and the tissues around the joint become inflamed. With time, the cartilage wears away, allowing the bones to rub against each other.

As mentioned, surgery is never the first option in case of joint arthritis. The patient will first be treated with pain medication, physiotherapy or special activity exercises. Only when these are no longer efficient, will the orthopedist bring up the surgical options.

The most common type of arthritis that leads to joint replacement surgery is Osteoarthritis. Also known as 'degenerative arthritis', osteoarthritis referrers to the degradation of the joints (mainly hip, knee, wrist and spine) and can cause them to swell up, become red, stiffen or become more tender. These symptoms usually appear gradually. Osteoarthritis is caused mainly by the aging process but can also be triggered by injury or obesity.

Another main cause for joint replacement surgery is Rheumatoid arthritis, a chronic inflammation disease. This is an auto-immune disease mainly targeting the lining of the joints. This kind of arthritis usually causes stiffness and swelling while the inflamed lining can invade and damage bone and cartilage.

It is important to know that people live with arthritis and successfully manage the main with combined types of treatments. When it comes to rheumatoid arthritis, there are even encouraging statistics showing that small numbers of patients go into remission in the first stages of the disease. However, when symptoms start affecting the patient's day-to-day life and keep him from functioning normally, it is recommended they undergoes surgery.

The term 'Joint Replacement Surgery' incorporates different types of surgery. The main types include knee and hip replacement but the term also referrers to wrist, ankle, foot, shoulder and elbow replacement surgery. The extent of your surgery will depend on the extent of the problem and severity of the arthritis.

In a hip replacement surgery, there is a total hip or partial hip replacement, also known as Hip Resurfacing, in which only part of the joint is replaced. When there is arthritis in the knee, if not severe the orthopedic may suggest a torn meniscus surgery or knee arthroscopy (relatively minor surgeries). If the arthritis is severe, a Partial Knee Replacement operation - also might be the solution. This less invasive knee replacement requires decreased healing time and is considered less painful. The total knee replacement includes the complete removal of the entire cartilage; the partial replacement removes only the damaged area of the cartilage. The rest of the joint replacement surgeries basically have similar options of partial and total joint removal and replacements.

When consulting your orthopedic specialist about surgery, it is important to not rush in to the operation without making sure you have tried all other non-surgical treatments, what type of procedure is recommended and why and how will this specific procedure help the problem.

Osteoarthritis and Loss of Joint Mobility Due to Breakdown of Cartilage

Nearly everyone, over the course of their lives, will experience some sort of joint pain. Chronic pain in the form of osteoarthritis is the mot common disorder affecting the joints and is nearly universal in people over the age of 80. For this reason, it is important that people know the symptoms of this degenerative disease, as well as some of the methods that doctors use to reduce pain and keep the joints healthy.

While osteoarthritis is common in people over age 80, it begins to manifest itself in people who are in their 40s and 50s. Below the age of 40, it is mostly men who have the degenerative joint disease and it is usually related to some sort of traumatic experience. From ages 40 to 70, though, it is mostly women who have osteoarthritis. By the time people hit their 80s, however, the distribution is even between men and women.

Osteoarthritis is referred to as a degenerative joint disease due to the loss of cartilage protecting the bones in the joints and the changes this loss of cartilage leads to. Pain in the joints, stiffness when using the affected joints, and occasional swelling are some of the symptoms indicating a potential loss of cartilage. It can begin with trauma, inflammation, or defects in the way the body makes and breaks down cartilage.

The end result of any of the causes of osteoarthritis, though, is that the protective cartilage breaks down and the bones become exposed and are able to rub up against each other when a joint is moved through a range of motion. Osteophytes, also known as bone spurs, can develop on the affected bones in an effort to maintain the stability of the joint. Ligaments and tendons can also become irritated and inflamed, and the muscles can get weaker, leading to further instability.

For older people, osteoarthritis of the spinal column can be a major problem. While the risk of herniating a disc lessens as people age, the risk of arthritis causing serious back pain increases. Osteoarthritis of the vertebrae can increase the chances of damaging the ligaments. Ligament damage in the back can be debilitating and can take months or years to heal fully.

A back doctor should evaluate anyone who has potential osteoarthritis of the spine, and x-rays can confirm the degeneration of the cartilage in any of the joints most affected. If the disease is suspected or confirmed by x-rays, it then becomes important to maintain joint function, range of motion, and the health of the cartilage protecting against bone rubbing on bone. Stretching and flexibility exercises can be used to mitigate the loss of mobility.

Various treatments can be used for reducing pain from osteoarthritis, including massage, acupuncture, and topical ointments to reduce pain and swelling. In extreme cases, surgery and total joint replacement may be used if all else has failed. Supplements such as MSM and glucosamine and chondroitin, if given enough time to work, may help reduce the rate of cartilage breakdown in some individuals.

