Is osteoarthritis a disease of wear and tear?
Well, that is what I learned in medical school 30 years ago.
Now, we know better, and the answer is NO.
Osteoarthritis is not a wear and tear of the cartilage.
The cartilage is this layer that protects the bones.
Today, I will explain to you what osteoarthritis is and what you can do to prevent it and improve
the pain from it.
So, let’s talk about ostoarthritis Osteoarthritis is a condition that affects
the cartilage that protects the bones.
But it is not caused by putting too much weight on the joint, using the joint, moving the
joint, or exercising that joint.
We used to think that too much weight was the cause of osteoarthritis because the most
affected joints are knees and hips.
But the true cause of osteoarthritis is not that the person is using the joint too much.
People can have osteoarthritis in any joint of the body, even the shoulders, the hands,
the fingers, the neck, anywhere.
Osteoarthritis is caused by slow, low-grade chronic inflammation.
Inflammation means that the immune system is sending cells and they produce substances
that destroy the cartilage.
But what causes this chronic inflammation?
And does anti-inflammatory work?
Nobody knows exactly what causes this chronic inflammation.
There are genetic factors involved.
There is new knowledge that the fat tissue in our body, known as adipose tissue produce
adipokines.
The first adipokine was discovered in 1994, and it is called leptin.
Now, scientists have discovered more than 100 types of adipokines.
These adipokines are produced in the fat tissues of our body, so obesity leads to osteoarthritis
not because it puts more weight on the joints.
If that was the case, obese people would have osteoarthritis only in the weight-bearing
joints, but also have OA in the hands, neck, and other joints of the body.
The adipokines, when in excess, they create a pro-inflammatory state in the body.
Then, this pro-inflammation is what starts destroying the cartilage, little by little.
We know that obese people who lose weight improve their symptoms of osteoarthritis,
and the reason is not because they are putting less weight on their joints, but probably
because there are producing less adipokines.
Before I continue, please remember that this video is for educational purposes only and
is not intended to replace medical advice, and if you have osteoarthritis, please talk
to your doctor.
If there is an emergency please go to the nearest emergency department or call an ambulance.
This takes us to the second factor that helps osteoarthritis.
Movement.
You probably heard me say this many times: Motion is Lotion.
Yes, moving the joint, putting weight on the joint, using the cartilage is really good
for the health of the cartilage.
I use the analogy of honey.
If the honey is crystalized and cold, it is sticky.
But if you stir it up, and warm it a little bit, it gets fluid and clear.
That is what the synovial fluid in our joints does.
The more we move, the more synovial fluid is produced, and the nutrition to the cartilage
is brought by the synovial fluid.
When the person puts weight on the joint, the cartilage absorbs the nutrients that are
in the synovial fluid.
Astronauts who go to space do not put weight on their joints, because there is no gravity
in space, and their joints have less fluid and the cartilage is thinner.
On the other hand, people who practice sports and to a lot of physical activity have thicker
cartilages in the joints they use most.
This shows that moving the joints is good for a healthy cartilage.
I have various other videos showing exercise for osteoarthritis of the hips and knees,
dancing, going up and down stairs and for osteoporosis.
Third, the pain that people feel from a joint with osteoarthritis is not a good measure
of how much damage there is in the joint.
A person can have very tiny osteoarthritis and a lot of pain.
Another person can have super severe osteoarthritis and do not have any pain at all.
Here are some examples.
Look at this neck x-ray.
There is almost no osteoarthritis, but the person has a lot of pain.
Why is that?
This person may have other problems around the bones, it could be the pain is coming
from the muscles like myofascial trigger points.
But it can also be that there is a little bit of pain coming from the osteoarthritis,
but when this painful impulse enters the spinal cord, and passes through the brain stem, and
goes to the brain, it is amplified.
That is because this person has central sensitization.
Their pain system is sensitized, so their pain is amplified.
Not only that, but this person may have lost the ability to block the pain.
Did you know that we have our own endogenous pharmacy?
Our brain is able to suppress pain by releasing powerful opioids like endorphins, enkephalins
and dynorphins.
But some people have lost the ability to suppress pain.
So, in this case, the small painful impulse from this tiny osteoarthritis gets amplified
in the spinal cord, it gets amplified in the brain cortex, and is not suppressed here in
the brain stem.
So guess what?
The person interprets this pain as very intense pain.
And yes, they feel it, it is real pain, but the volume is turned up.
Here is another person, this is a 92 years male who fell and hit his head.
He was taken to the emergency and they x-rayed his head and neck.
Fortunately, he did not have any neck fracture.
But, the neck x-ray showed very severe osteoarthritis.
It lost the normal curvature, there are lots of osteophytes, no disc space, and the facet
joints are very narrow.
So, this is terrible osteoarthritis of the neck.
But did you know that this person never had any neck pain, not even one day in his life.
So, what is the solution to this problem?
If you have pain and you were told this is due to osteoarthritis, here are some practical
things for you to do: First, think seriously about losing weight.
Even if you lose a few pounds or a few kilograms, the number of adipokines your body will produce
will reduce immensely, and maybe this will reduce the progression of your osteoarthritis.
Second, start exercising.
The more you move the better the nutrition to your joints.
I highly recommend water exercises.
You can move in all directions, there is resistance and cardio training and you can relax in the
water.
But if you do not have access to a pool, a lake, or a beach, then just start moving,
dancing, playing sports, walking, biking, anything.
Remember, motion is lotion.
Third, it is important to avoid central sensitization.
There are many mind-body therapies that help to retrain the pain system.
You may watch my other video where I talk about these therapies.
And last, eat healthy, especially an anti-inflammatory diet.
This means more fish, olive oil, omega-3, fruits, vegetables, and less processed foods,
white flour, and sugars.
I have a video with more details about anti-inflammatory diets, another video about omega-3 and another
about turmeric.
Turmeric has some anti-inflammatory properties and is great in Indian dishes, soups, chicken,
and rice.
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Send it to anyone you know that has osteoarthritis.
Thanks for watching.
Goodbye