Osteoarthritis refers to the pain and inflammation in the joint. In arthritis, this pain is a result of the wearing out of joints. The cause could be from trauma, or excess wear and tear due to weight or occupational requirements. Age can also be a determining factor in the development of Osteoarthritis, with the prevalence of diagnosis occurring after the age of 50. Studies show that 90% of adults scanned will show some degree of joint wear after the age of 50 (Neighbors, 2010, p. 103). Here we will discuss joint health, pain and inflammation, anti-inflammatory medications and herbal alternatives, nutritional support and lifestyle recommendations.
Cartilage contains no nerves or blood vessels, it is the outer layer of the cartilage called the perichondrium that has blood flow, and from which cartilage cells receive their nutrients (Marieb, 2014, p. 208). Once the cartilage is damaged, it cannot repair itself, and surgical intervention is usually required (Gomoll & Minas, 2014). There are three types of cartilage in the body, hyaline cartilage, elastic cartilage and fibrocartilage. Hyaline cartilage is the most abundant cartilage found in the body, while fibrocartilage is only found in 2 places, it is the cartilage that protects the knee joint, so it’s very important (Marieb, 2014, p. 208).
Inflammation is the bodies response to trauma (Marieb, 2014, p. 829). When cartilage is damaged, it notifies the bodies immune system that a trauma has occurred, and inflammatory markers are produced. Research indicates that this inflammatory response to joint injury is what encourages Osteoarthritis development, as the immune cells break down the cartilage tissue while creating the inflammatory response (Lieberthal, Sambamurthy, & Scanzello, 2015). The immune response also leads to capillaries leaking antibodies and increased fluid into the area affected by the trauma. This excess fluid in the area creates heat and inflammation. This is why it hurts so much. Pain is actually the desired response by the body, as it forces the individual to rest the area that was damaged giving the tissue time to repair (Marieb, 2014, p. 830). Depending on the severity of the damage, age of the person, how quickly the immune system responds to the trauma, their overall nutritional status, and how long it takes to heal the damaged area, this is usually not possible in the modern fast-paced world we all live in. In addition to this, in the case of Osteoarthritis, this inflammatory cascade also needs to be avoided to preserve and prevent future damage to cartilage tissue (Lieberthal et al., 2015).
Medication to relieve pain and how it affects the digestive system
The modern medicine answer to this is to prescribe corticosteroids usually injected straight into the joint or nonsteroidal anti-inflammatories (NSAID) taken in the form of diclofenac (Voltaren) or ibuprofen (Nurofen). These medications have shown to have a negative impact on the digestive and immune system, however. NSAID’s inhibit the repair of the mucous membranes lining the digestive tract (Bryant & Knights, 2015, p. 328). This results in the formation of ulceration and reduced nutrient uptake. The corticosteroids have a negative impact on the adrenal glands and hide the inflammatory response from other areas that need the immune system to prevent bacterial and fungal infections (Bryant & Knights, 2015, p. 74).
Herbal alternative anti-inflammatories
Zingerbar officinalis (ginger): Ginger inhibits the same inflammatory pathway as does ibuprofen and diclofenac but without the side effect of inhibiting the repair of the mucous membrane lining the digestive system. On the contrary, this herb supports digestive function (Bone & Mills, 2013, pp. 580-582). Applied externally ginger can aid in relieving pain and inflammation (Therkleson, 2014).
Capsicum annuum (cayenne pepper): Cayenne pepper applied topically blocks substance P at the pain receptors, thereby blocking the sensation of pain. Taken internally, the stimulation of circulation promotes the removal of inflammatory markers from the joint, to remove the cause of the pain.
Curcuma longa (turmeric): Turmeric at a dose of 1000mg a day will stop the inflammatory pathway, and thereby reduce pain and inflammation. Turmeric is however not very easily absorbed by our digestive system, carriers such as chilly, pepper, ginger, or phospholipids help to support the absorption of the curcuminoids in the turmeric. Another easy way to stimulate the absorption of turmeric is to consume it in a latte, when boiled in milk, curcuminoids are well absorbed due to the natural fats within the milk – low-fat milk options may reduce its effectiveness though.
Hot and cold packs: Contractions of muscles usually stimulate the movement of increased fluid in the joint back into the blood where it can be transported away from the area of pain. Alternating heating and cooling packs on the affected area can also stimulate this transport mechanism. Applying ice for 10 minutes, followed by heat for 10 minutes several times a day, will aid in reducing the inflammation.
As previously mentioned, rest and eating a nutritious diet are all great ways of helping the body recover and repair the trauma in the joint area. Taking nutritional supplements during this time can also help to provide the nutrients required to facilitate this repair plus help to naturally reduce pain and inflammation. Some nutrients include glucosamine, chondroitin, SAMe, vitamin D, vitamin C, omega-3 fatty acids (fish oils), manganese, boron, hydrolysed collagen, and bromelains. The quality of the supplement can make a big difference too we find in our experience, so best to chat to a natural health professional about the most suitable products for you.
Once you are feeling better and/or your practitioner recommends getting back into physical activity it is best to start slow using low-intensity exercise like light walking or jogging, swimming or water aerobics, using an elliptical machine, lifting lightweights or using guided machines, rowing or cycling at a casual pace.
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