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Osteoarthritis

Osteoarthritis

Joint ‘wear and tear’ is a common and growing problem, affecting around a third of those over 45 in the UK and with nearly everybody over the age of 60 showing radiographic signs.

Experiencing these symptoms?

  • Pain
  • Stiffness
  • Tenderness
  • Loss of flexibility
  • Grating sensation
  • Swelling
  • Larger 'knobbly' joints
  • Crackling sound in joints
  • Muscle weakness
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Our approach to osteoarthritis

Many are told that ‘it’s just what happens with age’ and find that conventional drugs fail to resolve the problem. More than 70,000 knee replacement surgeries, and similar numbers of hip replacements, are performed in England and Wales each year and that number is rising, but are all of these surgeries absolutely necessary, or can a holistic strategy intervene?

Conventional treatment

The way in which osteoarthritis is managed relies heavily on the health practitioner’s opinion of how severe they believe it is. Using this as a stepped guide, different treatment options are offered for mild to moderate or severe.

A UK survey found that 64% of patients with knee or hip osteoarthritis were taking more than one drug for pain relief, including paracetamol, ibuprofen, or non-steroidal anti-inflammatories (NAIDS), which are the first line treatment options in mild to moderate osteoarthritis. While these drugs can provide some relief from pain, they have no effect on disease progression and they can stop working if they are used long-term.

Where osteoarthritis is deemed to be severe, opioid drugs or hyaluronic acid injections may be offered. Opioids have been linked to serious adverse effects, with tramadol causing 184 deaths in 2016 in the UK and the way which hyaluronic acid is involved in osteoarthritis is not yet fully understood, although it is known to be one component of many required in the maintenance of joint health.

Once previous treatment options are deemed unsuccessful, surgical procedure is presented as the last solution. The rate at which these surgeries are now performed highlights the failings of preventative treatment options and the National Institute for Health and Care Excellence are now recommending that a holistic approach is essential in order to effectively manage osteoarthritis.

Holistic assessment

Age is an obvious risk factor, as degradation of the joint occurs with increased use. Your date of birth isn’t something that can be changed, but herbal medicine, nutrition and other natural remedies can work together preventatively to combat specific ageing processes, particularly in relation to joint wear and tear.

Excess weight is another common factor, as it causes increased pressure on the joints. Research shows that the risk of osteoarthritis increases by 36% for every 5kg of weight gain but many patients with osteoarthritis struggle to lose weight due to the pain experienced during physical activity. When the two problems occur together it can cause a difficult cycle, where one issue exacerbates the other, requiring the treatment of both in order to make real progress.

Psychological factors such as anxiety and depression are common in patients with osteoarthritis, and research shows that these types of mood disorders can increase the risk of fatigue, disability, increased GP visits and drug utilisation in osteoarthritis sufferers. The emotional impact on a person’s quality of life for someone with osteoarthritis is often overlooked but building a person’s strength often needs to also come from an emotional place, as well as physical.

Different foods can have a dramatic impact on osteoarthritis, and many find that making some dietary changes can really help, such as increasing their intake of omega 3 rich foods, which can help to lubricate the joints and reduce inflammation. In addition, ensuring that there is the right ratio between omega 3 and 6 in a person’s diet, has shown to be a highly influential factor in the control of inflammation. Eating the right things can help to reduce pain as well as providing the body with what it needs to heal, but certain vitamin or mineral deficiencies can also largely contribute to osteoarthritis, which is why a nutritional analysis is essential in the management of osteoarthritis.

Holistic treatment

Osteoarthritis is a complex condition, requiring an equally complex treatment strategy. By looking at the whole person, rather than focusing solely on the area associated with the pain, we can see how different bodily processes connect and where disharmony in another part of the body may ultimately be causing, contributing to, or exacerbating osteoarthritis.

Treatment equally should therefore treat the whole person and an effective strategy could involve a mixture of herbal medicine, vitamins and minerals, or other supplements, along with nutritional and practical lifestyle advice.

Patients with osteoarthritis often ask for advice about supplements, which seems to have become a real mine field. Many have concerns about the accuracy of ingredients and who to trust, which becomes further complicated by different dosages, combinations of ingredients or the use of different additives. Health food shops often have huge sections dedicated to different supplements for joint, muscle and bone care, and it is very difficult to establish the difference between them without researching each one in detail, particularly as the law prevents manufacturers from putting specific claims on packaging. Different brands compete to produce the most complete joint care solution, but in doing so become more generic as they fail to see that every-body is different and that each joint condition needs a different solution.

Glucosamine is a common ingredient in many joint care supplements. It is a substance which is found naturally occurring in the body and can help to rebuild and repair cartilage. Once prescribed by GPs, glucosamine is now unavailable due to cutbacks. There is a lot of conflicting information available about glucosamine as many of the trials conducted were not run for a long enough time, or patient’s were not taking the right dosage, and therefore some studies did not produce convincing results, though this does not mean that it is ineffective. There are also different types of glucosamine which are not equal, despite often being lumped together in medical literature. Glucosamine may not be right for every person. It certainly isn’t suited to diabetics and specific types can’t be taken by those with shellfish allergy. Finding the right supplements is often a crucial part of the management of osteoarthritis and patients often find it very helpful to include this within a holistic treatment strategy.

Another common natural remedy for osteoarthritis is turmeric (Curcuma longa), which is used to help reduce inflammation and slow the progression of cartilage and bone destruction. Research has found that turmeric can significantly reduce pain and inflammation caused by osteoarthritis, with similar results to non-steroidal anti-inflammatory drugs. Herbal medicine formulation could include turmeric and black pepper (Piper nigrum), which facilitates the action of turmeric, or a wide range of other herbs combined to suit the individual.

Conducting a wider assessment of a person with osteoarthritis can be an extremely effective approach in managing pain, inflammation and repairing damage caused to the joints. Osteoarthritis responds well to a comprehensive and holistic approach, tailored to the individual, and it certainly isn’t something you should just have to deal with as you age.

References

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