Osteoarthritis is rarely appreciated as one of the greatest problems affecting man. This form of arthritis is so universal that it is often regarded as a normal part of aging. Osteoarthritis is usually progressive and often de-forming and disabling. The prevalence in the U.S. for all aged 25-74 is 32.5 percent for the hands (42.4 million persons), 22.2 percent for the feet (29 million), 3.8 percent for the knees (5 million) and 1.3 percent for the hips (men only, 765,000).
There are many names for Osteoarthritis. The name most used is degenerated joint disease (D.J.D). The classification of Osteoarthritis as a disease has even been questioned by some authorities, who prefer to redefine it as “a mechanism of repair of dense tissue”. Osteoarthritis means inflammation of a bony joint, the term is usually applied to the process involved in D.J.D even though it is understood as a noninflammatory process that primarily involves breakdown of joint cartilage. This extremely common arthritis can even cause severe pain and disability, leading to loss of work and independents in the aged population.
More than 50 different terms have been applied to osteoarthritis. The most common terms including osteoarthritis, degenerative arthritis, degenerated arthrosis and degenerative joint disease (D.J.D). The difference between the terms arthrosis and arthritis has come from the fact that the disease process is not always inflammatory. For this reason, D.J.D has gained the most universal acceptance in the literature.
Articular cartilage provides the joint with a self lubricating surface and works well under normal joint loading conditions. However, cartilage has a limited capacity for repair and re-generation, so damage to cartilage disrupts the normal function of this tissue, thus interfering with a normal lubricating process within the joint. Insufficient lubrication may be a primary factor in the cause of osteoarthritis. The tissues of the synovial joint are inherently susceptible to the development of osteoarthritis if range of motion or the amount of stress on the articular cartilage is excessive. Joints are threatened during normal day-to-day activities, and much of the joint protection is from the dynamic system of coordinated muscle activity. O’Connor et al. defines a protective muscular reflex as a somatic muscular activity that prevents injury to a normal joint, or further damage to the injured joint, by preventing the joint from exceeding its normal range of motion.
NSAIDs In The Treatment Of Arthritis And Side Effects
NSAIDs are broad class of prescription and over-the-counter drugs, including aspirin, ibuprofen, naproxen, Voltaren and other similar drugs. NSAIDs continue to be the mainstay of drug therapy for patients with osteoarthritis. Unfortunately, these drugs are over prescribed, readily available and not used judiciously. These drugs are not without side effects; the American College of Rheumatology guidelines suggest that patients receiving long-term NSAID therapy obtained a blood count, urinalysis and chemistry panel every three months. Monitoring cannot wait until the side effects of NSAIDs cause symptoms. Renal failure does not produce symptoms until it becomes severe.
NSAIDs are the most prescribed drug in the U.S.. Even though this class of drug is widely used and perceived safe, there are serious risks of complications. Among these are gastrointestinal ulcers and hemorrhages that can lead to perforation and death. More than one percent of the population uses these drugs on a daily basis. Adverse effects from these medications as a group, are reported to the Food and Drug Administration (FDA) more frequently than any other medication class. In a study of economic effects of gastric ulcers in NSAID users, the per patient cost of hospitalization was $3,450; those in need of hospitalization and surgery cost of 15,700. The incidents in severity of acute mucosal injury are does depend but virtually 100% of subjects developed lesions after a single 650-1300 mg dose of aspirin. NSAID- associated GI problems were estimated to cause 32,000 hospitalizations and 3200 deaths per year in the U.S.. There is little evidence to suggest that NSAIDs have any advantage over sample analgesic’s and sample analgesic’s are also unsatisfactory. In a study of patience with chronic knee pain and osteoarthritis, treatment with either an anti-inflammatory, and analgesic dose of ibuprofen and/or acetaminophen showed no evidence of superiority of either the anti-inflammatory dose or the lower dose of ibuprofen compared to acetaminophen.
Rapid deterioration of joints from long-term NSAID treatment has been called analgesic arthropathy and is thought to be caused by loss of protective pain sensation, but it seems more likely that it is a direct effect of the drug on cartilage. In addition, oral administration of aspirin markedly accelerates development of osteoarthritis in C57 black mice, a strain genetically predisposed to the disease. If along with the external evidence that NSAIDs interfere with metabolism of articular cartilage and a repair of bone, clinical experience has shown use of these drugs cause acetabular bone destruction, joint disease and avascular necrosis of the hip. Even though NSAID induced arthritis has been a well-known since the 1960s, in a recent survey, 94 percent of primary care physicians indicated they would prescribed NSAIDs as an initial treatment for elderly patients with uncomplicated hip osteoarthritis.
There Is A Better Way
- Joint health depends on the following factors:
- Proper nutrition
Chiropractic adjustments are well-known for establishing proper joint balance and function. By improving the alignment of the body each joint is allowed to move in a more natural and balanced manner. Also chiropractic adjustments are beneficial in establishing normal range of motion and normal muscle reflex function as well as release of beta-endorphins (a natural pain killer).
Exercise is the next most important factor when it comes to joint health. Research study after research study has shown the beneficial effects in preventing or reversing arthritis with regular exercise. Diet: a number of studies have shown a large number of patients with osteoarthritis are ingesting less than the U.S. recommended daily allowance of vitamin A, C., D., E. ., B6, folic acid, pantothenic acid in the minerals zinc, magnesium, iron and calcium.
Most of these vitamins are associated with the chronic degenerated disease rampant in our society. Glucosamine sulfate, chondroitin sulfate, fish oils, magnesium, B-3, collagen, curcumin and other specialty nutrients have shown great promise in the controlled and even reversal of this disease. Through proper evaluation Dr. Keefe can establish a treatment program to help you regain your health.