Is Osteoarthritis Part of Metabolic Syndrome?

Osteoarthritis is the breakdown of cartilage, a spongy protein that covers the ends of the bones within a joint. Normal cartilage helps with shock absorption by serving as a cushion at the ends of the bones. The cartilage as the fluid within the joint allows for smooth joint movement. As osteoarthritis progresses, the space between the bones narrows, the cartilage wears down and the underlying bone is exposed. This results in painful movement of the joint as well as limited motion. Bone spurs can develop around the joint, limiting motion further and contributing to more pain. Inflammation plays only a minor role in osteoarthritis.

There are many causes of osteoarthritis, the most well known is the aging process. As we age, the water content of cartilage increases and the protein content decreases. As the water content increases, the cartilage becomes softer, more permeable and loses it's mechanical properties. The protein content decreases which contributes to slow degeneration of the cartilage, resulting in flaking and erosions.

Other causes of osteoarthritis include abnormal bone alignment. In the foot, the most common cause is faulty foot mechanics. When the foot is not in alignment and not functioning properly, this causes abnormal stress on joints in the foot, ankle, knee, hip and back. Trauma is a well known cause of arthritis. Direct trauma can disturb the joint structures, cause mal-alignment of the joint or cause weakness of the surrounding structures, resulting in instability of the joint and eventual osteoarthritis. Other causes, such as infection, medications (such as steroids) and genetics contribute to the development of arthritis.

Obesity is a common cause of arthritis. The exact mechanism of how excess weight influences osteoarthritis is unclear. Although the excess load placed on joint surfaces will accelerated the breakdown of cartilage, obesity is also correlated with osteoarthritis of the hand, indicating a more systemic cause. Obesity increases the chances of having metabolic syndrome. Metabolic syndrome is a condition characterized by a set of risk factors which are linked to coronary artery disease, stroke and type 2 diabetes. The risk factors include high blood pressure, abdominal obesity (fat around the waist), abnormal cholesterol levels (such as high triglyceride levels & low HDL levels) and insulin resistance (which corresponds with high blood sugar). The underlying theories of metabolic syndrome are tied to the body's metabolism, most likely insulin resistance. Insulin resistance is the cells inability to efficiently use insulin, a hormone which transports sugar from the bloodstream to the cells. The result is high blood sugar. Insulin resistance is correlated to weight gain and inactivity.

In a recent study in the journal Skeletal Radiology, popliteal artery wall thickness was evaluated in individuals with osteoarthritis. Forty-two patients who were diagnosed with osteoarthritis at multiple joints were compared to 27 patients without osteoarthritis (the control group). An MRI of the knee was used to evaluate vessel wall thickness of the popliteal artery. The osteoarthritis group had thicker vessel walls than the control group, even when the researchers made adjustments for gender, weight and age. Because vessel wall thickness is directly related to high blood pressure and peripheral and coronary artery disease, the authors suggest that osteoarthritis might be another facet of metabolic syndrome.

One theory to explain the link between osteoarthritis and metabolic syndrome is based on white blood cells, immune fighting cells, increasing in areas where fat accumulates, especially around the abdomen (abdominal obesity). As the white blood cells increase, they contribute to widespread inflammation in the body, causing a pro-inflammatory state (as indicated by high blood levels of C- reactive protein) and the production of immune chemicals (specifically cytokines) which cause a chain reaction resulting in damage to the cartilage. The combination of insulin resistance and the pro-inflammatory state may also affect the normal cartilage repair process.

It is possible that osteoarthritis might be an inevitable outcome for those with metabolic syndrome.

Kornaat PR et al. Positive association between increased popliteal artery vessel wall thickness and generalized osteoarthritis: is OA also part of the metabolic syndrome? Skeletal Radiol. 2009 Jul 3.
Rojas-Rodríguez J, et al. The relationship between the metabolic syndrome and energy-utilization deficit in the pathogenesis of obesity-induced osteoarthritis. Med Hypotheses. 2007;69(4):860-8.
Cicuttini FM, Baker JR, Spector TD: The association of obesity with osteoarthritis of the hand and knee in women: a twin study. J.Rheumatol. 1996; 23:1221-1226.
Felson DT: Weight and osteoarthritis. J.Rheumatol. 1995;43:7-9.
Armstrong CG, Mow VC. Variations in the Intrinsic Mechanical Properities of Human Articular Cartilage with Age, Degeneration, and Water Content. JBJS. 1982; 64:88-94.

Osteoarthritis - Treating a Degenerative Knee Problem - The Condition That Will Try to Slow You Down

Do you ever have pain from Osteoarthritis (OA) or another degenerative knee issue?

