Cartilage health can prevent need for joint surgery
Osteoarthritis is all about loss of cartilage, subsequent inflammation and changes to bone and joint structure. The result is pain and loss of mobility. The ends of bones such as the femur are covered in tough, flexible articular cartilage. It may surprise that despite its tough appearance and texture it is actually 80 per cent water, which acts like a shock absorber. Cartilage is a combination of living cells, the matrix they produce plus water. These specialised cells are called chondrocytes and their job is to secrete and maintain cartilage. They repair small amounts of damage as it occurs. Osteoarthritis starts when chondrocyte cells die, causing cartilage to break down. While there are a number of things that can damage chondrocytes, in most cases these are a combination of free radical damage from insufficient antioxidants and biochemical changes caused by trauma to the joint. While the triggers vary, the outcome is chondrocyte death and cartilage loss. This is then followed by unwanted inflammation in the joint capsule that further damages cartilage. Eventually the bone itself becomes compromised and the net result is more pain and restricted mobility. Nutritional therapy can help, especially in reducing inflammation, slowing the rate of cartilage loss and improving the function of existing cartilage. For example, therapeutic levels (800+ mg) of chondroitin can have significant effects on the health of chondrocytes and therefore cartilage protection and repair. Glucosamine also helps maintain cartilage while curcumin from turmeric helps reduce inflammation and fluid accumulation. An ex-builder contacted me with significant knee pain from advanced osteoarthritis. An orthopaedic specialist had recommended knee replacement. Two years on a personalised joint health programme and he now has very little pain and no longer needs surgery. In theory osteoarthritis (OA) is one of the simplest diseases. For years we thought that cartilage in our joints just wore away over time. We now know that OA is a complex disease where the processes that reduce cartilage are affected by genetics, past joint trauma and nutrition, especially levels of important antioxidants. Cartilage is very different from other tissue types. It has no nerve or blood supply and it appears as lifeless tissue. Cartilage is actually dynamic tissue. It is a matrix of proteins (collagen and elastin), chondroitin sulphate, water and living cells called chondrocytes. Research shows that the health of chondrocytes is central to the development of OA. Each chondrocyte looks after a small patch of cartilage, repairing damage by secreting new cartilage matrix where needed. The problem is when chondrocytes are damaged or die. This means that cell can no longer maintain cartilage. Eventually the cartilage thins leading to a (painful) bone on bone scenario. One of the most annoying and painful arthritic joints are small hand joints. While nutritional therapy can really help, these are among the slowest joints to respond. It seems counter-intuitive, but big weightbearing joints especially knees tend to respond faster. I have been helping someone with OA in their base thumb joint at the wrist. Within three months the pain had reduced, and now after a year, the discomfort is really minor, only when under heavy use. I use a two-pronged approach to supporting cartilage. Firstly we add compounds, especially chondroitin, that can support and repair cartilage. Secondly we add curcumin from turmeric and Omega 3 fish oil to reduce inflammation. Often the inflammation causes more pain and mobility loss than the actual cartilage damage. Thirdly we add the antioxidants that protect chondrocyte cells from further damage. John Arts (B.soc.sci, Dip Tch, Adv. Dip.nut.med) is a nutritional medicine practitioner and founder of Abundant Health Ltd. For questions or advice contact John on 0800 423559 or email email@example.com. Join his all new newsletter at www.abundant.co.nz.