Osteoarthritis is a degenerative joint disease characterised by inflammation, involving alterations in joint tissues, cartilage, bone and synovial membrane. Such degeneration causes progressive loss of joint function, whereby the articular cartilage that forms a thin protective layer covering the joints and subchrondial bone becomes gradually wasted, eventually causing friction. Such wear and tear leads to loss of function and chronic pain, thus affecting the quality of life of sufferers.
Common risk factors for the development of osteoarthritis include age, mechanical stress associated with occupations involving heavy lifting, joint trauma/injury, obesity, misalignment of body structure, alterations in sex hormones in particular oestrogen balance in post menopausal women and finally the presents of nutritional deficiencies. In addition to the latter etiologies, the naturopathic perspective considers the accumulation of waste substances in the body as a compounding factor in the development of osteoarthritis, hence the excretion of such wastes is an important element to consider in the management of this condition.
Conventional pharmalogical approaches towards the management of osteoarthritis include the use of pain and anti-inflammatory medications. These can be very beneficial for short-term use but are not sustainable long-term due to the side effects they can have and are in particular injurious to gastro- intestinal functional. The naturopathic management of osteoarthritis is a comprehensive, integrated and thorough approach which focuses on addressing key underlying factors with the use of the following (but not limited to):
Herbal therapies and Neutraceuticals
- Anti-inflammatory herbs such as devils, claw, turmeric, ginger, green tea, grapeseed, to name a few, are very helpful in reducing an array of inflammatory mediators that are causing chronic pain. These herbal medicines contain a complex, synergy of ingredients that have a gentle restorative action on the body and unlike conventional medicines can be used long-term to substantially reduce or even eliminate pain without the side-effects.
- Depuratives display cleansing and detoxifying properties to eliminate metabolic waste build up in the body, notably celery seed, which also has the added benefit of being anti-inflammatory.
- Circulatory stimulants such as ginger and prickly ash, which work to improve circulation to affected areas. Ginger also inhibits a range of inflammatory mediators and acts as an analgesic, thus being very effective in pain management.
Addressing nutritional deficiencies
- Vitamin C is critical for the development of normal cartilage via its ability to synthesis collagen, an essential protein that forms joint cartilage. Additionally studies have demonstrated it’s ability to reduce the progression of osteoarthritis through its potent anti-oxidant action which diminishes the harmful effects of reactive oxygen species that play a role in the pathogenesis of osteoarthritis.
- Vitamin D is necessary for normal turnover of articular cartilage and has the potential to prevent or even stunt cartilage loss, hence may play a protective role against further deterioration.
- Magnesium is an essential trace element that plays a paramount role in bone mineralisation . Magnesium deficiency leads to degradation of chrondocytes (cell component in healthy cartilage) and eventually impacts the health of articular cartilage. Its important to remember that magnesium deficiency cannot be tested via blood pathology methods as only 1% is available in blood, 50-60% is stored in bone tissue and 40% in soft tissue, therefore blood diagnostics are not an accurate measurement. Deficiency is based on symptomology, age and information obtained from assessments of lifestyle and dietary intake.
- Zinc has a functional role as an anti-oxidant and in the inflammatory mediating response. It is a critical component of connective tissue in the health of articular cartilage.
Dietary
- Elimination or reduction of inflammatory foods such as excess red meat, and total elimination of vegetable oils (e.g canola, sunflower, corn oil) and refined sugars should be considered. Reduction in the consumption of alcohol is also advised due to its deleterious impact on gut health and potential to deplete critical nutrients.
- Anti-inflammatory diet involves a diet rich in anti-oxidants (turmeric, ginger, vitamin c rich foods, brightly coloured vegetables) and essential fatty acids (oily fish such as mackerel, wild salmon, sardines, herring/flaxseeds) to help combat inflammation.
- Gastro-intestinal health is key to maximise absorption of nutrients and prevent nutritional deficiencies. Naturopathic treatments work towards ensuring optimal integrity of intestinal mucosal lining, sufficient production of hydrochloric acid for successful brake down of nutrients and favorable gut colony to ensure absorption of nutrients. It is important to note that pain medications such as non-steroidal anti-inflammatories have a dire effect on integrity of mucosal lining and will impair gut function when used long-term.
Lifestyle Therapeutics
- Exercise that involves muscle strengthening and stretching. This exercise should be appropriate for the individual’s constitution and exercise capacity. In most cases gentle exercise is involved with gradual build up in intensity conversant with tolerance.
- Massage to reduce pain, improve mobility and reduce stress associated with pain
- Hydrotherapy involves a specific regime of exercises in a heated pool (between 33 and 36 deg), which may improve physical function, pain, mental health and quality of life of participants. Studies have elucidated the need for maintenance of such exercises on a longer-term basis to elicit sustained improvements, along with the accompaniment of exercise on land for greater outcomes. Studies on knee osteoarthritis alone found the greatest improvement on pain, however no significant changes were observed on stiffness and walking ability.
- Maintenance of healthy body weight to ameliorate joint function, particularly in knee osteoarthritis
- Mind body therapies such as Tai Chi, Qigong, Yoga, Meditation to address emotional health and well-being. Tai chi and Yoga also improve strength, flexibility and balance.
It is advisable that patients consult with a qualified naturopath rather then attempt at self-prescribing due to the complex nature of the condition and requirements. Sound knowledge of nutritional biochemistry and the skilful use of herbal medicines are essential in being able to effectively address complaints. Working alongside a qualified naturopath and other appropriate healthcare professionals ensures all facets of the condition are addressed for long-term sustainable results.
Many salubrious blessings,
Salima Diagne
Complementary Medicine Practitioner, specialising in Nutrition and Naturopathy
(Adv Dip Nut Med, BHSc Nat)
HealthSpace Potts Point
