Osteoarthritis Risk Factors, Causes, Treatment and Supplements  2013

What is Osteoarithritis?
Osteoarthritis, a consequence of aging, is a chronic disease of the joints leading to spurring of bone, pain and
decreased mobility and function. Osteoarthritis is also called degenerative joint disease.

Osteoarthritis is related to a breakdown of cartilage in joints; it commonly occurs in the hips, knees and spine. Its main
symptoms are pain and morning stiffness, which usually worsens with exercise.

Osteoarthritis Risk Factors
Although osteoarthritis becomes more common with age, younger people can also develop it, usually as the result of a
joint injury, a joint malformation, or a genetic defect in joint cartilage. Both men and women have the disease. Before age
45, more men than women have osteoarthritis; after age 45, it is more common in women. It is also more likely to occur in
people who are overweight and in those with jobs that stress particular joints. [21]
_____________________________________________________________________________________________
What is cartilage?
Cartilage is a firm, rubbery layer on the ends of bones in healthy joins. It reduces friction in the joints and absorb "shock".

Cartilage contains a lot of water. When pressure is applied (e.g. standing or walking), some water from cartilage enters
the joint and coats coats the cartilage. When the pressure is removed (e.g. sitting), the water reabsorbed and the
cartilage regains its normal shape. In osteoarthritis, the cartilage may wear away in some areas causing bones rubbing
against each other in a joint.

To function as a shock absorber, cartilage is made up of four substances" collagen, proteoglycans, water and
chondrocytes. Collagen is a macromolecule to provide a framework to house other components inside the cartilage.
Proteoglycans contains protein and sugar. Proteoglycans are hydrophilic and they trap water in cartilage. Chondrocytes
are the cells producing new collagen and proteglycans in cartilage. These cells also release enzymes to break down old
collagen and protesoglycans.
______________________________________________________________________________________________
Treatments

People with osteoarthritis are always advised to start a gentle program of exercise to improve joint function and avoid
any vigorous activities such as soccer and basketball
. It may also be helpful if they take glucosamine alone, or a
combined with chondroitin daily for pain and to protect joints. If needed, patients are always suggested to have weight
loss.

Exercise
Exercise is one of the best treatments for osteoarthritis. Exercise can improve mood and outlook, decrease pain,
increase flexibility, strengthen the heart and improve blood flow, maintain weight, and promote general physical fitness.
Exercise is also inexpensive and, if done correctly, has few negative side effects. Walking, swimming, and water aerobics
are a few popular types of exercise for people with osteoarthritis, but patients must discuss with their medical doctor(s)
before practicing an exercise. Here is an outline of the advantages associated with certain types of exercise:

1. Strengthening exercises. These exercises strengthen muscles that support joints affected by arthritis. They can be
performed with weights or with exercise bands, inexpensive devices that add resistance.
2. Aerobic activities. These are exercises, such as brisk walking or low-impact aerobics, that get your heart pumping and
can keep your lungs and circulatory system in shape.
3. Range-of-motion activities. These keep your joints limber.
4. Balance and agility exercises. These help you maintain daily living skills. [21]

Weight Control
Osteoarthritis patients who are overweight or obese should try to lose some weight. Weight loss can reduce stress on
weight-bearing joints, limit further injury, and increase mobility. [21] A healthy diet and regular exercise help reduce
weight. Patients such discuss with their medical doctors for an appropriate meal plan.

Rest and Relief from Stressed Joints
Treatment plans include regularly scheduled rest. Patients must learn to recognize the body’s signals, and know when to
stop or slow down. This will prevent the pain caused by overexertion. Some people find relief from special footwear and
insoles. They may use splints or braces to provide extra support for joints and/or keep them in proper position during
sleep or activity. However, splints should be used only for limited periods of time because joints and muscles need to be
exercised to prevent stiffness and weakness. [21]

Heat and Cold Applications
Heat or cold can be useful for joint pain. Heat can be applied in a number of different ways—with warm towels, hot packs,
or a warm bath or shower—to increase blood flow and ease pain and stiffness. In some cases, cold packs (bags of ice or
frozen vegetables wrapped in a towel), which reduce inflammation, can relieve pain or numb the sore area. [21]
(However, once I got knee injury, and I applied heat applications. It ended up knee swelling (oedema). )

Transcutaneous electrical nerve stimulation
This is a technique to give a direct mild electric pulses to the nerve endings as to kill the pain.

