Know Your Bones

How Do Nutritional Supplements Help Relieve Osteoarthritis Pain?

There has been a lot of excitement recently about the potential relief from osteoarthritis (OA) one can gain from dietary nutritional supplements. These products are often called "nutriceuticals", a term used to explain benefits derived as being both nutrients and pharmaceuticals. In recent years, glucosamine and chondroitin, as well as naturally-occurring "good fats" have gained respect as pain relievers.

Nutritional supplements, however, have not proven to be any more effective in relieving pain than other remedies. Most studies contend that supplements are "just as effective" as certain pills for relieving OA symptoms. That in itself is good news.

Interestingly, we really don't know exactly how nutritional supplements relieve OA symptoms. Most of the compounds used in these supplements are found naturally in our bodies and are crucial to normal cartilage growth and repair. Different substances appear to work in different ways. So far, here's what the research suggests:

Glucosamine: Glucosamine is a mjor component of cartilage. It forms the building blocks for growth and maintenance of cartilage proteins. Remember that joint cartilage is 90% water - glucosamine absorbs water and keeps the joints lubricated. Taking supplements could promote the formation and repair of cartilage, perhaps slowing its deterioration and even preventing OA.

Chondroitin: Chondroitin is also found in your cartilage, bone and tendons. It is believed that chondroitin improves the durability of cartilage by helping its water retention and elasticity. It also appears that chondroitin can help block enzymes that can break down cartilage.

MSM and DMSO: MSM or methylsulfonylmethand (METH-ill-sul-FON-ill-METH-ane) and DMSO or dimethyl sulfoxide (DIE-meth-ill sul-FOX-ide) are related sulfur-containing organic liquids that are designed to relieve joint pain and inflammation. DSMO is a widely used commercial solvent, derived as a wood byproduct during the production of paper. Its many potential health benefits were first described in the early 1960's. It penetrates body tissues rapidly and is transformed into MSM in the body. These compounds quiet inflammation by scavenging free radicals released at the site of an injury, and keep swelling in check.

CM: CM or cetyl myristoleate (SEE-tull-meer-iss-TOLL-ee-ate) is a waxy fatty acid derived from beef tallow that seems to be an anti-inflammatory. Tests have shown that it prevents OA in laboratory mice.

Omega-3 "good fats": Omega-3 good fats come from fish such as salmon, mackerel, and tuna. A number of studies have supported their anti-infammatory effects as well.

There is also a wide range of other supplements, herbs, and oils that are believed to counteract inflammation. Certain foods are also linked with improving OA symptoms. The Arthritis Foundation is an excellent resource for reliable information about alternative and conventional therapies. You can find them online at www.arthritis.org.

Five Health Tips In Fighting Osteoarthritis

Osteoarthritis (OA) is a degenerative process that will continue at its own pace until its cause and cure is discovered. Until that time comes, maintaining good health can be strong fighter in staying relatively pain-free and active. Here are six health tips worth following:

1. Remember that all of your joint components are made of living tissue. These tissues rely on healthy blood flow and the right nutrients to repair themselves and stay strong and resilent. Eating poorly robs your body of the tools it needs to maintain itself, and smoking constricts your blood vessels, limiting the circulation to these tissues.
2. Daily activities may strain shrunken, stiff and irritated tissues. It may be easy to "over do" it unless you keep your joints limber and resilient with regular exercise.
3. Although osteoarthritis is often called "wear and tear" arthritis, don't be afraid that physical activity will wear you out. On the contrary, joints are designed for motion, and motion helps circulation nourish your joints.
4. Good health and a state of "wellness" means you respect the way all of your body's organs and systems are interrelated. Do everything you can to sustain your vigor and balance in order to ward off anything that threatens it with desease.
5. Choose your pharmacist as carefully as you would choose a physician. Thanks to his/her training and expertise, your pharmacist is a valuable consultant who can advise you about how to get the best results from your medications, potential drug interactions and side affects, possible allergy complications, drug costs, insurance coverage and lower-cost options.

You've got better things to do than let OA rule your day. Maintaining good health habits is certainly part of the right treatment strategy.

Some Tips On Applying Heat or Ice To Painful Joints

When you have a painful joint caused by osteoarthritis, applying heat treatments or ice treatments can help. But which should you choose? Why? How often and how long? Here are some answers.

The only time you must choose ice is during the first 48 hours after an injury or surgery. Cooling the area causes the nearby blood vessels to constrict. There's less swelling and, therefore, less pain. Conversly, heat opens up the blood vessels, improving flow. This increased circultion brings oxygen and healing elements to the scene while flushing away wastes. Kind of "in with the good and out with the bad."

