Healthy For LifeArthritis

Tell us what kind of arthritis are we talking about today and how big of a problem is it?

Arthritis BackgroundApproximately 66 million Americans suffer from Arthritis

Arthritis BackgroundApproximately 66 million Americans suffer from ArthritisSome popular pain-relieving medicines have been taken off the market

Is there more than one type of arthritis?

Arthritis BackgroundOver 100 different types of arthritis.Osteoarthritis and Rheumatoid Arthritis most common with OA far exceeding RA.Gout

Arthritis BackgroundOsteoarthritis“wear and tear” arthritis – most commonCartilage covering end of bones begins to deteriorate leading to bone on bone rubbing

Arthritis BackgroundRheumatoid ArthritisAutoimmune diseaseLining of joints attacked by body’s immune systemJoints become inflamed leading to damage, swelling, chronic pain and disability.Rheumatoid Arthritis

Are there any risk factors for developing arthritis?

Risk FactorsObesity -particularly knees and hipsAge - 1/3 over 65 with radiographic evidence in kneesFemale gender -females: male=2.6Occupation -hands, hips, knees are vulnerableGenetics – Identical twins have double the riskTrauma – repetitive acts have cumulative riskPre-existing or anatomical joint abnormalityPoor proprioception and/or quadriceps weaknessKnee Laxity

Are there any NEWSTART connections?

NEWSTART ConnectionsN-NutritionE-ExerciseW-WaterS-SunshineT-TemperanceA-AirR-RestT-Trust in God

NEWSTART ConnectionsNutritionAnti-inflammatoryTrans-fatsPro-inflammatory

NEWSTART ConnectionsNutritionObesityLose 10 pounds for 10 years½ risk of arthritis in knees

NEWSTART ConnectionsNutritionSulfur containing foodsRepair

Are there any scientific studies that show benefit from proper nutrition?

NEWSTART ConnectionsNutritionFramingham Osteoarthritis Cohort StudyThreefold reduced risk of cartilage loss and OA disease progression in middle and highest tertiles of vitamin C intake.

Are there any other NEWSTART connections?

NEWSTART ConnectionsExerciseKeep Those Joints in Motion

NEWSTART ConnectionsExerciseWalk on Different TerrainInvest in walking shoes

NEWSTART ConnectionsWaterHydrotherapy – Hot and Cold

NEWSTART ConnectionsWaterDrink two to three quarts of purified water daily to maintain adequate hydration.

NEWSTART ConnectionsRestMassage TherapyMassage Therapy can boost “feel good” endorphins – the brain’s natural pain killers. The Arthritis Foundation recommends finding an experienced therapist in arthritis massage.

How about natural medicines?

Natural Medicines for OsteoarthritisContains “capsaicin”-makes peppers fiery hotWorks as a counter-irritantDepletes substance P from sensory nervesSubstance P associated with pain transmissionCream (0.025-0.075%) applied several times per dayAllow at least 3 days of multiple capsaicin applications to achieve full effect.Capsicum/Cayenne pepperAnalgesics & Anti-inflammatory Agents

Natural Medicines for OsteoarthritisAgents that look promising but need more study:GingerCat’s clawDevil’s clawStinging nettleWillow bark – converted to aspirin in bodyAnalgesics & Anti-inflammatory Agents

Natural Medicines for OsteoarthritisGlucosamine is called an amino sugarIncreases mucopolysaccharidesIncreases synovial fluid/repair of eroded tissueStimulates new cartilage synthesisOver 20 studies lasting up to 3 yearsReduces pain scores by 28 to 41%Improves function by 21 to 46%Structure Modifying Agents

Natural Medicines for OsteoarthritisGlucosamine sulfate 1500 mg daily comparable to:Ibuprofen 1200 mg dailyFeldene 20 mg dailyAcetaminophen 1000 mg three times dailyLasts longer but slowerAnalysis of several pooled study results shows 54% reduced OA disease progressionStructure Modifying Agents

Natural Medicines for OsteoarthritisSeveral forms of glucosamine availableGlucosamine sulfateGlucosamine hydrochlorideN-acetyl glucosamineVast amount of research done with glucosamine sulfateStructure Modifying Agents

Natural Medicines for OsteoarthritisGlucosamine is often combined with chondroitin sulfateThe evidence for combining glucosamine with chrondroitin is sparse.Structure Modifying Agents

Natural Medicines for OsteoarthritisSAMe (s-adenosylmethionine)Thought to stimulate cartilage growth and repair by increasing number of chondrocytesEnhance chondrocyte proteoglycan synthesis and secretionIncrease cartilage thicknessSignificantly more effective than placebo and equal to NSAID’sGenerally well-toleratedMiscellaneous

Natural Medicines for OsteoarthritisSAMe has serotonergic effects – be careful combining it with anti-depressantsUse butanedisulfonate salt form – better bioavailability Miscellaneous

Natural Medicines for OsteoarthritisUsual dose – 600 to 1200 mg/day Miscellaneous

Natural Medicines for OsteoarthritisMore agents needing further evaluation:MSM (methylsulfanylmethane)Avocado and soybean oilCetylated fatty acidsAntioxidantsSOD (superoxide dismutase) – only intraarticular injections workMiscellaneous

Psa 22:14-19 I am poured out like water, and all my bones are out of joint: my heart is like wax; it is melted in the midst of my bowels. But be not thou far from me, O LORD: O my strength, haste thee to help me.