What Causes Osteoarthritis?

Many women experience joint pain whether it’s in their knees, hips, fingers or shoulders.  The pain might come and go, be worse in the morning, or feel aching and stiff most of the day.  The diagnosis is typically done with symptoms and possibly an x-ray that shows joint changes.  Arthritis can start as early as the late teenage years/early twenties however more than 50% of people over 65 years old exhibit symptoms of arthritis.  What causes the joints to begin to deteriorate and create arthritis?

1.       Joint injury – Research shows that those who sustained a joint early at a young age are more apt to develop arthritis in that joint at a later age.  As an example, 51% of women developed knee arthritis 12 years after tearing their anterior cruciate ligament (ACL) in soccer.  Many can point back to a car accident, sports injury, broken bone or other trauma when discussing their problem area(s). 

2.       Obesity – Extra weight on the body coupled with daily activities and gravity means more load on the hips, knees, ankles and feet causing those joints to become more strained and inflamed over time plus it increases the wear and tear on the cartilage that leads to osteoarthritis. 

3.       Age – Sorry ladies, aging does take its toll on the joints considering more than 50% of people over 65 have arthritis symptoms (as stated above).  Many women will say “I didn’t have these problems in my 20’s or 30’s!” but over time joint injuries happen, diet/lifestyle choices take effect, genetics kick in, hormones change, weight fluctuates…and suddenly one day women find themselves waking up more stiff and aching.  Those of you who can still go from sitting cross-legged on the floor to a standing position without (much) assistance count yourselves lucky. It will probably change.

4.       Congenital abnormalities – If someone were born with joint problems or cartilage issues, then over time the stress on the joints will cause arthritic changes.  For example, scoliosis in the spine, or one leg shorter than the other will shift the way the body carries itself causing joint problems. 

5.       Endocrine disorders – Diabetics and those with low thyroid hormone are at risk for more joint and cartilage problems that can lead to arthritis.  Women heading into menopause often complain of more joint pain because their estrogen levels are gradually (or suddenly) decreasing. 

What does all this mean?  It means, take good care of yourself!  This is your one body.  Eat healthy, stay hydrated, maintain a healthy body weight, limit sugars and processed foods, and stretch regularly.  Thankfully there are articles here for tips to reduce the symptoms of arthritis if your joints are causing you pain on a regular basis.  Lastly, talk with your health care provider about appropriate work-up and treatment suggestions. 

References:

1.       Sofat, N., Ejindu, V., Kiely, P.  What Makes Osteoarthritis Painful?  Rheumatology. 2011;50(12):2157-2165.

2.       Roos, E.  Joint Injury Causes Knee Osteoarthritis in Young Adults.  Curr Opin Rheumatol. 2005;17(2):195-200.

3.       Kramer, P.  Prevalence and Distribution of Spinal Osteoarthritis in Women.  Spine. 2006;31(24):2843-2848.

5 Health Questions To Ask Your Mom

Sunday was Mother’s Day and many were celebrating with cards, calls, flowers and brunch to honor the women in their lives.  Yet, how many know the full health history of their mom, grandmother and aunts?  This information could prove to be critical when it comes to your own health therefore these are 5 questions to ask the female family in your life.

1.       How was menopause?  This question is important as women tend to follow them other women in their family when it comes to peri-menopause and menopausal changes.  Do the hot flashes and night sweats start in the 40’s or 50’s?  How long did it take?  Was it rough?  Was it easy?  How did she treat it?  Any complications? 

2.       Who has had cancer in the family?  And at what age?  This applies to both the men and women however mom tends to know this information.  If grandma and the aunts had breast cancer at a younger age, this is more concerning than finding out grandma had it later in life.  Has anyone had thyroid cancer? Prostate cancer? Ovarian, cervical or uterine cancer? Skin cancer?  Know your family’s cancer history.

3.       What are the family trends?  If all the women eventually develop thyroid disease and go on thyroid medication, this helps both you and your health care provider to be extra diligent and pro-active.  Does heart disease run in the family?  What about obesity?  Fertility problems?  Endometriosis?  Osteoporosis?  Do the women tend to lose their hair as they age?  Everyone have their gallbladder?  What about digestive or food allergy problems?  All of this information is critical for future planning and may shed light into current symptoms.

