Joint structure
Our musco-skeletal system comprises 206 bones, about 100 joints and 600 muscles. The ligaments secure the bones firmly to give structure and protect vital organs whilst muscles are attached to the bones by a group of connective tissues called tendons that pull on the joints to allow motion. In between lies the white, shiny cartilage to provide friction-free movement lubricated by the synovial fluid to function smoothly without pain, catching or grinding. This fluid also provides nutrients and oxygen to the cartilage cells for survival.Basically, all the pieces must come together or any structural defect can cause pain, swelling and immobility.
Back pain
Spinal problems which typically inflicts pain on people aged 40 and above are increasingly common among patients in their 20s and 30s. Hitting hard are office workers who spend countless hours staring at the computers ending with more than just a backache. It can accelerate the normal wear and tear of the spine into spondylosis* at an early age. It can also be caused by an accident, a fall or lifting a heavy object or can develop over time as a result of age-related changes to the spine.
The host of problems mentioned can change the structure of the spine or damage it and surrounding tissue which are the interconnected network of spinal muscles, nerves, bones and discs. *Spondylosis is a degenerative disc condition where the joints and intervertebral discs that form the backbone wear out, generally due to ageing. It occurs mainly in the neck or lower back.
Typical sources of lower back pain include:
Signs and Symptoms
+ Stiff and painful neck
+ Lower back pain and tenderness
+ Stiffness and difficulty moving the back
+ Tingling sensations in one or both arms, hands, legs or feet
+ Numbness and weakness in one or both arms, hands, legs or feet
+ In severe cases of nerve pinching, difficulty in walking, unbalanced or unsteady gait with a tendency to fall especially when climbing stairs
+ Poor bladder control
+ Headaches and occasionally giddiness
Tips to protect your spine
Majority of the population will suffer from back or neck pain when they reach adulthood. Hence, early prevention is best to avoid unbearable pain later.
+ Take short frequent breaks away from the computer. If possible, move around and stretch every hour.
+ Do regular stretching and strengthening exercises.
+ Keep the top of the computer screen at eye-level. Viewing the screen at a 15-20 degree angle is less strenuous on the neck.
+ Adopt a good sitting posture. Sit upright and put both feet on the floor with the elbows, knees, hips and ankles are a 90 degree angle. Better if a cushion is placed against the back of the seat to support the lower back. When typing for prolonged periods, rest the elbows on the desk to relieve stress from the shoulders and neck.
Medical Treatment
+ Initial treatment for spondylosis is always nonsurgical. The individual should take a break from the activities until symptoms go away, as they often do. Doctors usually recommend muscle relaxants and non-steroidal anti-inflammatory medications such as ibuprofen and naproxen to relieve the pain and stiffness. This is often combined with physiotherapy to stretch and strengthen the spine and lower back and neck muscles to help in preventing future recurrences of pain.
+ If an MRI scan showed the slippage not significant, no surgery is required yet. A Precision Spine chiropractor may be able to restore your spine’s normal curvature and remove the excess strain.
+ Surgery to remove bone spurs or affected discs is recommended for patients experiencing severe neurological problems such as weakness, pain and numbness in the arms and legs, affecting their normal living. Procedure can include a spinal fusion performed between the lumbar vertebra and the sacrum. At times, an internal brace of screws and rods is used to hold together the vertebra as the fusion heals.
Considerations
Though spinal problems caused by cervical and lumbar spondylosis are not life-threatening, but if left untreated, can lead to increased pain and, decreased flexibility and mobility. When nerves are pinched, damage to the nerves often occurs, resulting in permanent pain, numbness, weakness or poor coordination.
Advances in medical technology have made minimally invasive spinal surgeries possible for patients with even with severe spondylosis. These patients can expect less post-operative pain and faster recovery.