Osteoarthritis (OA) and other knee problems that are degenerative in nature are not typically an emergent condition. Degenerative issues can still be very difficult knee problems to deal with, that can cause devastating discomfort and gets increasingly worsen as time goes on. Unfortunately, in a severe case, the knee joint can become increasingly deformed as misalignment issues perpetuate and this can hurt someone's ability to move.

1.) Signs & Symptoms of Degenerative Knee Problems

A.) Discomfort in the knee joint while moving about about or standing in a fixed position B.) A Stiff Knee C.) An increase in fluid at the knee joint

These signs typically bring an individual who is having trouble due to Osteoarthritis (OA) to the physician as the throbbing gets worse and your ability to move becomes more and more difficult.

2.) How Will Your Doctor Diagnose A Degenerative Knee Joint Condition

Your medical doctor will validate if you have OA (Osteoarthritis) after reviewing X-Rays of your knees. A physician will typically avoid making a clinical diagnosis of OA (Osteoarthritis) just from understanding your symptoms, because OA can be like other conditions as well. Once the diagnosis of Osteoarthritis has been realized, then you both can discuss various treatment methods for Osteoarthritis.

3.) Some Helpful Treatment Options

Management for this problem can include over the counter pain medications to donning a knee well designed brace when your pain gets out of hand, to going in and having a knee replacement surgery. The management of Osteoarthritis will depend upon the healthiness of the specific individual, how old they are and the development of the disease.

A.) Use of Cortisone

While cortisone injections can really help for decreasing the pain, but the problem is that the relief does not last forever. With these injections, you will most likely expect to get relief from the pain for a few days to a couple weeks. Sometimes it is more than a couple weeks, but not always. These cortisone shots are not inexpensive and will require for you to visit your physician on a routine basis.

B.) Knee Braces For Support and Pain Reduction

Sometimes, if a person has a medial compartment style of Osteoarthritis then can really benefit from the use of an unloader style knee brace. These low profile, light weight braces can help to bring the leg into improved alignment and can help to reduce pain while improving your stability at the same time.

If a person suffers from arthritis or another degenerative knee ailment in general, then a brace can also help this person as well. It is good to talk to your knee brace provider about your different options.

5.) Self Diagnosis

We do recommend that you speak to your physician about medical advice. This information is health oriented, but we can not take the place of your physician.

Got Osteoarthritis? Don't Worry, So Does Everyone Else Your Age

Osteoarthritis is a recurring disease caused by the deterioration of joint cartilages. It is actually the most common form of arthritis. The deterioration is mainly due to the years of wear and tear of the joints where the body's ability to form new bone margins between bone connections and cartilages have significantly decreased. Osteoarthritis is common in the phalanges and other joints found in the knees and hips.

As a common joint disease, osteoarthritis is widespread for both males and females. Typically, this disease starts to appear at the age of 40 and may get worse as one gets older. In a number of cases, osteoarthritis can cause serious handicap to people as it can decrease the dexterity of the fingers or toes and the mobility of hips, knees and elbows; in fact, osteoarthritis is second only to heart ailments when it comes to work-related disabilities.

Symptoms of osteoarthritis include deep pain in the joints especially after heavy exercise or excessive movement. However, the pain can subside after ample rest. If you suffer from osteoarthritis, you may also experience stiffness in the joints during the morning and after doing heavy exercise. And hearing or feeling that your joints are grating as you move can be considered normal if you have osteoarthritis.

The bad news about osteoarthritis is that it could be permanent as there is no known cure for it. However, there are many ways to relieve its symptoms. Medical attention pertaining to this disease is focused on soothing the pain that accompanies it. As of the moment, the most effective approach to relieving the osteoarthritis pain is to take oral pain pills. Some topical creams are also used to help alleviate pain.

Then, if ordinary analgesic and topical creams are not enough, anti-inflammatory drugs without steroidal derivatives can also be used. For extreme cases, injections with non-sulfated form of polysaccharides, a type of complex carbohydrates, can help in lubricating connective tissues like your aging joints. A process called visco-supplementation together with other surgical treatments, have increasingly become popular especially for osteoarthritis in the knees. But remember, all these measures just deal with the pain and in no way can these cures improve the principal disease which is osteoarthritis.

Instead of totally depending on synthetic medication, osteoarthritis sufferers must also aim to lose weight and do regular exercises. Weight can be a major factor in the overall wear and tear of joints, while adequate exercise can improve the strength of most connective tissues. As for your exercise, you can also add yoga movements. The twists and turns that are characteristic of yoga are proven to build flexibility and strength to connective tissues, plus they can also put a stop to stiffness in your muscles and joints.

