Arthritis- Osteoarthritis
What is it?
Arthritis is the name given to problems that cause swelling, pain and stiffness in joints. It can mean anything from slight tightness to severe pain and disability. There are over 100 types of arthritis, including osteoarthritis, rheumatoid arthritis and gout. As many as one in seven Americans may suffer from arthritis, with women more commonly affected than men. Arthritis is the number one cause of disability in America, limiting everyday activities for about seven million people. As the population becomes older, this number is expected to increase.
Symptoms of arthritis- osteoarthritis
Osteoarthritis is the most common joint disease. Initially, the onset is subtle and gradual, and usually involves one or only a few joints. Pain is the earliest symptom, usually made worse by exercise. Morning stiffness follows inactivity but this only lasts around 15 to 30 minutes and improves with exercise.
Osteoarthritis occurs when degenerative changes take place in the cartilage in the joints, causing a roughening or loss of surface. There is increased bone formation in the area under the cartilage. This bone becomes stiffer and tiny fractures occur. Joints may lose their proper shape and become enlarged, or develop bony bumps that can limit movement. More women than men suffer from osteoarthritis and symptoms usually start to show in middle age. As many as 75 per cent of those aged over 70 show some evidence of the disease, with knees and hands being the most commonly affected sites. The cervical and lumbar spine is also commonly affected.
Diagnosis of arthritis- osteoarthritis
In addition to symptom analysis, X-rays may be used to diagnose osteoarthritis as they show shrunken joints and bone abnormalities. Blood studies may also be used to rule out other disorders.
Causes of arthritis- osteoarthritis
There are many causes of osteoarthritis; including changes in bone and cartilage with aging, and wear and tear on the joints from abnormal physical stresses such as obesity, injury, inflammatory processes and hormonal effects. There seems to be an imbalance in the processes that repair and maintain the joints. Genetic factors seem to play a role and long periods of weight-bearing exercise may increase the risk.1 Low estrogen levels seem to increase the risk of osteoarthritis and hormone replacement therapy appears to reduce it.2
Treatment of arthritis- osteoarthritis
There is currently no way of stopping or reversing the changes which occur in osteoarthritis. Exercise is very important, as it maintains healthy cartilage and range of motion and develops the stress-absorbing tendons and muscles. Daily stretching exercises are particularly important as are periods of rest. Drugs such as aspirin are sometimes used to treat inflammation and for pain relief. Muscle relaxants may also be used. Knee and hip replacement surgery may be necessary in severe cases.
Vitamins, minerals and arthritis- osteoarthritis
Vitamin D
Recent research suggests that older people whose knees are affected by osteoarthritis may run the risk of worsening their symptoms if they do not get enough vitamin D. Results from the Framingham Osteoarthritis Cohort Study published in 1996 showed that men and women with low dietary intakes and blood levels of vitamin D had three times the risk of their symptoms becoming worse than men and women with high intakes. However, they did not find a link between low vitamin D levels and the risk of developing osteoarthritis in a previously normal knee.3
Anti-arthritis drugs, including corticosteroids, and reduced activity and exposure to sunlight in those with the disease may contribute to low vitamin D levels. Vitamin D supplements may be beneficial in those already suffering from osteoarthritis who have low intakes. However, very high doses of vitamin D should be avoided as they may cause calcium to be deposited in the tissues causing irreversible damage.
Antioxidants
Other results from the Framingham Osteoarthritis Cohort Study suggest that high intakes of antioxidant nutrients may reduce the risk of cartilage loss and disease progression in people with osteoarthritis. A three-fold reduction in risk of progression was found for those with high vitamin C intakes. Those with high vitamin C intake also had a reduced risk of developing knee pain. A reduction in risk of disease progression was seen for beta carotene and vitamin E intake but was less consistent. Antioxidant nutrients did not seem to affect the initial appearance of the disease.4
B vitamins
A controlled, double-blinded, crossover study done in 1994 found that patients taking vitamin B12 and folic acid supplements had less pain and stiffness than others not taking the supplements. The study involved 26 people diagnosed for an average of 5.7 years with osteoarthritis of the hands who had been medicated by prescribed NSAIDs. They were randomly given either 6400 mcg folate or 6400 mcg folate plus 20 mcg vitamin B12 or lactose placebo each for two months. The results showed that right and left hand grip values were higher and the number of tender hand joints was less in the supplements group. There were no side effects in the vitamin group.5
Nutrients and arthritis- osteoarthritis
Epidemiological studies suggest that there may be a link between boron deficiency and osteoarthritis. In countries such as Mauritius and Jamaica, where boron intake is low, the incidence of osteoarthritis is around 50 to 70 per cent. In countries such as the USA, UK and Australia, where boron intake is relatively high, the incidence of osteoarthritis is around 20 per cent. Boron concentrations in bones next to osteoarthritic joints may be lower than in normal joints and supplements of 6 to 9 mg per day have been used to treat osteoarthritis with some improvement of symptoms. This may be because boron increases bone hardness.6
Glucosamine
Short-term studies in sufferers of osteoarthritis suggest that glucosamine sulfate may produce a gradual and progressive reduction in joint pain and tenderness, as well as improved range of motion and walking speed. Results of the trials have also shown that glucosamine has produced consistent benefits in patients with osteoarthritis and that, in some cases, it may be equal or superior to anti-inflammatory drugs in controlling symptoms.7