Try heat to warm up your joints before activity, or while resting - ice afterward. Apply a warm or cold compress for 15 minutes. If it feels better, you've made the right choice. If not, switch. It's OK to experiment here.

Over a lifetime, your osteoarthritis (OA) symptoms will wax and wane. Modify your activities, apply heat or ice as needed, and keep your body strong and flexible to minimize your need for drugs. Over-doing household chores, a strenuous hike, or a slip or fall can irritate your joints and could cause a flare-up.

Some things to remember.

• OA is a complex disease with a variety of symptoms including pain, stiffness, swelling, and limited activity.
• OA also progresses at different rates in different patients (even in different joints in the same patient).
• Your personal treatment plan may have you using different drugs for different symptoms as your symptoms change over time.

Applying heat or ice treatments can play a helpful role in relieving pain that you may suffer.

[The above article was taken from excerpts  from Know Your Bones: Making Sense of Arthritis Medicine, a guidebook written for those who suffer from osteoarthritis.]

Is There a Cure for Osteoarthritis?

Currently, there is no cure for osteoarthritis (OA). Unfortunately, there is no magic wand that can rebuild the very complex cartilage tissue. However, there are dozens of arthritis medications available to relieve the pain, swelling, and stiffness of OA. But remember, the rate at which your cartilage wears away will not change for better or for worse whether or not you take your medicines.

A sudden increase in your OA symptoms does not mean that your joints are wearing out faster. Usually, a surge in your symptoms means a flare of inflammation. With this in mind, and because you can readily feel the symptoms, you can take your osteoarthritis drugs on an as-needed basis. If you have a lot of pain and stiffness every day, then take the medicine every day. On the other hand, if you're fairly comfortable today, you can skip it. If you don't have pain, you don't need the medicine.

OA drugs are categorized by drug class. Each class differs in the way your body deals with the drug, know as the mechanism of action. Different mechanisms of action target different symptoms of OA ( i.e. pain, stiffness and/or inflammation. However, it's important that you understand

• how each drug works,
• which drugs are related because they work in a similar way,
• what side effects can occur, and
• why a drug may or may not be right for you.

Combining smaller does of different medications to maximize relief while minimizing side effects may be the right answer. In future posts, I'll try to answer some of these questions and other frequently asked questions posed by my patients.

Remember, you can also ask your pharmacist about non-prescription treatments as well. Ask them to help you decipher the active ingredients label on the package of any over-the-counter medications you are considering buying. Your pharmacist can cross-reference theses ingredients with any of your other medications and advise you about possible drug interations.

Use only one pharmacy so all of your medication records are at one location. Most pharmacies use a computerized database to keep track of the prescriptions they fill for you. This database will cross-reference your medicines to check for potential problems...if it knows about everything you take.

[The above article was taken from excerpts  from Know Your Bones: Making Sense of Arthritis Medicine, a guidebook written for those who suffer from osteoarthritis.]

What Is Pain, Anyway?

Pain is defined as "an unpleasant sensory and emotional experience associated with actual or potential tissue damage." That is, it's your brain's way of telling you that something is wrong. Actual tissue damage is associated with problems like osteoarthritis (OA), where your joint is worn and irritated, or a broken bone or torn ligament.

Pain is also your body's way of protecting you from potential tissue damage. For instance, you'll pull away from something that's too hot to avoid a burn.

Your nervous system does a lot more for you than just telling you where it hurts. It regulates your body's response to any stimulus, good or bad, from within or from outside your body. Your nervous system tells your muscles where to move (and what to do when you get there), tells your eyes were to look (and what they see), and tells your ears what they hear. Each specific sensation has its own "wire" in the network connecting your body and brain.

Pain is transmitted by a "cable" or wires that is structurally and functionally distinct from all of the nervous system's other functions.

Medicines that relieve pain are call analgesics (an-ul-JEEX-ix). Their purpose is to quiet the way you perceive pain. That is, to minimize your awareness of pain. Ideally, they target on the pain cable and leave the rest of the network alone.

[The above article was taken from excerpts  from Know Your Bones: Making Sense of Arthritis Medicine, a guidebook written for those who suffer from osteoarthritis.]

What Is Osteoarthritis And Why Does It Hurt?

There are about 100 forms of arthritis. Osteoarthritis (OA) is the most common. "Osteo" is from the Greek word for bone. "Arthr" means joint. And "itis" means inflammation.