Other pain solutions include alternative approaches. Foremost among the alternative means of relieving osteoarthritis pain is acupuncture. In acupuncture, small needles are inserted into certain points of the body. When these points are stimulated, the flow of energy in the body becomes more efficient, thereby releasing substances like serotonin and endorphins which can soothe osteoarthritis pain among other things.

Finally, don't forget traditional hot and cold compress. Rotating hot pads and ice packs on your aching joints can also provide some remedy for osteoarthritis pain. This is similar to the way athletes take care of their injuries sustained in a match or training session. Although the effects can be short-lived, hot and cold compress sure beats grinding your teeth in pain.

If you are suffering from osteoarthritis, you should consult with your doctor. You can also use supplements like Phosoplex to relieve the pain and put you back in motion. For more information about this product, you can visit Phosoplex.com.

Winning the War on Osteoarthritis Joint Pain

Osteoarthritis is the most common type of arthritis, affecting about 21 million Americans. This degenerative disease causes limited range of motion in the affected joints and can affects the most basic of daily activities. In the worst cases, osteoarthritis results in debilitating pain.

Unlike other forms of arthritis, which are genetically linked, osteoarthritis affects people of every race, age and gender... athletes and couch potatoes alike. Despite the seemingly random nature of osteoarthritis, there are certain risk factors for developing the disease. Injury, aging and overweight all contribute to one's risk. Athletes, such as soccer and tennis players, are particularly susceptible to developing osteoarthritis due to the abnormal wear and tear on the weight bearing joints of their bodies.

Because of the progressive nature of osteoarthritis, continued use of the damaged joints causes the damage to worsen and pain to increase. Identifying osteoarthritis early can mean the difference between a lifetime of manageable or excruciating pain. Moreover, while it is possible to identify osteoarthritis early, it is impossible to cure the condition... this is why early detection and treatment are so vital.

In most cases, osteoarthritis develops over time and the pain is not constant. You may experience a stiff joint at first - particularly when rising from sleep or after prolonged periods of sitting. Perhaps your knee "gives out" when walking down stairs or crouching down. These could be signs of osteoarthritis.

The most important advice you may receive is to NOT ignore the pain and assume it will "just go away." If it is, indeed, osteoarthritis, the pain will not decrease with time. Taking action NOW is key to managing pain and keeping yourself healthy.

The first course of action many people take is over-the-counter or prescription anti-inflammatory medications, called NSAIDs. These popular medications are advertised as cure-alls for whatever ails you, but they do not come without risks. From gastrointestinal upset to stroke, for some patients the treatment is worse than the disease! In fact, NSAIDs do nothing more than decrease inflammation temporarily. As the patient continues to use the medications, a larger dose is required to achieve a minimum level of relief.

There is another option for osteoarthritis suffers wanting immediate and lasting relief. With a lot of medical practitioners onboard now, more and more people are turning to natural supplementation that has proven itself effective over and over again - glucosamine and chondroitin.

To understand why glucosamine and chondroitin supplementation are so effective, it is important to understand what happens in a joint affected by osteoarthritis. Another name for osteoarthritis - wear-and-tear arthritis - gives some clue - the repeated use of a joint, "wear and tear," wears away the cartilage cushion in affected joints. The cartilage is worn away too quickly to be replenished and inflammation results as the bones make contact with each other.

Whereas NSAIDs provide only temporary relief by decreasing inflammation, supplementation with glucosamine and chondroitin gives temporary and long-lasting relief. How? By giving the affected joints a booster shot of sorts with the very molecules needed to replenish damaged cartilage - glucosamine and chondroitin.

Osteoarthritis and Chiropractic

It is a common notion that osteoarthritis comes with aging but it is not like that. It has been observed that older people are not necessarily sufferers of osteoarthritis and it is not necessary that they will have to suffer the pain. Even someone young can develop this problem.

OA or osteoarthritis is more common in women than men and affects around 20 million Americans. It is also known as the degenerative joint disease. The slippery tissue that meets in a joint towards the end of the bones is known as the cartilage. In OA, the cartilage is affected. The main function of the cartilage is to help the bones to glide over one another. In case of OA, the cartilage does not work properly and breaks down. Due to this, the bones do not glide and just rub against each other which results in pain, swelling and loss of motion. Recent researches have shown that OA is not due to aging although the general observation of OA is in people above the age of 65 years. Various factors contributing in OA are lack of exercise, joint injuries, family history of OA and overweight.

In order to diagnose osteoarthritis, there are patient examination, x-rays and clinical history that need to be taken care of. Tests like drawing fluid from the joint are at times performed. Continuous pain in the joint, stiffness in the joint after sleeping,sitting or not moving for a long period of time, swelling in the joints or a crunching feeling when the bones rub against one another are some of the symptoms of osteoarthritis.