Nutrition should play an important role in the overall treatment plan with proper medication and appropriate activity. Important minerals for maintaining healthy joint function and support normal tissue repair are: Glucosamine sulfate, chondrotin, calcium, collagen, cartilages and methylsulfonyl methane (MSM). Sulphur is needed for the repair and rebuilding of bone, cartilage and connective tissue.
Nutrition should play an important role in the overall treatment plan with proper medication and appropriate activity. Important minerals for maintaining healthy joint function and support normal tissue repair are: Glucosamine sulfate, chondrotin, calcium, collagen, cartilages and methylsulfonyl methane (MSM). Sulphur is needed for the repair and rebuilding of bone, cartilage and connective tissue.
ARTHRITIS
Arthritis is a condition of swollen and inflamed joints arising from injury or degeneration, overstretched joints, obesity, enzyme deficiency, high uric acid, autoimmune disorder etc.
Owing to wear and tear, degenerative diseases affect mainly the older people. It usually appears in middle age occurring equally in both sexes. After age 55, the rate increases to five folds for women because they are no longer protected by the hormone estrogen. By 70, almost everyone has both problems in critical condition.
However in recent times, teenagers are also experiencing symptoms associated with arthritis such as back pain, shoulder pain and muscle weakness due to obesity, applying excess weight on joints repeatedly and wearing high heels. Occupational health hazards such as workers exposed to repetitive movements like typing or staring at computers also stand high risk of arthritis.
The common types are gout, rheumatoid arthritis and osteoarthritis which can be mild or severe, affecting one or more joints, causing pain, swelling, warmth or stiffness in the affected joint.
Some people find the condition incapacitating whilst others have very few symptoms. Those badly affected can suffer in silence even at resting mode. The cycles are more in line with activity, mood and the weather change. Most sufferers complain of joint stiffness and pain in the morning or after exercise. There may be audible cracking or grating noises when the joint moves.
OSTEOARTHRITIS
Causes
Apart from diet and lifestyle, it is mainly related to wear and tear of aging.
* Tends to run in families
* Being overweight and lack of exercise increase the risk
* Fractures or other joint injuries can lead to osteoarthritis later in life
* Long-term overuse at work or injury in sports
Medical conditions that can lead to osteoarthritis include:
* Bleeding disorders that cause bleeding in the joint
* Disorders that block the blood supply near a joint
* An inherited defect in the protein that forms cartilage.
* Other types of arthritis, such as chronic gout or rheumatoid arthritis
Symptoms
There are people with OA without the accompanying symptoms below:
+ Deep aching joint pain that gets worse after exercise or putting weight on it, and is relieved by rest
+ Pain that is worse when you start activities after a period of no activity
+ Over time, pain is present even when you are at rest
+ Grating of the joint with motion
+ Increase in pain during humid or moist weather
+ Joint swelling
+ Limited movement
+ Muscle weakness around arthritic joints
+ Further advance see development of bone growth called spur that can be detected only by X-ray.
+ Gradual loss of height with compression of spine.
Treatment
1. Medical treatment - Patients with mild OA may be treated only with pain relievers and topical cream. Most patients are given non-steroidal anti-inflammatory drugs (NSAIDs) which include compounds such as ibuprofen. They are able to relieve slight inflammation and pain but may experience side effects, like stomach ulcers, sensitivity to sun exposure, kidney disturbances, and nervousness/anxiety or depression. Some OA patients are treated with corticosteroids, which are injected directly into the joints to reduce inflammation. Hyaluronic acid, naturally found in the joints (for lubrication), may run low and need to be injected to protect the joint every 6-12 months. In severe osteoarthritis, surgery to repair or replace the affected joint may be recommended. However, note that artificial cartilages placed can last for about 10 years only.
2. Weight Control - Overweight puts more pressure to the joints and makes it more susceptible to injuries. Hence, losing some weight will reduce the strain on the hips and knees. Maintaining an ideal body weight at all times is advisable to reduce the burden on the joints.
