by Dr. John Neustadt

Joint pain causes too many people to miss out on some of the greatest moments of their lives. While friends and family are enjoying themselves riding bikes, playing tennis, hiking, gardening, dancing or playing with their kids and grandkids, they’re sitting on the sidelines, unable to fully participate. And if they do, they’re often experiencing pain and discomfort, or paying for it later as their joint pain flares up.

There are nearly 100 different types of arthritis. They can create mild and annoying discomfort to severe and debilitating pain. But they all have two things in common: (1) inflammation and (2) they reduce your quality of life. It doesn’t have to be that way. And of all the diseases, arthritis and heart disease have a lot in common and are intimately linked. In a beautiful two-for-one, natural approaches to arthritis also reduce your cardiovascular disease risk. 

Of all the arthritides (yes, arthritides is the plural of arthritis), osteoarthritis (OA) is the most common. If you suffer from arthritis, you’re unfortunately in good company. It’s one of the leading causes of disability in the US and around the world. More than 60 million people in the US and 250 million people around the world have arthritis, including 80% of people over 50 years old.

Osteoarthritis (OA) is a chronic, degenerative disease of the connective tissue in joints. It usually occurs in the older age-group and is a nearly universal consequence of aging. And more and more people are struggling to deal with it. Since the 1950s and ‘60s, the number of people in the US with OA has doubled.

OA can strike at any age, Although primarily seen in the elderly, there is a 35% incidence of knee osteoarthritis as early as 30 years old. In these younger folks, it’s often diagnosed as chondromalacia patellae. But by the time you’re in your 70s, OA is nearly universal and is the most common of any disease.

Joint Destruction Long Before You Know it

OA is similar to many other chronic diseases in that its slowly developing for many years before the first symptoms appear. Heart disease, Alzheimer disease and Parkinson disease progress in the background, without anyone knowing for years.

The first symptom of a heart disease is usually a heart attack. But by the time you’re stopped in your tracks by severe pain and a crushing pressure in your chest, and before you break out in a cold sweat and start to realize you need help or your going to die, the disease process had already been progressing without you knowing it for many years.  

Similarly, by the time someone finally seeks medical care for joint pain, they’ll typically already have advanced joint cartilage destruction. And this destruction had likely been there for years before finally creating pain.

Diagnosis is usually made based on clinical presentation. The chief symptoms of OA are pain and stiffness in the joints. It most often affects asymmetrical weight bearing joints and distal interphalangeal (DIP) joints. The pain usually increases after exercise.  

OA is diagnosed as primary or secondary. In primary OA there is no known cause. Primary OA is sometimes referred to as “wear-and-tear osteoarthritis.” In secondary OA, as the label implies, OA is a result of other factors. These can include trauma such as a previous sports injuries, having an autoimmune disease or structural abnormalities.

One common surgical procedure that can lead to the development of osteoarthritis years later is surgery where part or all of the meniscus in the knee is removed. This surgery is called a meniscectomy (total removal of the meniscus) or hemi-meniscectomy (partial removal of the meniscus).

Although an X-ray is used to diagnose OA, X-rays and lab test don’t correlate with the disease what people are feeling. We can have patients with similar X-rays, but one may be experiencing severe joint pain while the other patient may have only mild or no discomfort.

Heart Disease for Joints

When describing the process of developing OA, I like to tell people it’s like getting heart disease in your joints. Similar to heart disease, it’s been developing for years without them knowing it. They both also involve inflammation and connective tissue destruction.

In atherosclerosis (hardening of the arteries), the lining of the arteries is damaged. With OA, connective tissue in and around joints is destroyed and inflammation is part of both disease processes. In both diseases, the inflammation, and the development of the disease is “silent.” This means it’s occurring without any outward signs or symptoms, until one day suddenly the symptoms appear.

Osteoarthritis usually affects weight-bearing joints such as the spine and knees. The OA disease process at the tissue and cellular level is associated with destruction and loss of cartilage, remodeling of bone and intermittent inflammation.

In the healthy joints, just like in other tissues throughout the body, there is a constant turnover of cells. Old, worn out cells are broken down and new healthy cells are produced. A mechanical or biochemical disruption of proper joint functioning and cell turnover initiates the downward spiral of chronic degeneration.

In OA, the rate of degeneration is faster than the rate of repair, the body’s healing mechanisms can’t keep up with the damage and joints start to degenerate, ultimately leading to pain, decreased range of motion and swelling around the joint in more advanced cases.

Similar Problems, Similar Solutions

So many chronic diseases have similar underlying causes, and thus similar approaches to promoting health. These include poor diet, not exercising, not getting enough sleep and chronic inflammation. And these are risk factors for OA and heart disease too.

If you want to support joint health, the foundations of diet, exercise, proper sleep and managing stress are important foundational approaches that can also support heart health.

Diet

Nutrient deficiencies have been implicated in the onset and progression of OA.  Eating more whole, organic fruits and vegetables is a good way to increase the body’s nutritional status. Antioxidants, minerals and other phytonutrients create the colors in fresh fruits and vegetables, and those alkaline foods can reduce inflammation.

Exercise

Daily non-traumatic exercise such as swimming can be helpful. Exercise has been shown to be an effective approach to managing of osteoarthritis and reduce heart disease risk. It can reduce impairment, improve function, and prevent disability in OA patients.

The amount of disease progression may decrease someone’s ability to participate in exercise. Range of motion exercises may help maintain joint mobility. Additionally, low impact stretching exercises, such as gentle yoga therapy is beneficial in many types of arthritis, including OA. There are many exerices that you can do at home and work into your daily routines. For examples, read the blog, 5 Simple Ways to Work Exercise into Your Life.

Sleep and Stress

The important of getting enough sleep (and high-quality sleep) and managing stress cannot be overstated. As in all chronic degenerative diseases, lifestyle plays a major role in its onset and progression. Adequate sleep and stress reduction are important components of preventing chronic diseases and play major roles in healing. To support healthy sleep, take Sleep Relief and follow the recommendations in my Checklist for Better Sleep.

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