In order to treat or even prevent osteoarthritis, exercise is an important thing to do. It results in strengthening of muscles around the joints and provides proper functioning and moving of the joints. The key factors that affect the seriousness of the symptoms are the patient's mood and outlook. Exercise helps in improving that and the weight of the patient as well.

Chiropractors have a good knowledge about the symptoms and treatment of OA. They can determine the effect of degenerative changes in the spine, knees, hips and other joints that can get affected. They can help the patient reduce the pain and get the condition back to normal. With the various methods that are available, chiropractors can help the patient achieve long term relief. So, consult your chiropractor in case you think you are suffering from OA and can notice the symptoms.

Degenerative Osteoarthritis - The Best Pain Relief Measures

Degenerative osteoarthritis is an agonizing condition that is suffered by millions of people all over the world. However, though potentially debilitating, the disease can actually be treated the natural way. Read on to understand more about this form of arthritis and the remedies that can alleviate the symptoms of this disease.

Degenerative osteoarthritis is one of the most common forms of arthritis. At the moment there is no permanent cure to treat this condition, which is also known as degenerative joint disease. However, with early diagnosis, proper treatment and a program of regular exercise and weight strengthening, the pain associated with it can be significantly reduced.

Degenerative joint disease is most commonly suffered by the elderly, as it is considered to be an inevitable process of aging. Eventually it is something that can affect by all of us. Although the cause of the disease can not be pinpointed to one factor, it is often thought that obesity and excess weight are some of the main culprits. This is backed up by recent research that demonstrated that even a modest decline in weight could improve the mobility of the joints and reduce pain in the knees and hips.

As for its prevention and treatment, increasing the intake amount of Omega 3 fatty acids in the form of fish oil supplements is highly recommended. After all, Omega 3 is an excellent anti-inflammatory substance that can help reduce pain caused by the disease. Fish oil supplements can also prevent more damage from occurring in the cartilage. Consuming Omega-3 fatty acids can also help the cartilage from thinning. This is especially useful to prevent age-related osteoarthritis, such as the degenerative type.

Taking fish oil supplements, which are rich in Omega-3 fatty acids, is one alternative remedy that you should definitely look into if you want to improve your condition. Not only will they help to reduce the symptoms of degenerative joint disease, but they will also improve your general health. Omega 3 fish oil supplements are good for the heart, brain, skin, digestive system and of course, your joints.

In addition to taking supplements, you should also eat fresh fish and mussels. One specific mussel that is highly rich is Omega-3 is the green lipped mussel. The anti-inflammatory properties in these mussels have been shown to reduce pain and joint stiffness in your body. A combination of eating fresh fish, green lipped mussels and taking fish oil supplements is the best remedy to combat the disease.

Make sure to include these Omega 3 rich foods as a part of your daily diet. For more great tips and ideas about the benefits of fish oil supplements, visit my website.

Arthritis Treatment: What's on the Horizon for Osteoarthritis Treatment?

Osteoarthritis is the most common form of arthritis affecting more than 30 million Americans. It is a disease of articular hyaline cartilage which covers the ends of long bones. The purpose of hyaline cartilage is to cushion and absorb the impact of both direct stresses and shearing forces applied to the joint.

Osteoarthritis affects primarily weight-bearing joints such as the hip, knee, low back, and neck. However, it can also involve the shoulder, ankle, base of the thumb, and base of the big toe.

Despite the focus of attention in rheumatology on newer therapies for diseases such as rheumatoid arthritis, there has been relatively little done to deal with osteoarthritis. This is unfortunate since osteoarthritis (OA) is a significant cause of pain, reduced mobility, reduced productivity, and diminished quality of life.

Between symptomatic therapies consisting of rest, physical therapy, analgesics, non-steroidal anti-inflammatory drugs (NSAIDS), injections of glucocorticoids ("cortisone") and viscosupplements, there is a void until the patient requires joint replacement.

I will discuss some of the "avant-garde" therapies that are being evaluated for treatment of OA.

The first treatment is the use of stem cells. Stem cells are blank slate cells, cells that can be coaxed to differentiate into any type of tissue cell. The focus of attention has been on the use of adult mesenchymal stem cells. Studies have demonstrated that when these cells are introduced into OA joints, that they are incorporated into the articular cartilage of the affected joint. While most investigations have been demonstrated in animal models, there have been small studies and multiple anecdotal reports indicating similar results in humans.

The second type of treatment that has been studied is the use of anti-cytokine drugs. Some feel that OA is a systemic disease that requires systemic therapies.

Cytokines, which are protein messengers, play a pivotal role in the generation and propagation of inflammation. One cytokine that may have a role in the chronic inflammation seen in OA is interleukin-1. Attempts to block the effects of this cytokine have been studied with mixed results. When given systemically it didn't perform much better than placebo. When given as an injection in a joint, there have been mixed results.

