VOLUME 2 ISSUE 12    November 2007 VIEW ARCHIVE

When Bones Hurt Dealing with the discomfort of osteoarthritis by Michelle Gibeault Traub, R.D. As we age, aches and pains become all too common. Our bodies start to show signs of wear-and-tear which can result in osteoarthritis, an often painful and debilitating condition that impacts the joints between bones. While the joint damage of arthritis can be an unfortunate consequence of age, the pain and discomfort is not inevitable.   Osteoarthritis Overview Osteoarthritis (OA) is the most common form of arthritis with approximately 21 million people showing signs of the disease in the US alone. There are actually over 100 different types of arthritis, all of which relate to inflammation of the joints. Osteoarthritis in particular occurs when cartilage between the bones begins to breakdown and become rigid. Healthy cartilage serves as a shock absorber, enabling bones to move smoothly across one another wherever they join to form joints (i.e. the knees, hip, neck, and fingers). When cartilage breaks down or is worn away, bones may rub together causing great pain, bone spurs, and joint stiffness.   Recognize Your Risks The simple movements of daily activity, coupled with normal aging, can lead to the wearing away of cartilage. However, while many adults do exhibit some form of cartilage damage, there are certain risk factors that make an individual more prone to actually developing the full-blown pain and loss-of-motion characteristic of osteoarthritis. These risk factors include: prior injuries, use of repetitive motions either on the job or as part of daily activities, a family history of arthritis, being  a female over age 45 (menopause may play a role), general aging (symptoms are most common in adults 50 and older), and finally being overweight. Clearly, most of these risk factors are out of one’s control. However, being overweight is a major risk factor that can be managed. Even modest weight loss can relieve joint paint and pressure in the weight-bearing joints of the knees and hips. In fact, losing ten pounds of weight can relieve nearly 60 pounds of pressure from the knee joint.   Get Help for the Hurt If you are one of the millions affected by the pain of arthritis, or you simply hope to decrease your risk for joint inflammation, there are many ways to improve joint health, including:      Foods & Supplements**: Vitamin D – a recent study presented at the American College of Rheumatology’s annual meeting indicated that vitamin D deficiency resulted in greater pain in individuals with OA of the knee. Consuming a minimum of 400 IU of vitamin D from foods and supplements is recommended. Vitamin C and other antioxidants – Vitamin C is utilized in the formation of collagen in cartilage and it serves as an antioxidant that is effective in preventing inflammation. Studies have suggested improvements in OA patients who consumed an average of 152 mg of Vitamin C per day. Other excellent sources of antioxidants include colorful fruits and vegetables and dark chocolate. Omega-3 fatty acids – Omega-3 fatty acids are well known for reducing inflammation in the body. However, the richest sources come from fatty-fish such as tuna, salmon, and herring which often contain mercury. Supplementation of 1000 mg per day of Omega-3 fatty acids via fish oil (containing DHA and EPA) may be an effective way to calm joint inflammation. [NOTE: fish oil in high doses acts as a blood thinner, always consult with your physician before using.]    Water – Often overlooked, water is the body’s natural lubricant. Drinking at least 8 cups of water a day helps to keep tissues and joints hydrated. Glucosamine and Chondroitin Sulfate – Evidence has shown that 1,500 milligrams (mg) of glucosamine and 500 mg of chondroitin sulfate per day can help to relieve joint pain. For more details, see Arthritis Today Sam-e –Widely used in Europe as an arthritis treatment, Sam-e is recommended at levels between 200 mg to 1,600 mg per day. MSM- In a small study reported in the journal, Osteoarthritis and Cartilage, OA subjects given 3 g of MSM twice a day reported less pain and improved movement. Green tea – Research has shown that substances in green tea may actually inhibit cartilage breakdown. Spices – The Arthritis Foundation reports turmeric, ginger, and cayenne pepper as anti-inflammatory agents that can help reduce joint pain. Visit their Supplement Guide for more information. Exercise: Since weight loss is such an important component of arthritis management, regular exercise is essential. This may seem counterintuitive because if you are in pain, exercise is the last thing you want to do. However, walking, swimming, stretching, yoga, and tai chi are all effective at burning calories and keeping joints limber. Seeking the advice of a physical therapist is highly recommended since they can design a program that will be safe for the joints. Medications: When the pain of arthritis strikes, the use of pain relievers is often recommended. Medications called NSAIDs (nonsteroidal anti-inflammatory drugs) such as naproxen sodium (Naprosyn), ibuprofen (Motrin, Advil), and meloxicam (Mobic) are generally the best choice because as their name suggests they relieve inflammation, as well as pain. Alternative Treatments: Acupuncture, injections with hyaluronic acid (in the knee joint only), hot and cold therapy, massage, capsaicin cream applied to the area, and the use of braces and other supports are also helpful in managing arthritis.   Let’s Clear Up the Confusion  It is important to note that while osteoarthritis shares the prefix “osteo” (meaning bone) with its distant cousin osteoporosis, the two diseases are very different. In fact some studies even indicate that if you have osteoarthritis, you are not as likely to develop osteoporosis. Osteoarthritis impacts the cartilage between bones, while osteoporosis affects the actual bones themselves. Pain is a primary complaint of patients with osteoarthritis, while those with osteoporosis rarely feel anything at all. Regardless, since both illnesses fall under the category of rheumatic diseases (pertaining to the musculoskeletal system including the bones, joints, muscles, and tendons); they are effectively diagnosed and treated by a specialized physician called a rheumatologist.   If you are experiencing pain in your bones or joints, or if you have several risk factors for arthritis, it is important to seek treatment as soon as possible. Through x-rays and other screening methods, your physician can determine the level of damage that exists and recommend measures to minimize further damage. As with osteoporosis, early diagnosis is a key to effectively managing osteoarthritis. To find a rheumatologist in your area, visit The American College of Rheumatology’s “Find a Rheumatologist” Web page. ** The safety and efficacy of supplements for arthritis and other ailments is widely debated. Always inform your doctor of any supplements you are taking, and be sure to purchase supplements from reputable companies who follow USP (United States Pharmacopeia) standards. NOTE: The calcium in Adora Calcium meets USP standards. Resources National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) Arthritis: Handout on Health - Osteoarthritis   Arthritis Foundation   The American College of Rheumatology References Mary Kaye Sawyer-Morse, PhD, RD, LD Osteoarthritis: Managing “Growing Pains” Through Diet and Lifestyle Today’s Dietitian. November 2006. retrieved 11/8/07 LINK Zychowicz, NP. Rusty Hinges: Understanding Osteoarthritis Pain Advance for Nurse Practitioners. September 2007. retrieved 11/9/07 LINK Jun Wang, et al. Low Vitamin D Levels are Associated with Greater Pain and Slow Walking Speed in Patients with Knee Osteoarthritis (KOA)Presentation Number: 199; American College of Rheumatology 2007 meeting, retrieved 11/8/07 LINK Dr L.S. Kim N.D. et al. Efficacy of methylsulfonylmethane (MSM) in osteoarthritis pain of the knee: a pilot clinical trial Osteoarthritis and Cartilage. Volume 14, Issue 3, March 2006, Pages 286-294. Carol & Richard Eustice. Osteoporosis Vs. Osteoarthritis: Similar Names, Very Different Conditions. Updated: May 25, 2006. Arthritis.about.com. retrieved 11/8/07 LINK. Top of Page

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