By Ray Fosterrlf@mt-rushmore.net


This is one of a number of Medical Checkpoints giving information about common conditions and what you can do about it. Your opinion and reaction to these Medical Checkpoints would be valued and appreciated. Medical Checkpoints are published periodically by NEWSTART Healthcare and are provided as a free service.



Harrison's Principles of Internal Medicine 13th Edition (CD ROM):


Osteoarthritis (OA), also termed degenerative joint disease, represents failure of the diarthrodial (movable, synovial-lined) joint. In idiopathic (primary) OA, the most common form of the disease, no predisposing factor is apparent. Secondary OA is pathologically indistinguishable from idiopathic OA but is attributable to an underlying cause.


OA is the most common joint disease of mankind. Knee OA is the leading cause of chronic disability in developed countries; some 100,000 people in the United States are unable to walk independently from bed to the bathroom because of OA of the knee or hip.


What is going on:

The word "idiopathic" in the definition above means "It is not known". The official answer is that the cause of the most common joint disease of mankind is not known. This may be in part to blindness on our part to the obvious. Today all around the world in the third countries, this disease is not what it is in the first world countries. Where people walk there if they get there and where people cook their own food, raised or gathered by themselves, primary OA is virtually unknown. It would appear fair to say that diet and exercise is directly related to primary OA.


Quoting from Samuel Turek's Orthopaedics page 384: "The presently accepted view is that osteoarthritis (osteoarthrosis) is a degenerative process of unknown etiology affecting articular cartilage of the previously healthy joint; it is designated in the literature most commonly as primary osteoarthritis." Today with the advent of arthroscopy we can look inside of joints and see and probe the articular cartilage. A very wide variation in firmness and integrity of articular cartilages can be observed. Some articular cartilages appear smooth, shiny, and very firm and rubbery, resisting any penetration with a blunt probe. Other cartilages are dull, very soft and friable, and are easily penetrated to bone with a blunt probe. There appears to be a close correlation between the individuals diet and lifestyle and the integrity of the articular cartilage. Smoking, tea and coffee intake, alcohol intake, high fat diet, a highly refined diet and lack of exercise may all be related to loss of articular cartilage health and integrity.


We know that all body tissues are nourished from the blood. It would be reasonable to expect that what impedes the blood flow, especially on the microscopic level, would interfere with the health of the tissues. Thus the microscopic blood flow provide a rational link between diet and lifestyle and the health of the articular cartilage and the most common joint disease known.


What to do:

1. The first thing to do is to establish the diagnosis. Is your joint pain due to osteoarthritis or not? It is imperative that the correct diagnosis be made. For this purpose seek professional medical advice.


2. While established osteoarthritis associated with advanced age may not be able to be completely reversed and cured, exercise such as walking daily to tolerance, with little by little increases in walking tolerance associated with a high fiber diet such as is best obtained from a whole plant source will result in great improvement in the pain and increased range of motion of the joints within 6 to 8 weeks or sooner. Outdoor walking and exercise is preferable where possible because of the beneficial effect that limited ultraviolet light from the sun has on the body. A Wholesome high fiber plant diet and an abstemious, active lifestylepromoting a good microscopic blood flow is the most effective treatment and comes the closest to providing a cure. No amount of medication or surgery can do what exercise and a high fiber, unrefined diet will do for primary osteoarthritis. All other treatment is what is called "symptomatic", i.e. it is directed at making the joint feel better. Can't I damage my joints with exercise? Gentle exercise such as walking appropriately for your age and ability that is not so fast that you cannot talk is good and not harmful to your joints. Alternate pressure and pulling on your knees and hips as occurs in walking increases the blood flow and stimulates repair to cartilage. Rust out is more to be feared than wear out!


3. Local heat will have the effect of making the joint feel better while promoting healing. Alternate hot and cold applied locally will increase the blood flow to the part and have the effect of "washing out" the collection of pain chemicals while bringing in the needed repair substances. Heat will ease the pain and relax the muscles allowing for more normal local blood flow. There are a number of easy ways to apply hot and cold to the part (e.g. 3 min hot and 1/2 min cold): - shower or water baths or heating compress or electric pad and ice locally. Use a thermometer to measure the heat of the hot water. Start the hot water about 100F (37.7C) and increase the temperature by adding more hot water (without burning yourself) to a maximum temperature of 110F (43C). Add ice to the cold water to keep it cold and end the treatment with cold (at least three hots and three colds). If you have diabetes, peripheral neuritis, or other disease that makes your body part insensitive to temperature, consult your professional medical providers before attempting to use hot and cold on yourself.


4. Specific exercises designed to put a joint through a full range of motion can be most helpful in overcoming stiffness associated with osteoarthritis. In this connection it is well to realize that there is loss of elastic tissue with age that is not going to be regained even with faithful, intelligent exercises. However putting the joint through a full range of motion once a day and isometric exercises for the bedfast or invalids will be beneficial. Isometric exercises are muscle tightening efforts and holding the tight muscle for a few seconds without moving the joint. These exercises are often not painful to do where exercises associated with joint movement may be painful. The intermittent compression effect on the joint cartilage tends to improve the joint cartilage nutrition. Full range of motion once a day to tolerance combined with isometric exercises is a good treatment plan for individuals not able to walk.


5. Pure water intake - 6 to 8 glasses a day, 8 hours of sleep at night and additional restduring the day if necessary, erect posture promoting full, deep, breathing of pure air andtrust in Divine power are other powerful aids in the prevention and treatment of osteoarthritis. Choosing a cheerful attitude and attempting to help others reacts in blessings to all concerned.

6. If all else fails before considering surgery see what an anti-inflammatory diet will do for you. What is an anti-inflammatory diet? Foods that come from plants. The less refined the food the better. Why are plant foods anti-inflammatory? It is because of the chemical messengers that are in plant foods (ecosinoids and prostaglandins) all have the effect of decreasing inflammation in our bodies. Try it. It will work! Why do I want to eat an anti-inflammatory diet? It will give you less pain. Pain comes from inflammation. It will also give you less blood clotting tendency for your blood. That would be nice!

7. What about the advertised cures for arthritis? There are some high-tech medical treatments for arthritis today. The body makes growth chemicals that can make cartilage grow and almost seem to cure arthritis. However it is something like bypass surgery for heart disease. Unless the diet and lifestyle is changed, the bypassed arteries clog up again for the same reasons they got blocked in the beginning. In plant foods are wonderful phytochemicals that will help cartilage grow. Gentle exercise will stimulate cartilage growth. Avoiding the anti-inflammatory medications that work by blocking the body's natural repair efforts is also to your advantage. The best arthritis cure is free to all. What has been shared above is very high-tech!



Desire Help with your OA?

Visit the Black Hills Health and Education Center online at http://bhhec.org or

Phone 1 (800) 658-5433