Osteoarthritis (OA)

Osteoarthritis is a degenerative joint disease resulting in pain, deformity, and limitation of joint motion due to loss of cartilage (the shock-absorbing gel-like material between joints)

OA is the most common form of Arthritis approximately effecting 1 in 7 people. It primarily affects the elderly.

OA can be divided into two categories: Primary and Secondary.

 Primary Osteoarthritis - this is often diagnosed in older people due to the inability to restore and synthesis normal collagen structure.

 Secondary osteoarthritis - usually cased by predisposing factors responsible for the degenerative changes such as inherited abnormalities, trauma, and/or inflammatory conditions. 

Risk Factors:

·     Age related changes in collagen – matrix

·     Food sensitivities

·     Post trauma on the joint

·     Genetic predisposition

·     Inflammatory disease

·     Obesity


Symptoms:

·     PAIN – Initially movement triggers pain and may be relieved by rest – morning stiffness is common.

·     The weight bearing joint such as knees, hips, hands are the joints principally affected.

·     Deep aching pains localised to the joint.

·     Joint swelling & tenderness

·     A ‘grating sound’ when the joint is moved

·     Later stages may result in bone deformities. 

 

Therapeutic considerations

Normally the body deals with damage to cartilage by attempting to repair itself. The main therapeutic goal should be to decrease rate of damage and enhance the repair and regeneration of the collagen matrix. 

Diet & Exercise 

·     Achieve normal body weight to minimize stress on weight bearing joints.

·     Improving insulin sensitivity, as insulin stimulates cartilage cells to increase synthesis of structural molecules.

·     Lack of exercise can also decrease the hydration of the joint cartilage. OA pain causes reduced activity, decreasing muscle strength

·     Diet rich in complex slow releasing carbohydrates and dietary fibre has proven beneficial in the treatment of OA. Mediterranean diet – abundant plant foods, fruits, veg, nuts, seeds, whole-grains, beans, minimally processed, fresh, seasonal locally grown foods. 

 

NUTRITIONAL SUPPLEMENTS

Glucosamine Sulfate - Glucosamine is the most popular nutritional approach to osteoarthritis. It is the fundamental building block required for the biosynthesis for cartilage. It appears that as some people age they lose the ability to manufacture sufficient levels of glucosamine. The result is that cartilage loses its gel like nature and its ability to act as a shock absorber. The therapeutic effect of Glucosamine is best seen over a few months. 

Chondroitin - Chondroitin sulfate is composed of derivatives of glucosamine sulfate with a sugar molecule. The absorption rate of Chondroitin is much lower than glucosamine due to the difference in size (chondroitin sulfate is at least 50 to 300 times bigger – too large to pass through the intestinal barrier into cartilage cells.) However studies show that it can improve joint health.

Hyaluronic Acid- Hyaluronic Acid provides a structural framework and affects the ability of the cartilage to hold water. By the age of 70, the hyaluronic acid content in most people has dropped by 80%, predisposing them to a decrease in connective tissue integrity particularly in skin and joints. Hyaluronic injections are injected directly into the joints a have shown improvement in symptoms. Oral supplementation has also seen to increase the body’s hyaluronic acid stores.

Vitamin C – Deficiency is associated with altered collagen synthesis and compromised connective tissue repair.

Vitamin D – Low Vitamin D has been associated with an increased risk of progression for osteoarthritis especially in people under the age of 60.

Vitamin K – Foods rich in Vitamin K such as green tea, kale, turnip, spinach and other leafy green veg may offer some protection against arthritis.

If you or someone you know is struggling with OA and you would like to know more (including what supplements and dosage you should take) please do consult a nutritional therapist and or naturopath. 

Love H x