Osteoarthritis is defined as loss of cartilage with changes in the ligaments, capsules, bones and usually mechanics. Ninety percent of individuals over the age of fifty have shown radiographic evidence of degeneration of some joints. A high percentage of these joints cause no problems or pain. Estimates of individuals in their thirties effected by Osteoarthritis range from ten to twenty percent of the population. This makes Osteoarthritis one of the most prevalent and costly diseases in America.

Signs and symptoms are pain, stiffness and tightness in a joint with loss of mobility. Pain is usually aggravated by activity and relieved by rest and non- weight bearing. Signs and symptoms start gradually and progressively get worse. The most common joints affected are the knees, hip, neck, lower back and hands. But really, any joint can be involved, especially if an injury or deformity has altered the joint mechanics.

Osteoarthritis is classified as primary or secondary. Both primary and secondary are basically the same. Secondary usually has a cause that significantly accelerates the degenerative process of the joint. This is either an injury to the joint, deformity or something that alters the mechanics of the joint. It is more than likely that we all will get Osteoarthritis to some degree or another. This is especially true if we live a long and active life. How we take care of our joints will determine the degree of dysfunction for all of us. Modern technology has made giant steps in joint replacements. None have come close to nature’s joints.

Self-Care

We will talk about four life style changes and then give some nutritional advice. The four are strength, flexibility, motion or joint play, and posture. We will start with strength.

Strength. Start with a strengthening program of the muscles around the joint. The stronger the muscles around the joint, the less pain and dysfunction that the individuals have. Proper warm up of the joint is mandatory before exercising. Concentrate on strengthening exercises with two to three sets of eight to twelve reps. These should be performed two to three times a week, skipping days in between routines. When exercising, when you reach your last rep, you should feel the muscle fatigue but you will remain in control. Start out with light resistance and gradually increase the resistance. If the joint gets sore, ice the joint for ten to twenty minutes either before exercising or after. If the joint gets severely sore, do both. If mildly sore, you can do one or the other. Hopefully, this will also be a part of your normal exercise routine.

Flexibility. Stretch all the muscles around the joint. As Osteoarthritis progresses, the joint becomes restricted. In severe cases, joints can become restricted in a fixed position. Examples are clenched hands or hip flexor deformities. If these muscles are not stretched, they will start to contract up. Where they contract up are called trigger points or Myofascitis. These points can cause pain and in alive individuals, accounts for more pain than the actual arthritic joint itself. Also, by stretching the joint, you help maintain the function and flexibility of that joint. Stretches should be done two to three times a day. Each stretch is held for ten seconds. Sometimes full flexibility is impossible due to joint deformity. In that case, do the best you can. If an arthritic joint becomes painful, stretching exercises can relieve some of the pain of an arthritic joint. Some individuals believe that they should not work or stretch an Osteoarthritic joint, movement and the stretching can actually decrease the pain of an osteoarthritic joint.

Joint Play. A special mention is made of joint play. Joint play is a term meaning motion that exists in a joint after all voluntary motion is used up. An example might be easier to understand. Bend you fingers back as far as you can without any help. Now, with your other hand, bend the finger back some more. This is joint play. All joints have a little extra motion in them after voluntary movement. This is the first motion lost in Osteoarthritis. An excellent way to restore this range of motion is with manipulations. Manipulations take the joint beyond the voluntary range into the joint play area. Manipulations usually require more sessions at the start and then a maintenance schedule to maintain the motion and the improvements in the joint. Manipulations may also cause pain when first administered and this shouldn’t be cause for alarm.

Posture. Posture should be addressed. Changes in posture can drastically reduce stress on some joints. Posture changes for the spine are under Neck and Back Pain.

Herbs / Nutrition

Glucosamine Sulfate has been shown in studies to decrease pain and stiffness. Some studies have shown Glucosamine Sulfate to be better than over the counter medications like Tylenol, Aspirin, and Ibuprofen. The studies also suggest that it may offer some repair functions of the damaged cartilage. Glucosamine Sulfate is recommended for symptoms and preventative measures for Osteoarthritis. 500 mg three times a day are taken. Results usually are seen within six to eight weeks.

S-Adenosylmethionine or SAM. SAM is another nutrient used in the maintenance of cartilage. Several studies have shown SAM to be beneficial in the treatment of Osteoarthritis. Studies show that SAM has been as effective as Motrin, Advil, and Nuprin. SAM is a natural ingredient. The difference is, it appears to maintain the cartilage, while non-steroidal anti-inflammatory medications appear to break down cartilage.

Cartilage and Collagen Repair Nutrients. Vitamin A, Vitamin C, Vitamin E, Zinc, copper and boron – these are the nutrients that are needed to maintain normal cartilage functions. Small studies with Vitamin C, Vitamin E and Boron have shown both a protective effect and some improvement in symptoms. These nutrients are taken as a long-term maintenance and preventative measures for Osteoarthritis. These nutrients are also known as antioxidants and have shown other health benefits.

Recommendations
Glucosamine-Sulfate : 500 mg three times a day.
Vitamin E: 600 iU’s divided, two times a day.
Vitamin A: 5000 iU’s a day divided, two times a day
Vitamin C: 1000 to 2000 mg, divided, two to three times a day.
Multivitamin Mineral: Minerals, especially Zinc, 45 mg a day, Cooper, 1 mg a day, and Boron, 6 mg a day.

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