4.       Any outliers in the family?  The 2^nd cousin with celiac’s disease may not strike you as important however as your gas and bloating worsens, it could be a direct link.  The weird uncle whose mood alternates from really happy and hyper to down and depressed may be suffering from undiagnosed bi-polar.  This can be genetically linked as can depression in the family.  If just grandma had aches and pains it could have been undiagnosed fibromyalgia or a certain type of arthritis – how is your pain?

5.       What about your siblings?  Not all brothers and sisters are close therefore they may not inform each other about different health issues, concerns, scares and symptoms but mom usually knows.  Ask her if your symptoms sound like anyone in the family or periodically check in on the health of the rest of the family.  You may find out that your older sister has been having problems getting pregnant too or that your brother experiences the same types of migraines that you do and the same medications are not working.

While some people may prefer to keep some of their health history private, the more you know the more you (and your family) can be pro-active and prevent when possible.  Let your health care provider know of any changes as well to routinely keep your chart up-to-date and help them provide the best care possible for you.

 

Learn more on the women's health website, Emowher!

References:

1.       Segurado, R., Deterawadleigh, S., Levinson, D., Lewis, C., Gill, M., Nurnbergerjr, J., Craddock, N. Depaulo, J.  (2003). "Genome Scan Meta-Analysis of Schizophrenia and Bipolar Disorder, Part III: Bipolar Disorder". Am J Human Genetics 73 (1): 49–62.

2.       Steiner, A., Baird, D., Kesner, J.  (2008). Mother’s Menopausal Age is Associated with her Daughter’s Early Follicular Phase Urinary, Follicle Stimulating Hormone Level.  Menopause. 15(5): 940–944.

5 Tips to Helping Arthritis Naturally

Many women suffer from arthritis aches and pains that linger for hours or stay for days.  The pain and stiffness can really inhibit daily activities such as putting on shoes, opening jars, and even walking.  Osteoarthritis is commonly known as degenerative arthritis and is due to repetitive use, injury, aging, genetics, and certain diseases.  Treatment can be difficult as many of the causes are not curable such as aging (sorry ladies) or genetics however these 5 natural tips may be helpful to reducing your inflammation.

1)      Tumeric – the spice that is also known as curcumin has pain reducing qualities as it inhibits the inflammatory pathway known as COX-2.  One cannot eat enough of the spice therefore taking a good quality supplement at 1500-2000mg one to two times per day.

2)      Green Lipped Mussels – these mussels from New Zealand have promising anti-inflammatory properties for those with arthritis.  The typical dose is 500-1000mg one to three times per day.  It can take 4-6 weeks to take effect however research is promising.  Be very careful for those who have an allergy to mussels.  Side effects may include nausea or diarrhea so start with a lower dose and work up.

3)      Devil’s Claw – also known as Harpagophytum procumens, is an herbal plant that comes from Africa and contains the active ingredient, harpagosides to lower pain and inflammation.  The typical dose is about 1000mg per day (totally 50-60mg harpagosides – read the label) in divided doses.  Those with ulcers or gallbladder disease should use this plant cautiously and those with blood sugar problems need to monitor their levels as Devil’s claw has been known to lower glucose levels.

4)      Krill oil – everyone knows about the vast importance of fish oil but Krill oil is quickly making a name for itself with it comes to reducing pain and inflammation (especially c-reactive protein) with arthritis.  The typical dose is 300mg per day (along with your normal fish oil supplement) for joint protection.  Like fish oil, side effects can include ‘fish burps’ especially in poorer quality supplements, heartburn and nausea.  Those who have allergies to certain seafood such as shrimp should avoid it and krill oil (like fish oil) can potentially act as a blood thinner so be aware with blood thinner medications or before surgery.

5)      Glucosamine and Chondroitin – these supplements are the most commonly used for arthritis and joint pain however they must be taken at the appropriate dose and can take up to 8 weeks to have an effect.  If they are stopped then the beneficial effect goes away.  Glucosamine and chondroitin have both been shown to lower c-reactive protein and lowers inflammatory cytokines.  Glucosamine must be taken at doses of 1500mg per day and chondroitin at 400-500mg per day.  Some supplements are from a seafood source therefore those with allergies need to be aware.  Side effects may be gastrointestinal in nature such as diarrhea or nausea.

