Osteoarthritis (OA)

 

OA is a slowly progressive degenerative disease of the bone, cartilage, and synovium of a joint that can lead to total loss of joint function requiring joint replacement. OA should not be considered the result of wear and tear, but rather a breakdown of normal physiologic repair mechanisms. Basically, if the body is supplied with the proper anti-inflammatory diet and the correct nutrient building blocks these processes can not only be halted but in many cases also reversed. It is important to address the root of the disorder rather than simply treating the symptoms of autoimmune conditions. Often these treatment strategies require significant life style changes that take time but are certainly worth the effort in the long run.

 

Integrative Approach to OA

 

  • Diet. Embrace a 30-day whole food diet consisting of fruits, vegetables, and small portions of cold water fish and skinless chicken. After 30 days, transition to an anti-inflammatory diet. An anti-inflammatory diet eliminates all processed foods, sugary beverages of any kind (soda, and juices), and sometimes gluten and dairy. There are many web sites and resources that provide recipes and meal plans for healthy eating. Remember food is medicine and should be the first line therapy when addressing OA.

  • Weight loss. Achieving normal body mass index (BMI) is associated with significant improvement in joint pain and joint function. The diet described above automatically will assist in weight loss.

  • Exercise. Three forms of exercise should be incorporated. Patients should receive cardiac clearance from their physician before beginning significant exercise, and should not exercise with an acutely inflamed joint.

  1. Aerobic training, one hour three times a week

  2. Resistance training, one hours three times a week

  3. Flexibility and range of motion, two to three times a week. Yoga therapy provides excellent static and stretching of the major muscle groups.

  • Massage. Trails have shown that Swedish massage therapy in patients with OA significantly reduced pain and stiffness while improving physical function and range of motion. A 60-minute session once a week is recommended.

  • Acupuncture. Acupuncture has shown to relieve pain and reduce the need for non-steroidal anti-inflammatory drugs. Most treatments last between 25 and 30 minutes and should be performed one to three times weekly.

  • Supplements. Many supplements have shown benefit in OA. Because supplements are considered nutraceuticals and can interact with pharmaceuticals, please consult an integrative provider to assist you in choosing supplements right for your body. Typically 2-3 supplements in each category are used depending on your specific needs. You do not need all of the following supplements! Supplements helpful in OA fall into three categories; Joint support, Anti-inflammatories, and Anti-oxidants.

  1. Glucosamine sulfate: 400-3200mg daily

  2. Hyaluronic acid: 40 mg daily

  3. Methylsulfonylmethane (MSM): 3000-6000mg daily

  4. Solubilized keratin: 300 mg daily

  5. Chondroitin sulfate 450-3600mg daily

  6. S-adenosylmethionine (SAMe): 200-1200 mg daily

  7. Fish oil: 1400mg EPA and 1000mg DHA daily

  8. Curcumin 400-800mg daily

  9. Boswellia serrta: 100 mg daily

  10. Krill oil with astaxanthin 350mg daily

  11. Ginger extract 150-1000mg daily

  12. Bromelain 500-1000 mg daily

  13. Soy and avocado unsaponifiables

  14. Vit D: 5000 IU a day

  15. Green tea

  16. Vit C 1000-2000mg a day

  17. N-acetyl-cysteine: 600-1800 mg daily

  18. Milk thistle: 750mg daily

  • Topical application of olive oil has been found to relieve pain and improve function. A Healing Touch practitioner that uses olive oil with therapeutic grade essential oils, like Boswellia serrta (frankincense), and Wintergreen (methyl salicylate) can facilitate healing based on energy medicine principals and herbal therapy. Topical capsaicin cream (Zostrix) is also helpful.

  • Pharmaceuticals. Pharmaceuticals fall into four basic categories; Non-opioid analgesics (liver toxicity), Non-steroidal anti-inflammatories (GI bleeding), Topical analgesics (local irritation), and Narcotic medications (overdose, death). It is beyond the scope of this article to cover these medications; however, the emphasis is the danger that each of these medications poses to the body and the goal should be to wean off of them as soon as possible.

  • Injections. Steroid injections may be useful but should be limited due to the possibility of joint infection from contamination.

  • Surgery. Joint replacement is sometimes required, but does not negate the adoption of a healthy lifestyle in promoting healing and preventing further joint damage.