3. Physiotherapy and exercise - Physiotherapist can work out exercises to maintain strength in the muscles around the joints and reduce stiffness in the affected joints. Even after a surgery, keep to exercise routines that help to increase muscle and tendon capability, strengthen the joint cartilage and assist in bone density. Choose activities which emphasize on muscle strength maintenance such as swimming, yoga, running or cycling to help in improving joint stiffness and enhancing the flow of synovial fluid. For those "less abled", choose exercises like swimming which do not strain your joints too much.
4. Heat Treatment and Medication - Warm baths and heating pads are soothing to painful joints. At times the physiotherapist may use a form of electrical treatment to help relieve your pain and stiffness. Your doctor may also prescribe some medicines for the pain.
5. Walking Aids - Good footwear and a walking stick can help you move around more comfortably.
6. Supplements - As the main components of cartilage are glucosamine, chondroitin and collagen, adding these nutrients directly to the diet for overall joint health maintenance is crucial for recovery, and extra doses for the elderly and those who tend to overuse the joints. The chronic inflammatory disorder can be alleviated with consumption of omega-3 derived from deep sea fish source or dietary supplements like fish oil. Natural antioxidant nutrients such as vitamin A, C and E are useful in clearing free radical damage around the joints.
Glucosamine is a mineral that occurs naturally in the fluids around the joints. Thus, it is effective on osteoarthritis of the knee, as well as hip and spine. Those who fall short of glucosamine can supplement to slow the breakdown process. Some evidence suggest that people who take glucosamine sulfate might be less likely to need total knee replacement surgery. However, note the difference between glucosamine sulfate and those drugs in the time it takes to reduce pain. The NSAIDs, such as Motrin, Advil and Feldene - relieve symptoms and reduce pain usually within about 2 weeks, whilst glucosamine takes about 4-8 weeks and effects vary for different individual.
RHEUMATOID ARTHRITIS
The affected parts are usually the small joints, especially of the wrists, hands and feet. It causes pain, stiffness and swelling which is worst in the morning. Later, other joints like the shoulders, elbow, hips, knees and ankles my also be involved. The patient can barely manage daily chores like gripping utensils, turning taps, dressing or writing.
In most instances, the damage is so severe that the bone surfaces are also destroyed as the inflammation triggers the production of enzymes that slowly digest adjacent tissues. The body responds by replacing the damaged tissues with scar tissues, filling up the space between the joints. As a result, it creates stiffness, swelling, fatigue, anemia, weight loss, fever and crippling pain.
Note it knocks people below 40 as compared to OA on those above 40 but both tend to affect ladies more than men. While OA affects only single joint, RA tend to hit all the synovial joints.
Causes
The main contributory factors are physical and emotional stress, malnutrition and bacterial infection. Health reading on 'rheumatoid factors' can indicate whether antibodies are present in the blood of the RA sufferers upon the invasion of infecting bacteria travelling to the joint through the bloodstream from an infected source.
Treatment
+ Occupational therapy and physiotherapy - Changes have to be made to improve the ability to function independently for daily activities eg. specially designed tools like large-handled spoons are required to take meals.
+ Heat/cold remedies and medication - Warm water or a heating pad can ease stiff joints whilst cold packs or water is more effective for a hot, painful joint. For a start, medications is required to alleviate the pain and swelling of the joints.
+ Surgery - If all attempts failed, surgery is the last option to repair badly damaged joints.
+ Supplements - Damage on the bone, cartilage and muscle tissue can be reconstructed with nutrients like protein, folic acid and zinc. On a longer term basis, the mineral germanium can reduce the impact of auto-immune disorder.
GOUT
Gout hits men more than women due to their dietary habits.
Treatment
Though gout is treatable, if left unattended can cause kidney stones which may lead to kidney damage.
2. Heat/cold treatment - A hot compress or ice pack to the affected joint can relieve the pain.
3. Drink more water and avoid alcohol.
4. Diet - Watch your diet as detailed below
Avoid eating high-purine foods eg.
