Osteoarthritis is a degenerative joint disease, usually associated with localised joint pain, stiffness and crepitus (cracking sound). These symptoms are due to a reduction in cartilage integrity which results in reduced shock absorbing properties, leading to bone rubbing on bone. Some people may have mild osteoarthritis and show no symptoms, whereas others may have lost a significant amount of their joint lubrication and shock absorbing properties, and experience severe pain and have significant loss of joint function.

Osteoarthritis most commonly affects the weight bearing joints such as the knee and hip joints as well as the spine, and is also found in frequently used joints, such as thumb and finger joints. Even though we don’t die from arthritis specifically, it is perhaps the disease which has the highest morbidity rate in the western world.

Osteoarthritis is the most common form of arthritis and is typically a result of age-related wear and tear on joints. This is a very different form of arthritis compared to rheumatoid arthritis, which is more of a chronic inflammatory condition affecting many joints in the body, and possibly related to an auto-immune response.

The following are answers from a naturopathic perspective to some frequently asked questions about osteoarthritis:

How do I know if I have osteoarthritis?

Majority of the population aged above 40 years will show some signs of joint degeneration on an x-ray, however many will not feel any symptoms until the cartilage and bone deterioration is significantly worsened. These are some common symptoms of osteoarthritis:

  • Joint stiffness on waking or after inactivity.
  • Pain in the joints that is worse when the joint is moved and relieved when the joint is rested.
  • Bony deformities in the joints – eg. ‘nodules forming in finger joints.
  • Reduced range of motion
  • Swelling or heat felt around the joint.

What are the causes?

Osteoarthritis is often considered an age-related condition for a couple of reasons. The longer we live, the more wear and tear our joints experience and as we age, our ability to repair and heal cartilage and bone is reduced. These are some of the more common potential risk factors for developing osteoarthritis:

  • Increasing age
  • Repetitive joint stress and use – eg.  professional sport or occupational use
  • Injury to the joint or bone leading to ongoing mal-alignment and stress on the joint
  • Genetic predisposition
  • Obesity

How is osteoarthritis treated?

Recently complementary therapies such as naturopathic medicine have become more attractive to sufferers of osteoarthritis due to concerns about potential side effects of some pharmaceutical anti-inflammatory medications, as well as the inability of these medications to contribute to improving the over-all health of the joint and alter the progression of the disease.

Naturopathic treatment of osteoarthritis aims to focus on safe and effective measures to reduce pain and inflammation, as well as provide nutritional and lifestyle advice to enhance healthy functioning of the joints and where possible, delay onset of further cartilage and bone degeneration. Naturopathic treatment can be used safely and effectively alongside orthodox medical treatment of osteoarthritis. 

Glucosamine and chondroitin sulphate are naturally occurring substances found in cartilage. As supplements, glucosamine and chondroitin sulphate (usually derived from bovine cartilage) taken in therapeutic dosage may significantly improve symptoms such as pain and immobility associated with osteoarthritis, as well provide nourishment to the cartilage and potentially slow down the progression of osteoarthritis. A total of 1500mg of glucosamine sulphate and 800mg of chondroitin sulphate taken per day in divided doses, is recommended for optimal therapeutic action. Although these nutrients in supplemental form are very unlikely to produce side effects, they are best taken under the guidance of an experienced and qualified health practitioner.

Good quality omega 3 essential fatty acids such as EPA (eicosapentaenoic acid) taken in therapeutic doses may promote anti inflammatory activity in the body and reduce the severity of pain associated with various forms of arthritis.  1-2 grams of EPA (not general omega 3 fish oils but specifically EPA) per day in divided doses is recommended for optimal anti inflammatory activity. Many people buying cheaper quality fish oils don’t come close to the therapeutic range needed for the cardiovascular, nervous system and anti-inflammatory benefits. Generally 2 capsules taken both morning and evening of a very good quality fish oil capsule is required for the optimal therapeutic dosage to be achieved.

Antioxidants such as vitamins A, C and E have been shown to reduce oxidative stress and potentially reduce inflammation in the body via a protective mechanism. Consuming antioxidant rich foods such as all kinds of berries and other fresh fruit and vegetables may support anti inflammatory activity.

Some foods that may exacerbate inflammation include caffeine, alcohol, animal products and processed foods. A reduction in consumption of these foods may reduce symptoms of pain and irritation for some individuals.

Some people with osteoarthritis require additional support to manage pain. Usually pain and inflammation go together, so managing inflammation is critical. There are many herbal medicines which can provide significant anti-inflammatory action in the body, however these should only be taken if prescribed by a qualified naturopath or herbal medicine practitioner.

Naturopathic treatment will often include advice to improve digestion and ensure the body is able to effective breakdown and absorb nutrients supplied to the body. A sluggish digestive system may also encourage an inflammatory environment in the body.

Topical cream preparations of Capsaicin (component of chilli peppers) are available over the counter and may provide pain relief for some sufferers of osteoarthritis.

Other modalities that are worth investigating as adjuvant treatments of osteoarthritis include: chiropractic, acupuncture, hydrotherapy, physical therapy, massage, yoga and Tai Chi.

What can I do to prevent osteoarthritis?

Looking after your musculoskeletal system by consciously and consistently eating healthy well balanced meals consisting of lean protein (including vegetarian sources of protein too), and a variety of coloured fruit and vegetables. This allows the body and its internal organs and systems to have exposure to a variety of essential nutrients to promote vitality and optimal health. 

Avoiding highly refined foods such as packaged food, and avoiding food high in saturated fat, trans-fats and/or sugar can help prevent weight gain and therefore reduce the chance of creating an unhealthy load on the joints.

Be aware of good posture and exercise regularly to strengthen muscles to support joints. Investigate any ongoing musculoskeletal pain to reduce incidence of mal-alignment problems contributing to stress on joints.

Supplements containing therapeutic amounts of chondroitin and glucosamine sulphate, can help reduce symptoms of osteoarthritis via anti inflammatory activity as well as nourish the joint and promote cartilage regeneration. Regular ‘joggers’ sometimes choose  to supplement with these nutrients as a protective measure for  joint health.

It is important to note that dosages and the correct form of supplements are extremely important when it comes to achieving results and considering pharmaceutical drug interaction potential. Professional prescription of any nutritional supplement is strongly advised. 

For further information or to make an appointment, please contact Diana Arundell at Avoca Naturopath on 0410 465 900 or visit www.avocanaturopath.com.au