Osteoarthritis: Causes and Treatments

As we age, our bodies may not recover as quickly from strenuous activity or long periods spent sitting or standing in a single position. On those occasions, some people may feel stiffness or discomfort, but it usually passes in time. If you’re feeling chronic pain in your joints, hands, hip, knee, lower back or neck, however, you may be suffering from a condition called osteoarthritis (OA).

Causes and Risk Factors

According to the Arthritis Foundation, osteoarthritis is a disease of the joint, and is the result of a variety of factors – some that can be controlled and some that can’t.

Osteoarthritis generally occurs when there is an absence of cartilage, the important connective tissue that cushions the bones in our joints. When that cushion is removed, bones meet, causing pain, stiffness, swelling and reduced mobility. While it is a rare, some patients’ bodies do not produce an adequate amount of collagen, the protein that creates cartilage. Other patients may have a bone structure that breaks down their cartilage cushion more quickly.

Those factors are generally hereditary and not preventable. Other factors, however, can be managed to help prevent OA from occurring.  For example, being overweight or participating in activities that encourage repetitive movements, can increase a person’s risk of developing osteoarthritis.  The Arthritis Foundation explains:

Weight: Being overweight puts additional pressure on hips and knees. Many years of carrying extra pounds can cause the cartilage that cushions joints to break down faster. Research has shown there is a link between being overweight and having an increased risk of osteoarthritis in the hands. These studies suggest that excess fat tissue produces inflammatory chemicals (cytokines) that can damage the joints.

Injury and overuse: Repetitive movements or injuries to joints (such as a fracture, […]

Using Diet to Reduce Rheumatoid Arthritis Symptoms

In recent years, you may have heard discussions or read articles about “inflammation” in the body and its connection to autoimmune diseases such as rheumatoid arthritis, lupus, multiple sclerosis, and psoriasis. “Inflammation” is a real issue for many of our patients, especially those who suffer from rheumatoid arthritis, a condition we see quite frequently where the patient’s overactive immune system is attacking his or her joints, causing pain. Anti-inflammatory and immune-suppressing medications can and are often used to treat such conditions. However, a patient’s diet can also play a part in reducing inflammation in the body.

A growing number of nutritional and medical experts suggest that a body’s autoimmunity problems are caused by tiny holes in the gut that allow particles of food, bacteria and other substances from inside the intestines to escape into the rest of the body. This is important because a “leaky gut”, and more specifically, an invasion of foreign substances into the body, can trigger the body to respond by producing inflammation – the same process used to fight any other bacterial infection. Over time, that chronic inflammation can cause tissue damage, resulting in an autoimmune disease such as the ones listed above.

Enter the Paleo autoimmune protocol (a stricter version of the more popular Paleo Diet). The Paleo autoimmune protocol seeks to seal the holes in the gut wall by eliminating the foods thought to cause them, namely:

Processed, fried and high fat foods (especially those that contain high amounts of salt, preservatives, additives, or sugar)
Alcohol
Breads & Grains (including whole and heritage grains)
Potatoes
Legumes
Dairy
Eggs
Nightshade vegetables such as tomatoes, eggplant, and peppers
Nuts and seeds
Certain spices such as curries, paprika and chili powder
Refined sugar

Those who follow this protocol typically eliminate the trigger foods mentioned above for […]

The PEP Program Shown to Help Reduce Occurrence of ACL Injuries

If you are a young female athlete, parent or coach of an athlete, you may be aware that adolescent girls have a 4 to 8 time higher risk of sustaining a non-contact anterior cruciate ligament (ACL) injury than male athletes participating in the same sports. While reasons for this may vary, an article published in Contemporary Pediatrics suggests that this higher risk factor is related to a female athlete’s neuromuscular control of knee motion during athletic activities such as landing from a jump or quickly changing direction:

Current evidence suggests that the primary reason girls are at greater risk than boys for noncontact ACL injuries is that girls tend to have less neuromuscular control of knee motion during athletic maneuvers. In other words, girls tend to use their muscles differently than boys when landing from a jump or quickly changing direction. Biomechanical studies have identified 4 neuromuscular strategies that are more common in girls and that may lead to dynamic knee valgus, a position that places the ACL at a high risk of tearing.