Another material that has been studied is botulinum toxin (Botox). It appears to have beneficial effects in regards to pain and inflammation. It has been used in OA of the knee as well as of plantar fasciitis.

Other therapies that have been studied include platelet-rich plasma (PRP), insulin-like growth factor, and bone morphogenic protein. Results are controversial.

The Pathophysiology of Osteoarthritis - What Causes It?

The main cause of Osteoarthritis is an imbalance in the natural breakdown and repair process that occurs with cartilage. In Osteoarthritis, damaged cartilage cannot repair itself in the normal way.

It occurs when the cartilage that covers and cushions the ends of bones in your joints deteriorates over time. Cartilage is composed of water, collagen, and specific proteins. In healthy cartilage, there is a continual process of natural breaking down and repair of the cartilage in joints. This process becomes disrupted in Osteoarthritis, leading to cartilage deterioration and an abnormal repair response. The reason this normal repair process is disrupted is not known but it is likely caused by several factors.

With aging, the water content of the cartilage increases, and the protein makeup of cartilage breaks down.

Eventually, the smooth surface of the cartilage begins to deteriorate and become worn causing friction between the bones. If the Cartilage wears down completely; the result will be bone to bone contact. Repetitive use of worn joints over the years can irritate the cartilage, causing joint pain and inflammation of surrounding tissues. As pieces of cartilage break off, the bones thicken and broaden, causing inflammation. This inflammation may stimulate new bone outgrowths called spurs (also called osteophytes) to form around the joints. As the bones thicken and broaden, joints become stiff, painful, and may be difficult to move. Fluid may also build up in your joints.

An Imbalance:

An imbalance in the homeostatic process of the degradation and rebuilding phases of cartilage is believed to be the primary cause of OA. When joints engage in movement, the production of chondrocytes is stimulated in order to replace those cells lost in degradation. Prolonged disuse of joints causes changes in the makeup of the matrix of cartilage, ultimately resulting in a loss of joint function. Age-related changes in the composition of the matrix, decreased sensitivity of chondrocytes to stimulation and a loss of function of these cartilaginous cells all contribute to the development of OA in a joint.

Abnormal reparative processes and inflammation of the cartilage can lead to the formation of boney structures known as osteophytes or bone spurs, which replace normal flexible, functional cartilage. Inflammation can occur through the formation of osteophytes and through swelling that is associated with the inflammatory process, contributes to patient pain and discomfort.

Inflammation:

The most prominent inflammation, termed synovitis, presents in the form of warmth, swelling, and thickening of the fluid within the joint. Though laboratory testing has identified common signs of inflammation in some Osteoarthritic patients, not all patients with OA present with the inflammatory component of the disease.

Pain involving one or more joints is the most common complaint made by osteoarthritic patients to their physicians. The onset of pain in OA is insidious and its severity is mild to moderate. OA pain in less-advanced disease states is generally worsened with joint use and relieved by joint rest. However, patients exhibiting more advanced OA are more likely to complain of joint pain during rest and throughout the night. The degradation and loss of cartilage in the joint causes pain, as the weight-bearing joints are no longer cushioned at the junction of the two bones. The structural sources of pain include the synovial membrane, joint capsule, periarticular ligaments, periarticular muscle spasm, periosteum, and subchondral bone. The pain mechanism can be the result of one of the many abnormal features that can occur in OA. Possible mechanisms of pain in OA include: increased intracapsular pressure, pressure between bones, microfractures, effects of muscle wasting, and the structural changes within and around the joint.

Stiffness:

In addition to pain, stiffness is also a common symptom of OA. Stiffness associated with prolonged periods of immobility, as during sleep, often resolves within thirty minutes of joint use. The stiffness associated with OA is the result of abnormal joint function, and the effect that it has on the structures surrounding the joint. The duration of time for stiffness to resolve lengthens with progression of the disease. In addition to stiffness, patients may also present with crepitus, which is an often audible and palpable grinding between the bones of a joint, secondary to the increased contact between boney surfaces. Additional symptoms resulting from structural changes within the joint include a decreased range of motion in the affected joint, resulting in functional impairment.

Knee Osteoarthritis and Supartz Joint Fluid Therapy

Osteoarthritis is common in the knee joint. It is a disease that involves both biomechanical and biochemical factors that destabilize the cartilage matrix and cause pain, functional limitations, and disability. In the United States, it is the leading cause of disability and over 20 million people are affected by it.

Cartilage is a rubbery tissue at the end of bones which allows the joint to move easily. Normally, the knee contains lubricating substance called hyaluronan in the synovial fluid, a fluid which cushions your knee.

In osteoarthritis, there is not enough hyaluronan by which it can be hard to move your joints. The surface layer of cartilage breaks and wears away. The bones under the cartilage rub together, causing pain, swelling, and loss of motion of the joint. Over time, the joint may lose its normal shape.