+ organ meats like liver, kidney and brain
+ small fish like ikan bilis, sardines and fish roe
+ meat extracts, yeast extracts (eg Marmite) and stock cubes
+ seafood like crab, cockles, prawns, scallop
Take less of moderate-purine foods eg.
+ asparagus, cauliflower, mushrooms and spinach
+ peanuts, beans and peas
+ chiku and custard apple
+ wholegrain breads and cereal
+ soybean products like bean curd
NUTRITIONAL REMEDIES
If it is true that 'you are what you eat' then what is the link between diet and arthritis?
+ organ meats like liver, kidney and brain
+ small fish like ikan bilis, sardines and fish roe
+ meat extracts, yeast extracts (eg Marmite) and stock cubes
+ seafood like crab, cockles, prawns, scallop
Take less of moderate-purine foods eg.
+ asparagus, cauliflower, mushrooms and spinach
+ peanuts, beans and peas
+ chiku and custard apple
+ wholegrain breads and cereal
+ soybean products like bean curd
NUTRITIONAL REMEDIES
If it is true that 'you are what you eat' then what is the link between diet and arthritis?
Thinning down the acidity in the blood is top priority. All foods and supplements alkaline in nature are best combating agents.
Some arthritis patients appear to have low levels of vitamins and minerals in their bodies. Research also indicated that some natural supplements may be able to play a part in relieving joint pain. Hence, nutrition should play an important role in the overall treatment plan with proper medication and appropriate activity.
Important minerals for maintaining healthy joint function and support normal tissue repair are: Glucosamine sulfate, chondrotin, collagen, cartilages and methylsulfonyl methane. Sulphur is needed for the repair and rebuilding of bone, cartilage and connective tissue.
GLUCOSAMINE SULPHATE - Found naturally in our joints and muscle, this amino sugar is vital for joint health, especially to manufacture new cartilage for damaged joints. One clinical study of 212 patients with osteoarthritis of the knee found significant improvement in pain and mobility in patients who took one 1500 mg supplement of Glucosamine sulphate once a day. Other clinical studies show that taking 1500 mg of this Glucosamine daily can improve joint symptoms linked to sports injuries and arthritis by 40% - 70%.
There are some common side effects to observe when taking glucosamine:
+ Gas, soft stools, upset stomach, drowsiness, insomnia, headache, skin reactions, sun sensitivity and nail toughening.
+ May experience a temporary increase in blood pressure and heart rate, including palpitations.
+ It is not clear whether glucosamine affects blood sugar levels. Patients with diabetes or patients who are hypoglycemic (low blood sugar) are advised to be cautious when taking glucosamine.
+ Glucosamine is not recommended for use during pregnancy or breastfeeding.
+ Glucosamine may increase the risk of bleeding in certain patients, especially those with bleeding disorders and on blood-thinning medications. They should have their blood clotting time checked more frequently to monitor the situation and adjust Glucosamine dosage if necessary.
+ Glucosamine is sold as a dietary supplement with most extracted from animal tissue, specifically crab, lobster or shrimp shells. Patients who are allergic to shellfish should avoid such products. Extract from chicken is a better choice.
Is advisable to take this mineral after a meal to prevent digestive complications
CHONDROITIN: This element, naturally found in the body is used as a building block for larger structures known as proteoglycans, which are vital component of cartilage tissue. Many studies have found it to be effective in joint repair, help prevent the erosion of joint space and ease pain.
+ It inhibits the enzymes that break down cartilage.
+ It helps to raise the level of hyaluronic acid that is essential in binding joint tissues firmly together for a strong structure and higher resistance to damage.
+ It is able to draw in more fluids which act as a shock absorber and thus protects joints from further damage.
Recommended dosage to start off is 1500 mg of glucosamine and 1200 of chondroitin daily for 6 – 8 weeks. With improvement, the dosage can be reduced to 1000 mg of glucosamine and 800 of chondroitin or less. For chronic sufferers, result can be more noticeable within a few months.