Other than krill oil, the other four natural supplements should not be used in pregnant women and remember to discuss all supplements with your health care provider.

 

Read more at the women's health website, Empowher, here!

References:

1) Lev-Ari, S., Strier, L., Kazanov, D., Elkayam, O., Lichtenberg, D., Caspi, D., and Arber, N. Curcumin synergistically potentiates the growth-inhibitory and pro-apoptotic effects of celecoxib in osteoarthritis synovial adherent cells. Web. 7 May, 2013.

http://www.medscape.com/medline/abstract/16249246

2) De Silva, V., El-Metwally, A., Ernst, E., Lewith, G., and MacFarlane, G. Evidence for the Efficacy of Complementary and Alternative Medicines in the Management of Osteoarthritis. Web. 7 May, 2013.

http://www.medscape.com/viewarticle/741637_3

3) Deutsch L. Evaluation of the effect of Neptune Krill Oil on chronic inflammation and arthritic symptoms. J Am Coll Nutr. 2007 Feb;26(1):39-48.

4) Kelly, J. Glucosamine, Chondroitin, Fish Oil May Reduce Inflammation. Web. 7 May, 2013.

http://www.medscape.com/womenshealth

5) Rovati, L., Girolami, F., and Persiani, S. Crystalline Glucosamine Sulfate in the Management of Knee Osteoarthritis. Web. 7 May, 2013.

http://www.medscape.com/viewarticle/7657351)

     

Arthritis happens when inflammation occurs in the joints causing pain and stiffness.  It can occur in any joint as many people can experience it in the large joints such as the hips or knees while others feel it in the smaller ones such as the fingers, neck or toes.  The symptoms of arthritis may come and go or rotate around locations in the body.  They may occur continually throughout the day or feel worse in the morning and improve with movement and stretching.  Regardless of the symptoms, here are 5 tips to help when working with arthritis.

First, know the type of arthritis you have.  Many assume that their symptoms are a result of age, overuse or injury which is known as ‘osteoarthritis’ however there is an autoimmune inflammatory type known as rheumatoid arthritis.  The symptoms can be different in that the joints may become swollen, hot and tender to touch.  Additionally those with the skin condition, psoriasis, may have psoriatic arthritis.

Second, take fish oil regularly.  The omega-3 fatty acids help lower inflammation by reducing cyclooxygenase-2 (COX-2) activity which is similar to the effect of over the counter pain medications.  Choose a good quality oil and take between 1000-3000mg per day.  Be careful if you have bleeding problems as fish oil can act as a blood thinner.

Third, consider cutting out the nightshade family, otherwise known as the Solanaceae group who have specific alkaloids known to irritate your joint spaces.  This family includes potatoes, tomatoes, eggplants and peppers.  Cut out these foods for 2-4 weeks and see if it makes a difference in your pain and inflammation. 

Fourth, do not stop exercising but you may need to tweak your routine.  Consider lighter impact moves that do not put added pressure on the knees, hips or feet.  Look at yoga, pilates, Barre method, or swimming.  Continue your cardio and weight routine with appropriate adjustments for when your joints are feeling more inflamed.  Switch to walking instead of running or try the low impact elliptical machine.

Fifth, add in the spice, Tumeric, however the supplement form is more concentrated and therefore more potent.  Tumeric is known to be anti-inflammatory and helpful for those with all forms of arthritis.  Like fish oil, make sure to get a good quality supplement and consider taking 1000-2000mg per day. 

References:

Norling, LV., and Perretti, M.  The role of omega-3 derived resolvins in arthritis.  Web.  29 April, 2013.

http://www.ncbi.nlm.nih.gov/pubmed/23434193

Childers, NF, and Margoles, MD.  An Apparent Relation of Nightshades (Solanaceae) to Arthritis.  Web.  29 April, 2013.

http://noarthritis.com/research.htm

Iversen, MD., Brawerman, M., and Iversen, CN.  Recommendations and the state of the evidence for physical activity interventions for adults with rheumatoid arthritis: 2007 to present.  Web.  29 April, 2013.

http://www.ncbi.nlm.nih.gov/pubmed/23538738

Asher, GN., and Spelman, K.  Clinical utility of curcumin extract.  Web.  29 April, 2013

http://www.ncbi.nlm.nih.gov/pubmed/23594449