(1) Girls tend to use their quadriceps muscles much more than their hamstrings. Kinetic and kinematic analyses have found that during a jump landing or quick change in direction, girls have reduced knee flexion, increased quadriceps activity, and decreased hamstring activity compared with boys. This “quadriceps dominant” strategy has been shown to increase both anterior tibial translation and strain on the ACL.30 Notably, ACL strain is significantly reduced when there is co-contraction of the hamstrings.4

(2) Girls tend to have 1 leg stronger than the other, whereas boys tend to have equal strength in both legs. Asymmetry in leg strength promotes asymmetric weight distribution between the feet upon landing, causing a shift of the […]

Are Women and Girls Really More At Risk For ACL Injuries?

We’ve been getting questions lately from some of our more active female patients about whether or not they should worry more about anterior cruciate ligament (ACL) injuries because of their gender and their propensity for “high-risk” sports like skiing or soccer.  The answer it seems is yes…and no.  Last year, the Journal of Bone and Joint Surgery*(JBJS), published a study where they compared MRI scans of male and female athletes with non-contact ACL injuries with athletes who participated in similar sports, but did not sustain injury to their ACLs.  What they found was that the common factor between those who sustained injury wasn’t gender, it was geometry.

Here’s how an February 2012 article published by the American Academy of Orthopaedic Surgeons** described it:

The ACL is a ligament that runs through, and stabilizes, the middle of the knee joint. While the ACL can be injured through contact, it is most commonly strained or torn without contact, when a person suddenly changes direction, stops abruptly or lands incorrectly after a jump, such as in soccer, basketball and skiing.

The study found that most of the women (those who had ACL injuries and those who did not) and only the ACL-injured men shared a common geometry on the outside of their knee joint: The upper part of their shin bone at the joint (tibial plateau) was much shorter and more rounded. This may help to explain why women have an ACL injury rate that is two-to-five times greater than that of men.

“A lot of people who have ACL tears have a high degree of laxity (loose ligaments) in their knee joints,” said Christopher J. Wahl, MD, the study’s lead author and an orthopaedic surgeon and team physician in the Department of […]

Beware of Herbal Supplements if You’re Having Surgery

It’s not unusual to see patients in our practice taking herbal supplements.  We don’t weigh in one way or another on the efficacy of “natural” vitamins and supplements but we do caution our patients who are considering having a surgical procedure done against taking them prior to and after their surgery.

While every patient experience is different, what many may not realize is that these supplements may cause abnormal blood pressure, heart rates, and bleeding.  They may also interfere with other medications, including anesthesia during your surgery.

We generally recommend to our patients that they disclose any “over-the-counter” medication they are taking (including aspirin, herbs, vitamins and dietary supplements) to their physician.  We also ask patients to stop taking them one week prior to surgery to reduce their risk of excessive bleeding, or negative interactions with other medications that we prescribe to treat orthopaedic problems and manage pain.

Not sure if your supplement may be a problem?  Here’s a list of common herbal supplements that we recommend against:

  Dong Quai
  Gingko Biloba
  Ginger
  Ginseng
  White Willow Bark (salix alba)
  Devil’s Claw (harpagophytum procumbens)
  Turmeric (curcuma longa)
  Boswellia (bosellia serrata)
  Stinging Nettle (urtica dioica)
  Cat’s Claw (uncaria tomentosa)
  Quercetin
  Reservatrol
  Cayenne
  Omega-3 FA
  St. John’s Wort

If you’re a patient and have questions about how a supplement you may be taking may interact with your prescribed medication, please contact our office.