Osteoarthritis - all you need to know

 

Osteoarthritis is the most common joint problem, and can cause pain, discomfort and stiffness. Fortunately there are a number of herbs and natural supplements that can help slow arthritis progression and significantly reduce symptoms.

Affecting an estimated 10% of men and 18% of women over 60 years of age, osteoarthritis is by far the most common type of arthritis in the world. The development of osteoarthritis is due to the degeneration of the cartilage in your joints, and this can result in the common symptoms of pain, stiffness, and decreased range of motion. Osteoarthritis most frequently affects the joints in your knees, hips, spine, and hands (Glyn-Jones 2015).

Conventional treatment often involves the use of pain relieving medication, which can help reduce pain, stiffness, and improve range of motion but pain relieving medications can have important side effects and do not slow the progression of the disease. Diet and nutritional therapy, however, has been shown to result in important reductions in pain, without side effects, and may help prevent the onset or slow the progression of osteoarthritis (Green 2014).

 

Diet

An unhealthy diet high in refined foods and low in essential vitamins, minerals and other important nutrients could contribute to the development of osteoarthritis. Eating a varied diet rich in fruits, vegetables, whole grains, legumes, and nuts as well as herbs and spices may help (Sanghi 2015).

In a study of people aged 19-70 with osteoarthritis, participants were given instructions to eat a whole-foods, plant-based diet for 6-weeks. Compared to an ordinary diet, the healthy whole food diet was associated with a significant reduction in pain, and the pain relief was seen as early as 2-weeks after initiation of dietary change (Clinton 2015).

Weight loss through dietary change has also been shown to result in important improvements in osteoarthritis symptoms. After a 16-week weight loss diet 64% of elderly women with osteoarthritis experienced a significant improvement in symptoms (Gudbergsen 2012). And another study also found that a 16-week weight loss diet resulted in fast and effective weight loss and highly significant improvement in symptoms in overweight people with osteoarthritis (Riecke 2010).

 

Exercise

Exercise is widely recommended for osteoarthritis and because it has similar benefits to pain relieving medication, but no side effects, people often prefer it as a treatment option (Fraenkel 2008). Both strength training (e.g. weights) and aerobic exercise (e.g. brisk walking) can reduce pain and improve function and overall health (Roddy 2005). For example, in one study, simple home-based exercises for around 30 minutes a day significantly reduced osteoarthritis pain within 6-months and continued to have benefits for at least 2-years (Thomas 2002). And a number of studies have found that regular Tai Chi practice is also an effective way of relieving pain and improving physical function (Ye 2014).

 

Glucosamine

Glucosamine is an is an essential component of connective tissue, cartilage, ligaments, and other structures, and has been widely used as a dietary supplement for osteoarthritis for decades. The benefits of glucosamine are thought to be due to pain relieving effects, as well providing nutritional support for the damaged cartilage and slowing further destruction of the joint tissue (Salazar 2014).

Although there are a lot of studies on glucosamine the benefits are still controversial, but this is thought to be due to differences in dietary supplement formulations. Glucosamine sulfate at a once daily dose of 1500mg has been shown to significantly reduce the symptoms, prevent further cartilage degeneration, and reduce the incidence of osteoarthritis-related surgery (Reginster 2012). Lower doses, or other types of glucosamine such as glucosamine hydrochloride may not be as effective.

 

Glucosamine, Chondroitin and MSM

Glucosamine supplements often contain other nutrients, especially chondroitin and methylsulfonylmethane (MSM) and both may improve the effect of glucosamine. Chondroitin, like glucosamine, is a structural component of cartilage. There are over 40 studies showing that chondroitin (alone or in combination with glucosamine) reduces pain in people with osteoarthritis (Singh 2015). For example, a recent study found that 400 mg of chondroitin plus 500 mg glucosamine three times daily was as effective as an anti-inflammatory medication in reducing pain, stiffness, flexibility and joint swelling after 6-months in people with painful knee osteoarthritis, with no side-effects (Hochberg 2015).

A naturally occurring type of dietary sulfur, MSM has also been studied for osteoarthritis and may be helpful. In one study a combination of 500 mg glucosamine and 500 mg of MSM was better at reducing pain and swelling and improving flexibility and mobility of joints than either supplement by itself (Usha 2004). Other studies using MSM as a powder at a range of 1-3 grams three times daily have also found MSM may help reduce symptoms of osteoarthritis (Debbi 2011).

 

Type II collagen

Undenatured type II collagen (UC-II) has been shown to work quickly for symptom relief and has been called “next generation glucosamine,” however UC-II works as anti-inflammatory and does not provide nutrition for your joints in the same way glucosamine does. A pilot study in women suffering from joint pain found that UC-II significantly reduced pain, including morning stiffness, stiffness following periods of rest, and pain that worsens with use of the affected joint as well as improvements in flexibility (Bagchi 2002).

