OsteoArthritis & OsteoPorosis

by Dr. Sheena Wu, ND & Dr. Sarah Bourret, ND

 

Osteoarthritis is often confused with osteoporosis since often people have both. While osteoarthritis is a complex degenerative disease of a joint, hat causes joint pain and reduces joint mobility and function, osteoporosis is the loss of bone mass which causes risk of fractures.

Despite the fact that osteoporosis, arthritis and osteoarthritis (a form of arthritis) are completely different conditions, they are frequently confused, in particular osteoporosis and osteoarthritis, because both names start with “osteo.”

• Osteoporosis is a bone disease in which the amount and quality of the bone is reduced, leading to fractures (broken bones). Osteoporosis produces no pain or other symptoms unless a fracture has occurred.
• Arthritis (arth = joint; itis = inflammation) is a disease of the joints and surrounding tissue. Osteoarthritis and rheumatoid arthritis are the most common forms of arthritis.
• A joint is the location at which two or more bones make contact and allows for movement of the bones.
• A person can have osteoporosis and osteoarthritis at the same time.

• Both diseases may cause pain and limit mobility, but the cause of this pain and the way it is treated are quite different.
• An accurate diagnosis of your pain is very important. With an accurate diagnosis, you will be better able to develop a pain management program that works for you.
• The prefix “osteo” (which means “bone”) is the only thing that osteoporosis and osteoarthritis have in common.

 

OSTEOARTHRITIS

Osteoarthritis is the most common type of arthritis, affecting around one in six people in Canada.  It is a progressive degenerative joint disease where the joint cartilage, the protective layer between two bones breaks down and wears away, leading to bones directly rub and grind against each other.  Overtime, the accumulation of damage will lead to stiffness and pain, as well reduced movement and function of the affected joint, which ultimately affects ones ability to do physical activities, reducing quality of life.

 

Causes

Although more likely to affect the elderly, osteoarthritis can occur at any age.  It is a result of overuse of joints and the accumulation of wear-and-tear, which is often the consequence of aging, obesity, works of high physical demands, and sports such as athlete or dancer.  It can also be exacerbated or caused by injuries such as dislocations, ligamental injuries and torn cartilage as well.  Genetic and sex can also play a role in the risk of osteoarthritis.

Osteoarthritis is diagnosed based on medical history, physical examination and x-rays of the affected joints. activities, reducing quality of life.

 

Symptoms

Given the wear-and tear nature, osteoarthritis is most common in weight-bearing joints – knees, hips, feet & big toes, hands & fingers, and spine.  Symptoms of osteoarthritis are generally localized to the affected joints, including stiffness, pain, decreased range of motion, and thus function of joints, and possibly swelling.  The symptoms may come and go, the intensity can increase over time with progression.  One known symptom is the “morning stiffness” that typically lasts about 30 minutes and improves with gentle motion that “warms up the joint”.  Pain may increase throughout the day with physical exertion and will again be relieved by rest.  There can also be crepitus, the crackling or grating sensation of joint when moving.

 

Treatment

As osteoarthritis is a condition due to wear-and-tear, there are currently no cure.  The treatment goals will be focused on symptom management, improve function as well as slowing and prevention of further progression.  Depending on the severity, it can include a combination of self-management strategies, medications, treatment by healthcare professionals or possibly joint replacement surgery for severe osteoarthritis.

Osteoarthritis can be managed with the use of joint protection (decreasing the amount of work the joint has to do), exercise, pain relief medication, heat and cold treatments, and weight control. Severe arthritis may be treated with an operation, where damaged joints are replaced with an artificial implant. Knee and hip joint replacements are commonly performed.

Here are some things that can help with symptom management –

• Physical activity and light-impact exercise

It is often thought that arthritis needs to limit their movement.  However, not enough physical activity can lead to muscle weakness, which in turn worsens joint pain and stiffness.

Aside from lessening existing symptoms, daily light or moderate physical activity strengthens the muscles, increase blood flow to joint and help promote joint regeneration.  Overtime, slowing or even preventing further progression, maintain and improve the mobility of the joint.

• Maintain a healthy weight

While there are no clear-cut definition of healthy body or healthy weight, obesity is found to be a risk factor for osteoarthritis.  Excess body weight on the load-bearing joints leads to an increased wear-and-tear, which in turn quickens the process of osteoarthritis development.  Reducing excess weight can help reduce straining and pain, as well as slowing progression, even a modest amounts of weight loss – 10-20 lbs – can be beneficial.

• Anti-inflammatory Diet

As osteoarthritis involves inflammatory of the joint, a diet focusing on reducing inflammation can provide symptom relieve and delay progression.  Antiinflammatory diet emphasizes whole foods, fish, leafy greens, nuts and seeds, while decrease or eliminate the consumption of processed foods, simple sugars and simple carbohydrates, red meat, as well as any food sensitivities

• Topical applications

Castor oil

The anti-inflammatory effects of castor oil when applied topically can reduce the symptoms of pain in arthritic joints.[1]  Apply a thin layer of castor oil on affected joint, cover with a thin cloth to prevent sticking to other surfaces, use a heat pad or other heat application for 20 minutes to achieve optimal benefit.

*Important note – castor oil is very sticky, so use a cloth or old towels/t-shirt for ease of clean-up. Castor oil is NOT to be taken internally

 Heat & Cold

Heat applications on painful joints relaxes tight muscles and increase circulation and metabolize waste products quicker.  It is best used for chronic joint pains where there are no signs of inflammation or flare of acute injury or aggravation.