MSM (Methylsulphonylmethane): Another vital building block for cartilage formation, it contains sulphuric content which has therapeutic properties crucial for the healing of injuries.
TURMERIC: Its active ingredient - curcumin is believed to be thrice more effective in reducing inflammation and easing pain than aspirin, ibuprofen or naproxen as it can shut down an enzyme responsible for a stream of pain-producing hormones. As a potent antioxidant, it helps to protect our cells against damage from harmful free radicals. No toxic side effects have been reported with this spice.
FISH OILS (Omega3): It can counteract the overproduction of toxins that impair the body's production of prostaglandins, which are natural anti-inflammatory compounds.
Other nutrients that are useful:
Vitamin C - A potent antioxidant that can prevent free radicals from damaging the joint tissue and acts as an anti-inflammatory agent.
Vitamin B - The B vitamins help in pain relief especially B5 (pathothenic acid) and anti-inflammatory especially B6.
Chicken Collagen Type II - Collagen is a fibrous protein that comprises about 25% of the protein in our body and can be found in bones, cartilage, tendons, ligaments and other connective tissues. There are more than 10 different types of collagen, with Type II being the most predominant. Chicken Collagen obtained from sternum of chickens, offers a rich source of collagen type II and is naturally rich in proteoglycans such as glucosamine sulfate and chondroitin sulfate.
Shark cartilage - Sharks have an endoskeleton comprised entirely of cartilage consisting about 6% of the body weight of sharks. This type of elastic tissue mainly made of collagen, also contains a rich source of calcium and phosphorus which are the important elements for bone protection. Its benefits include relieves arthritis pain, reduces the stiffness and strengthens the immune system.
Boswellia - This ayurvedic herb derived from the resin of the plant is used traditionally to treat arthritis, rheumatism, coughs, sores, bronchitis and asthma. The major component is boswellic acid which has anti-inflammatory and anti-arthritic effects.
Siberian ginseng - Siberian ginseng has been used traditionally as an adaptogen, performance enhancer and immune-stimulant. It is not a species of ginseng, but seems to have comparable activities. Active components are thought to include several eleutherosides and polysaccharides. It has been shown to reduce stress symptoms in general, boost immune system response and enhances the body’s overall resistance to infection. Thus, it may beneficial to support the joint system to function efficiently.
More comments
+ Taking foods containing the amino acid histidine (eg rice, wheat, rye) can help to remove excess metals from the body. This is crucial for arthritis patients tend to have high levels of copper and iron in their bodies.
+ Beware that many of the suppressant drugs on the shelves can cause biological changes such as stomach ulcer, severe gastrointestinal bleeding, kidney and liver damage. There is a high probability of depletion of nutrients leading to development of other ailments.
+ In several countries Glucosamine is widely available as health supplement but no check on its purity. As a result, many products commercially available are found to be not up to standard and thus are unable to deliver results. In USA and Canada, random samples taken found the glucosamine level in the range of 0% - 82% of label claims.
Imagine you lose the mobility to walk and need to be helped around. Joint health is so vital to our daily life. Start your joint maintenance work early!
VIVA corner
VIVA has a host of products to tackle all types of arthritis.
+ VIVA Flexiguard is a proprietary nutraceutical formulation, containing glucosamine sulfate, chondroitin, bovine cartilage, chicken cartilage, MSM and other proprietary ingredients like boswellia powdered extract, Siberian ginseng and wheat sprout. In combination, this formulation works synergistically to provide the body with the right nutrients to help in maintaining healthy joint function and flexibility.
+ VIVA Ageguard provides the essential amino acid for the reconstruction of tissue damaged.
+ B-easy provides full range of vitamin B for production of hydrochloric acid, which helps to prevent bone spur by aiding calcium absorption. It also aids in maintaining a healthy nervous system.