Massage
A massage therapist will lightly stroke and/or knead the painful muscles. This may increase blood flow and bring warmth
to a stressed area. However, inexperienced therapist may worse the conditions.

Medicines
The common medications for osteoarthritis are pain killers, such as diclofenac (Voltaren) etodolac (Lodine), ibuprofen
(Motrin, Advil), indomethacin (Indocin), valdecoxib (Bextra) and celecoxib (Celebrex). OTC Products include
acetaminopen (Tylenol), aspirin (Bayer, Ecotrin, Bufferin), ibuprofen (Motrin, Advil) and naproxen (Aleve). However,
some of these medications are NSAIDs, NSAIDs come with lots of side effects, such as ulcers, bleeding, and perforation
of the stomach or intestine. Some painkillers are narcotics, such as odeine or hydrocodone, and they have strong side
effects to some users. Consequently, corticosteroid injections directly into the affected area have been used for specific
cases. Corticosteroid treatment, in general, is not for long term use. Consequently, supplements such as hyaluronic acid
substitutes are popular used for treating osteoarthritis.

Herbs and Supplements
The most commonly used supplements include boswellia [1], cat's claw [2], cayenne [3,4], chondroitin sulfate [5], ginger
[6],
glucosamine sulfate [7], SAMe [8, 9] and niacinamide (vitamin B3) [10-12]. Supplements that may be helpful include
cartilage [13, 14], methylsulfonylmethane [15], cetyl myristoleate [16], collagen [17], devil's claw [18], stinging nettle [19]
and
guggul [20], These supplements have been reported to be useful for treating osteoarthritis, however, most are
conducted in animals, it is unclear if the benefits can be repeated in our body. Further, the dosage form and composition
of the supplement products are always not the same as those in the studies.

The recommendations above are not comprehensive and are not intended to replace your doctor's advice. If you
have any question, you should consult with your doctor. DO NOT COPY TO OTHER WEBSITES OR BLOGS
____________________________________________________________________________________

References

1. Safayhi H, Mack T, Saieraj J, et al. J Pharmacol Exp Ther 1992;261:1143–6.
2. Piscoya J, Rodriguez Z, Bustamante SA, et al. Inflamm Res 2001;50:442–8.
3. McCarthy GM, McCarty DJ. J Rheumatol 1992;19:604–7.
4. Altman RD, Aven A, Holmburg CE, et al. Sem Arth Rheum 1994;23(Suppl 3):25–33. 5. Kerzberg EM, Roldan EJA,
Castelli G, Huberman ED. Scand J Rheum 1987;16:377.
6. Srivastava KC, Mustafa T. Med Hypotheses 1992;39:342–8.
7. Houpt JB, McMillan R, Wein C, Paget-Dellio SD. J Rheumatol 1999;26:2423–30.
8. Schumacher HR. Am J Med 1987;83(Suppl 5A):1–4 [review].
9. Harmand MF, Vilamitjana J, Maloche E, et al. Am J Med 1987;83(Suppl 5A):48–54.
10. Kaufman W. Conn State Med J 1953;17(7):584–9.
11. Kaufman W. J Am Geriatr Soc 1955;11:927.
12. Hoffer A. Can Med Assoc J 1959;81:235–8.
13. Leeb BF, Schweitzer H, Montag K, Smolen JS. J Rheumatol 2000;27:205-11 [review].
14. McAlindon TE, LaValley MP, Gulin JP, Felson DT. JAMA 2000;283:1469-75 review].
15. Lawrence RM. Int J of Anti-Aging Med 1998;1:50.
16. Siemandi H. Townsend Letter for Doctors and Patients 1997;Aug/Sept:58–63.
17. Adam M. Therapiewoche 1991;38:2456–61 [in German].
18. Chantre P, Cappelaere A, Leblan D, et al. Phytomedicine 2000;7:177–83.
19. Randall C, Randall H, Dobbs F, et al. J R Soc Med 2000;93:305–9.
20. Singh BB, Mishra LC, Vinjamury SP, et al. Altern Ther Health Med 2003;9:74–9.
21.
Osteoarthritis, NIH Online Publication.