Symptoms of Knee Osteoarthritis

The deterioration of cartilage occurs gradually and there may be no symptoms in the early stages of osteoarthritis. Symptoms may appear over time. These include:

• Knee stiffness especially in the morning

• Knee pain whether a person moves or not

• Crackling sound or grating feeling

• Red and swollen skin around the knee

Symptoms do not always correlate with the amount of damage to the joint and they may come and go for no apparent reason.

Risk Factors of Knee Osteoarthritis

Knee is vulnerable to pain, and a number of widespread risk factors are causing a rise in osteoarthritis of the knee. Some risk factors include:

• Aging

• Obesity

• Heredity

• Injury to the knee joint

• Lack of exercise or sedentary lifestyle

• Muscle weakness

• Overuse of the knee joint

• Skewed feet

• Wearing inappropriate footwear

How Supartz Therapy Can Help with Knee Osteoarthritis

Supartz Joint Fluid Therapy is a viscosupplement which is used as a nonsurgical and nonpharmacological treatment for osteoarthritis of the knee. It contains highly purified sodium hyaluronate, also known as hyaluronan or hyaluronic acid. Viscosupplements are designed to replace normal component of the joint involved in joint lubrication.

In five randomized, double-blind studies in patients with osteoarthritis of the knee Supartz injections were significantly more effective than phosphate-buffered saline control injections. The goal of Supartz Joint Fluid Therapy is to supplement the poor quality hyaluronic acid in your knee with additional highly purified hyaluronic acid. A course of Supartz therapy can help relieve pain, improve mobility, and get back to exercising, which is important for arthritic joints.

Most patients treated with Supartz therapy experienced minor to no discomfort during the injection. There is no definite treatment that can cure osteoarthritis, but with effective Supartz treatment and proper physician care, many people with osteoarthritis can have healthy and active lives.

Varus - What Does This Mean in Osteoarthritis of the Knee?

Doctors have very little time with each patient these days so it pays to be able to speak a little of their language. Of course you should always try and clarify any points you do not understand before making major decisions but this is easier said than done.

'Varus' is a term used by the medical profession to describe joints that form an angle different from the usual. It does not apply only to the knee. Varus means that the part of the body furthest away from the torso is angled towards the midline position. In simple terms, if the knees are described as varus, they are 'Bowlegged'

Varus knees indicate that the arthritis is mainly on the inside of the knee. If the doctor says your knees have become more varus between visits, the degenerative process is progressing.

Due to natural variation, knees come in a range of angles than can still be 'normal' for the individual. What is important is when the angle changes over time. This angulation can begin before the onset of other symptoms such as pain. When knees get to the stage that they require surgery, the good news is that surgeons can correct this angulation (up to a point). It is common for patients to have legs straighter after their operation than they have had for years.

It is also important to note that the initial stages of degeneration can occur very slowly over a number of years. As the disease process progresses however, there can be rapid advances in degeneration in relatively short periods of time with angulation increasing markedly in the knee.

Chiropractic Manipulation Helps Osteoarthritis of the Hip

Osteoarthritis of the hip is a common joint disorder, which can cause pain, inflammation, and stiffness. Age is a top contributing factor for the disorder. Other factors include family history, obesity, overuse, or a previous fracture or injury. Hip pain caused by osteoarthritis is often combined with stiffness, swelling, limited range of motion, and difficulty walking or sitting for extended periods of time.

Positive lifestyle changes can help reduce the symptoms associated with osteoarthritis. Maintaining a healthy diet and weight, getting ample rest, getting your alignment checked and exercising regularly can help limit your pain and stiffness. Exercise helps with strength and movement of the joints. Swimming is particularly beneficial since it can help improve strength and mobility of the joints but is non-weight bearing.

Chiropractic care for osteoarthritis of the hip has been studied and has been recommended as an effective treatment. In a major study, "Comparison of manual therapy and exercise therapy in osteoarthritis of the hip: a randomized clinical trial," researchers compared the effectiveness of chiropractic mobilizations and manipulations of the hip joint with an exercise only program (no manipulations or mobilizations).1 The study followed more than one hundred patients with osteoarthritis of the hip in a single-blind, randomized clinical trial. Half of the participants received the chiropractic manual therapy and the other half received the exercise program. Success rates for the manual therapy group were 81% compared to only 50% for the exercise group. "The manual therapy group had significantly better outcomes on pain, stiffness, hip function, and range of motion."1

The research showed that while exercise can be beneficial for patients with osteoarthritis of the hip, that manual therapy provided by a chiropractor is superior to exercise alone and can greatly improve a patient's quality of life.