UC-II was also found to be far more effective than glucosamine and chondroitin for pain relief and improving range of movement (Crowley 2009). In people with more severe rheumatoid arthritis UC-II for 3 months resulted in a decrease in swollen joints and tender joints (Trentham 1993). And in healthy people without arthritis, supplementation with UC-II improved knee joint extension and enabled people to exercise longer before experiencing any joint discomfort (Lugo 2014).

 

Boswellia

The gum resin of Boswellia serrate, also known as simply Boswellia or Frankincense, is a traditional ayurvedic medicine used for pain relief and has been extensively studied as a natural and safe anti-inflammatory. The resin contains boswellic acids, which are thought to be responsible for its health effects (Abdel-Tawab 2011). Boswellia extracts with high levels of boswellic acids are a very promising solution for pain relief as they work fast, with just one capsule or tablet daily and have excellent safety.

A large scientific review of herbal therapies for osteoarthritis found that Boswellia extract was one of the most widely studied and promising herbs for pain relief (Cameron 2014). In one study 100 mg of a high-potency Boswellia extract significantly improved pain and functional ability within just 5 days of use (Vishal 2011). And another study of a high-potency extract found that 100 mg once daily also significantly improved in pain and flexibility as quickly as 7 days (Sengupta 2010).

 

Curcumin

The yellow spice Turmeric is rich in phytonutrients called curcuminoids that have been shown to be very safe and have an anti-inflammatory effect that may help protect your joints and reduce osteoarthritis pain (Herotin 2013). Dietary supplements sold as curcumin are often actually a mixture of various curcuminoids at a concentration of about 95%. These high strength curcumin/ curcuminoid products are the best studied for osteoarthritis.

People with osteoarthritis taking curcuminoids for 6 -weeks had significant improvements in the pain and physical function scores compared to placebo in one study (Panahi 2014). Another investigation over 3-8 months found that a curcumin extract also reduced symptoms and improved function and quality of walking; and these benefits were associated with reductions in inflammation (Belcaro 2010). And over a 4-week period curcumin extract was as effective as an anti-inflammatory drug (ibuprofen) for the treatment of knee osteoarthritis with fewer gastrointestinal side effects (Kuptniratsaikul 2014). Doses used in these studies vary from just 200 mg of enhanced bioavailability curcumin up to 1500 mg a day.

 

Lifestyle Labs Recommends

Diet: eat a varied diet rich in fruits, vegetables, whole grains, legumes, nuts and seeds, as well as herbs and spices. Use mostly virgin olive oil. Avoid sugars, refined grains, processed foods and too much red meat

Exercise: gentle exercise for at least 30 minutes a day, ideally a combination of aerobic exercise such as brisk walking or resistance exercise e.g. pilates, yoga, tai chi, or weights

Weight loss: weight loss with diet or exercise can help reduce excess weight and decrease arthritis symptoms including pain

Glucosamine sulphate: take 1500mg once daily for at least 3-months

Glucosamine combinations: take 1500 mg glucosamine once daily with 500-1000 mg of Chondroitin and/ or MSM.

Type II collagen (UC-II): take 10 mg once daily for at least 30 days

Boswellia: take 100 mg of a high potency extract once daily for at least 7-days

Curcumin: take 1000 mg daily of curcumin or curcuminoids for at least one month

 

REFERENCES:

Abdel-Tawab M, et al. Boswellia serrata: an overall assessment of in vitro, preclinical, pharmacokinetic and clinical data. Clin Pharmacokinet. 2011 Jun;50(6):349-69. doi

Bagchi D, et al. Effects of orally administered undenatured type II collagen against arthritic inflammatory diseases: a mechanistic exploration. Int J Clin Pharmacol Res. 2002;22(3-4):101-10.

Belcaro G, et al. Efficacy and safety of Meriva®, a curcumin-phosphatidylcholine complex, during extended administration in osteoarthritis patients. Altern Med Rev. 2010 Dec;15(4):337-44.

Cameron M, Chrubasik S. Oral herbal therapies for treating osteoarthritis. Cochrane Database Syst Rev. 2014 May 22;5:CD002947.

Clinton CM, et al. Whole-foods, plant-based diet alleviates the symptoms of osteoarthritis. Arthritis. 2015;2015:708152.

Crowley DC, et al. Safety and efficacy of undenatured type II collagen in the treatment of osteoarthritis of the knee: a clinical trial. Int J Med Sci. 2009 Oct 9;6(6):312-21

Debbi EM, et al. Efficacy of methylsulfonylmethane supplementation on osteoarthritis of the knee: a randomized controlled study. BMC Complement Altern Med. 2011 Jun 27;11:50.