Osteoarthritic cartilage can become brittle, thin, and frayed. Eventually it wears away, leaving craters of underlying bone. This process can take many years, or sometimes happens quickly - perhaps after an injury. Irritated joints try to protect themselves by producing extra fluid, and can become swollen (called "water on the knee").

Normally, the synovial membrane (see my last post) that lines the joint looks like a sheet of satin. However, when inflamed, it becomes more like wet terrycloth. This inflammation of the joint lining is usually what causes arthritis pain. The swollen lining gets pinched between the moving bones. Once the cartilage layer is thinned and worn, the joint loses its spacer and becomes less stable. If your muscles are weak and flabby, they can't provide the necessary support.

Think of the rough surfaces within the joint acting like a match head on a flint. Imagine a wobbly knee where every step causes the jagged surfaces to rub together, igniting a little "fire." That fire is the inflammation of arthritis pain.

So what exactly is inflammation anyway?

Inflammation is the tissues' response to injury or irritation. It causes pain, swelling, redness and heat, and results from an elaborate sequence of biochemical reactions in the body. Although these biochemicals are associated with the undesirable symptoms of OA and fever, they also do good work.

• They begin the first steps of healing after an injury.
• They help the body fight off infection.
• They regulate kidney function.
• They balance acid and mucus production inside the stomach.
• They help maintain blood pressure
• They control blood clotting.

So when using medications that block inflammation to treat OA symptoms, the challenge is to block the bad effects of inflammation while permitting its healthy housekeeping functions to continue.

[The above article was taken from excerpts  from Know Your Bones: Making Sense of Arthritis Medicine, a guidebook written for those who suffer from osteoarthritis.]

Understanding Osteoarthritis - What Is A Joint And How Does It Work?

To better understand what osteoarthritis is, let's first take a look at what a joint is and how it works.

Your musculoskeletal system contains muscles, bones and associated tissues that move your body and maintain its form. Wherever two or more bones come together, a joint is formed. For example, your knee joint contains three bones - the femur or thighbone, the tibia or shinbone, and the patella or kneecap. Your hip is a ball-and-socket joint between the head of the thighbone and the pelvis. And your wrist is actually a linkage of 10 separate bones.

Bones are held together with strong bands called ligaments. Muscles cross the joints to provide active support and movement. Tendons attach muscles to bones. When a muscle contracts, it moves the bones like levers at the joint. Strong muscles protect the joints they cross by acting as stabilizers and shock absorbers.

Your joints are also lined with a sensitive membrane called the synovium (sin-OH-vee-um). This membrane's job is to produce a few drops of fluid, called synovium fluid, that lubricates the joint. A normal healthy knee joint, for example, usually contains about one half teaspoon of synovial fluid.

Cartilage is the tissue that covers the ends of the bones and forms the joint's surface. It is a remarkable tissue. Hyaline cartilage is the strong, slippery contact where motion occurs at your joints. And it is this cartilage that can become affected by osteoarthritis.

There are no blood vessels in cartilage. Here the synovial fluid and underlying bone nourish the cells. There is also no nerve endings in cartilage. So the actual fraying and cracking of worn cartilage is not really the source of pain. Instead, osteoarthritis symptoms arise from inflammation or strain in the structures that surround the joint.

In my next post, I'll discuss what osteoarthritis is and why it hurts.

[The above article was taken from excerpts  from Know Your Bones: Making Sense of Arthritis Medicine, a guidebook written for those who suffer from osteoarthritis.]

If You Suffer From Arthritis, You Are Not Alone

If you suffer from arthritis, you are not alone. A study conducted by the National Council on Aging found that over 20 million people in the United States suffer from osteoarthritis (OA). Many doctors believe that number will double by the year 2020. Also, an earlier study done by the Centers for Disease Control and Prevention concluded that OA disables about 10% of those 60 years or older. Chances are, if you are not personally suffering from OA, you probably know someone who does. Perhaps  a family member or friend.

Over the next several weeks, I will be writing some additional articles about OA. I'll explain what osteoarthritis is, and what some of the arthritis treatments are that you can seek out to help control it. I hope you will find the articles informative, and I invite your comments and questions.

For anyone looking for an easy to read reference book about OA, please take a look at a guidebook I wrote initially for my patients. It's helping many of them - and it provides some great information. Most likely, it can answer many of your questions and also help you better understand the advice you receive from your doctor and pharmacist.

The title of book is Know Your Bones: Making Sense of Arthritis Medicine. You can read more information about the guidebook by clicking here or on the cover of the book and links in the upper left column of this blog.

So please look for these future articles. There will be lots of information about the numerous treatments that are available to you and how they differ. I'll also include health tips and some general advice many of my patients ask me about.

Stay tuned...