Cold applications decrease blood flow to reduce swelling and slows transmission of pain signals, slowing or inhibiting inflammatory response.  It is best for pain and swelling after exercise or during the first 24-72 hours after a flare or injury.

After the initial 48-72 hours, try alternating hot and cold applications with the hot vs cold time on a 3:1 ratio (eg 3 minutes of hot application, then switch to cold application for 1 minute).  Continue the alternation for 15-20 minutes, ending in cold application.

*Note – caution on not using temperatures that can burn the skin, use a thin cloth or paper towel on the packs for protection

• Acupuncture

It has been found that acupuncture provides anti-inflammatory and analgesic effects for osteoarthritic joints compared to placebo, providing significant reduction in pain intensity, functional mobility, and overall quality of life.[2][3][4][5]

Osteoarthritis can greatly impede on the quality of life, Naturopathic Doctors can provide an individualized and comprehensive plan to support patients using various supplements and modalities.

[1] https://pubmed.ncbi.nlm.nih.gov/19288533/

[2] https://pubmed.ncbi.nlm.nih.gov/33174383/

[3] https://pubmed.ncbi.nlm.nih.gov/31305415/

[4] https://pubmed.ncbi.nlm.nih.gov/29198932/

[5] https://pubmed.ncbi.nlm.nih.gov/33988943/

 

OSTEOPOROSIS

Osteoporosis is a bone disease. The word “osteoporosis” literally means porous bones. It is a bone disorder characterized by decreased bone strength as a result of reduced bone quantity and quality. A person with osteoporosis has an increased risk of breaking a bone (fracturing) easily.  It is caused by a decrease in bone formation relative to resorption (breaking down more bone than making) and NOT a normal part of aging, more associated with poor nutrition and/or lifestyle habits.

Other signs associated with calcium metabolism problems: periodontal disease, nocturnal leg cramps, osteoarthritic changes in joints, poor nail growth, backaches, decreased height.

Osteoporosis is called “the silent thief” because it can progress without symptoms until a broken bone occurs. When bones become severely weakened by osteoporosis, simple movements – such as bending over to pick up a heavy bag of groceries or sneezing forcefully – can lead to broken bones. Hip, spine and wrist fractures are the most common fractures associated with osteoporosis.

Diagnosis

Osteoporosis is diagnosed through a bone mineral density test, DEXA scan, a simple and painless test that measures the amount of bone in the spine and hip and involves the following:

-T score < -2.5 = osteoporosis diagnosis

-This value represents the number of standard deviations above or below the mean bone mineral density for sex and race matched to young controls.

 

Contributing Factors

• Diet high in acidic foods– meats, high protein, whole grains (except millet)
• Diet high in protein, especially animal proteins
• High phosphorus diet – meats, dairy, poultry, soft drinks
• Reduced calcium consumption
• Excess consumption of coffee, alcohol; smoking
• Inactivity/little exercise
• Low gastric pH – adequate levels of stomach acid are needed to absorb calcium and all minerals
• Premature ovarian failure – low estrogen production prior to menopause/low progesterone levels (progesterone stimulates bone building activity)
• Aluminum toxicity

Treatment

Osteoporosis can be treated with lifestyle changes and, often, the use of prescription medication. Paying attention to diet (adequate calcium and vitamin D intake) and getting regular physical activity are important lifestyle changes. Weight-bearing and strength training exercises can help to manage pain and improve the strength of bones and muscles, which helps to prevent falls. Broken hips caused by osteoporosis usually need to be repaired surgically. This can include the use of specialized “pins and plates,” but can also involve hip replacement surgery. This is determined by the surgeon based on the exact type of hip fracture that has occurred. If you have osteoporosis, there are effective medications that can reduce your risk of fracture.

Nutrition

• Decrease protein consumption if too high/balance acidity with alkaline foods
• Increase blood pH (alkalinize) with clean water, minerals, vegetables and fruits
• Alkaline Diet – low animal protein, high in vegetables/fruit (at least have a balance of animal protein and dark leafy greens/vegetables to counteract the protein’s acidity) when our blood pH is acidic, calcium is used as a buffer (leached out from the bones into blood)
• Bring calcium : phosphorus ratio level to 2:1 or 1:1 ratio
• Supplement highly absorbable Calcium – calcium citrate or malate, in addition eat foods high in calcium
• Supplement Magnesium – with calcium and other important minerals
• Potassium Citrate – decreases acidity; found in all nuts/seeds, apples, bananas, fish, sweet potato and yogurt
• Vitamin K2 – involved in synthesis of osteocalcin, a protein involved in mineralization of bone; found in egg yolks, butter and fermented soy
• Vitamin D3 – moves calcium into bone/bone remineralization
• Vitamin A – involved in bone matrix formation by osteoblasts
• Folic Acid
• Boron – involved in hydroxylation of beta-estradiole; steroid hormone metabolizer, increases vitamin D, estrogen and testosterone; lowers alk. phos. and calcitonin
• Silica
• Manganese – stimulates the production of bone matrix
• Zinc – important in bone matrix formation
• Copper – important in cross-linking collagen
• Isoflavones – helps the bone to absorb calcium
• Decrease caffeine, alcohol and sodium intake – too much causes calcium excretion in urine

*Important Note: For individualized and proper supplementation/dosages of vitamins and minerals, it is highly recommended to schedule an appointment with a Naturopathic Doctor or healthcare specialist.

 

Activity

• Weight-bearing exercises – walking, jogging, biking, aerobics, stairs, squats, lunges, side kicks, weight train (lift weights!)
• Move everyday for at least 30 min. – 1 hour

 

For support and to learn about your physical and bone health, as well to prevent issues and create longevity wellness, schedule an appointment with one of our practitioners!