Fraenkel L, Fried T. If You Want Patients with Knee Osteoarthritis (OA) to Exercise: Tell them about NSAIDS. Patient. 2008 Jan 1;1(1):21-26.

Glyn-Jones S, et al Osteoarthritis. Lancet. 2015 Mar 3. pii: S0140-6736(14)60802-3.

Gudbergsen H, et al. Weight loss is effective for symptomatic relief in obese subjects with knee osteoarthritis independently of joint damage severity assessed by high-field MRI  and radiography. Osteoarthritis Cartilage. 2012 Jun;20(6):495-502.

Green JA, et al The potential for dietary factors to prevent or treat osteoarthritis. Proc Nutr Soc. 2014 May;73(2):278-88.

Hochberg MC, et al. Combined chondroitin sulfate and glucosamine for painful knee osteoarthritis: a multicentre, randomised, double-blind, non-inferiority trial versus celecoxib. Ann Rheum Dis. 2015 Jan 14. pii: annrheumdis-2014-206792.

Henrotin Y, Priem F, Mobasheri A. Curcumin: a new paradigm and therapeutic opportunity for the treatment of osteoarthritis: curcumin for osteoarthritis management. Springerplus. 2013 Dec;2(1):56.

Kuptniratsaikul V, et al. Efficacy and safety of Curcuma domestica extracts compared with ibuprofen in patients with knee osteoarthritis: a multicenter study. Clin Interv Aging. 2014 Mar 20;9:451-8.

Lugo JP, et al. Undenatured type II collagen (UC-II®) for joint support: a randomized, double-blind, placebo-controlled study in healthy volunteers. J Int Soc Sports Nutr. 2013 Oct 24;10(1):48.

Panahi Y, et al Curcuminoid treatment for knee osteoarthritis: a randomized double-blind placebo-controlled trial. Phytother Res. 2014 Nov;28(11):1625-31.

Reginster JY, et al. Role of glucosamine in the treatment for osteoarthritis. Rheumatol Int. 2012 Oct;32(10):2959-67.

Riecke BF, et al. Comparing two low-energy diets for the treatment of knee osteoarthritis symptoms in obese patients: a pragmatic randomized clinical trial. Osteoarthritis Cartilage. 2010 Jun;18(6):746-54.

Roddy E, et al. Evidence-based recommendations for the role of exercise in the management of osteoarthritis of the hip or knee--the MOVE consensus. Rheumatology (Oxford). 2005 Jan;44(1):67-73.

Salazar J, et al. Glucosamine for osteoarthritis: biological effects, clinical efficacy, and safety on glucose metabolism. Arthritis. 2014;2014:432463

Sanghi D, et al. Elucidation of dietary risk factors in osteoarthritis knee-a case-control study. J Am Coll Nutr. 2015 Jan 2;34(1):15-20.

Sengupta K, et al. Comparative efficacy and tolerability of 5-Loxin and AflapinAgainst osteoarthritis of the knee: a double blind, randomized, placebo controlled clinical study. Int J Med Sci. 2010 Nov 1;7(6):366-77.

Singh JA, Noorbaloochi S, MacDonald R, Maxwell LJ. Chondroitin for osteoarthritis. Cochrane Database Syst Rev. 2015 Jan 28;1:CD005614.

Thomas KS, et al. Home based exercise programme for knee pain and knee osteoarthritis: randomised controlled trial. BMJ. 2002 Oct 5;325(7367):752.

Trentham DE, et al, Weiner HL. Effects of oral administration of type II collagen on rheumatoid arthritis. Science. 1993 Sep 24;261(5129):1727-30.

Usha PR, Naidu MU. Randomised, Double-Blind, Parallel, Placebo-Controlled

Study of Oral Glucosamine, Methylsulfonylmethane and their Combination in

Osteoarthritis. Clin Drug Investig. 2004;24(6):353-63.

Vishal AA, Mishra A, Raychaudhuri SP. A double blind, randomized, placebo controlled clinical study evaluates the early efficacy of aflapin in subjects with osteoarthritis of knee. Int J Med Sci. 2011;8(7):615-22.

Ye J, et al. Effects of tai chi for patients with knee osteoarthritis: a systematic review. J Phys Ther Sci. 2014 Jul;26(7):1133-7.

 

       

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      Dr. Lifestyle

      Dr. Lifestyle is our own collective of leading health, nutrition and fitness experts. Having several brains makes it really hard to decide what we feel like for breakfast (Chia Coconut Pudding, or a Green Smoothie?), but when it comes to health advice we are an all-knowing, hyper-intelligent, super human.