Chiropractic is a natural form of healing that uses manual therapies (commonly adjustments) and other physiotherapy modalities. A chiropractic adjustment is one of the most common forms of manual therapy used by chiropractors. In this study, adjustments were made to the hip and spine (manipulation or mobilization). A manipulation is a high velocity action performed with specific, directed force, which helps to move the joint beyond the patient's passive (or resting) range of motion to achieve its full range of movement. Mobilization is a low velocity action applied within the patient's normal (active) range of motion.

Chiropractic adjustments are intended to restore proper body alignment, range, and quality of motion. The patients in this study who received the adjustments experienced a better outcome in managing their hip pain. Further, more than six months after the adjustments, the patients were still experiencing the positive benefits of the manual therapy, suggesting the long- term effects of the therapy.

Chiropractic care is a safe and cost effective alternative to surgery. While some patients with osteoarthritis of the hip will inevitably need surgery, it is well worth the effort to a visit to a chiropractor first. Hip adjustments by a chiropractor may help you avoid or at least delay the need for surgery.

References
1. Hoeksma HL, Dekker J, Ronday HK, et al. Comparison of manual therapy and exercise therapy in osteoarthritis of the hip: a randomized clinical trial. Arthritis Rheum. Oct 15 2004;51(5):722-729.

Valgus - What Does This Mean in Osteoarthritis of the Knee?

'Valgus' is a term used by the medical profession to describe joints that form an angle different from the usual. It does not apply only to the knee. Valgus means that the part of the body furthest away from the torso is angled away from the midline position. In simple terms, if the knees are described as valgus, they are 'Knock-kneed.'

Valgus knees indicate that the arthritis is mainly on the outside of the knee. The wearing down of the cartilage lining on the outside of the knee has led to a change in the angle through the joint. The terminology a doctor would use would be to describe being knock-kneed as having a valgus deformity, or the latin phrase 'genu valgum.'

Doctors approximate the angle of deformity to assess the progression of the degenerative joint disease. Please note: there is natural variation between individuals, with some having a larger angle through the knee than others. The change in angle is the important factor.

When a knee becomes so painful that surgery is the only option, the good news is that in most cases the surgeon can correct any angulation. It is not uncommon for patients to have a straighter knee after their operation than they have had for years.

As is common in osteoarthritis, it is important not to focus too much on factors such as joint angle - after all it is just a measurement. Symptoms, particularly pain, generally take priority in the decision making process. It is wise to seek an expert opinion however, as on some occasions, large deformities make surgical intervention more difficult than usual.

Arthritis Treatment: How Does Osteoarthritis Develop?

Osteoarthritis is the most common form of arthritis affecting almost 30 million Americans. It is a disease that affects articular cartilage, the tough cushiony material that caps the ends of long bones within a joint.

In addition to gradual loss of articular cartilage, there is thickening of the bone underlying the cartilage and growth of spurs, called osteophytes. Also, chronic inflammation of the synovium the lining of the joint also occurs.

Cartilage consists of a matrix that is made up of proteoglycans and collagen. Within this matrix is a second component, chondrocytes, which are cartilage cells.

While osteoarthritis is not absolutely due to aging, it is definitely associated with it. Over time, cartilage begins to develop small cracks, called "fissure." These are basically stress fractures of the cartilage. The development of fissures is accompanied by an alteration in matrix chemistry so that the strength and load bearing properties of cartilage start to wane. Essentially, the cartilage loses its water content, the physical properties of cartilage change, and fewer chondrocytes are present, and therefore less matrix is created.

The development of osteoarthritis is frequently broken up into three major phases. The first phase consists of edema or swelling of the matrix. Small cracks appear, and there is disorganization of the chondrocyte population. This happens because the chondrocytes no longer manufacture good quality matrix. The strength and elasticity of cartilage begins to fail. There is a pronounced imbalance between cartilage synthesis and cartilage degradation. This is caused by the chondrocyte behaving abnormally and manufacturing destructive enzymes called proteinases. These proteinases degrade matrix.

The second phase is characterized by extension of these fissures. They become deep cracks and the underlying bone also starts to crack.

The third phase is when cartilage pieces begin to flake and break off. Underlying bone is exposed and the bone develops cysts, and becomes harder- the term used is "sclerosis." Osteophytes- bony spurs- form.

In addition, the lining of the joint capsule, the synovium, becomes inflamed. The inflammation of the lining is due to small pieces of cartilage being gobbled up and recruiting inflammatory cells to help break down these pieces. The inflammatory cells cause the production of cytokines. These are protein messengers that promote inflammation.

Another feature that complicates the picture more is that with cartilage loss, there are biomechanical factors involved. Forces involved in cartilage compression, shearing, and other stresses cause further cartilage abnormalities.

So... there is a complex interaction involving multiple "players" that causes osteoarthritis.