How to reduce the impact of the seemingly
inevitable.
A recently published study reported that by 40 years of
age, 49% of professional footballers will have developed
osteoarthritis in at least one joint. Whilst this is a shocking
statistic, of greater concern was the fact that 78% of those
diagnosed with it were concerned as to how it would affect their
quality of life in the future.
Indeed, the results of the study suggested that quality of life
was significantly reduced for those with osteoarthritis compared to
those without. But exercise is beneficial for joint health, I hear
you cry. You’re right: physical activity is very important in
maintaining healthy joints. Unfortunately however, competitive
sport, in particular those sports that result in injury to joints
through contact trauma, can increase the risk of osteoarthritis.
Indeed, it has been suggested that rugby may cause more problems
than football, with 80-90% of players suffering from osteoarthritis
by the age of forty.
Whilst competitive sport may increase the risk of
osteoarthritis, we are all susceptible to the effects of joint
‘wear and tear’ that lead to loss of mobility, pain and
osteoarthritis. Ageing alone causes a number of changes in the
articular cartilage that may result in the development of
osteoarthritis. So what is osteoarthritis and, if it is inevitable,
how can we protect our joints?
Osteoarthritis is the most common form of arthritis and the most
common disorder of the joints in middle-aged and older people,
affecting the hands, hips, shoulders and knees. It is a chronic
condition with a variable pattern of progression and severity and
is a major cause of disability and reduced quality of life. In
osteoarthritis, the cartilage that protects the ends of the bones
breaks down and causes pain and swelling. And joint pain can range
in severity from mild to debilitating. It is often increased when
the affected joint is used; however, maintaining activity is
important in protecting the joint, reducing pain and maintaining
mobility when the joint is diseased. A number of factors can
accelerate the development of osteoarthritis. The most important
appears to be trauma injury to the articular surface. Other factors
include obesity and inactivity. Obesity appears to lead to
metabolic changes of the cartilage and damage associated with a
chronic increase in weightbearing forces. In contrast, inactivity
fails to exert adequate mechanical forces on cartilage to promote
growth and repair. Therefore physical activity and a healthy
weight, particularly in later life, are important to optimise the
growth and repair of articular cartilage.
The standard treatment for osteoarthritis and general joint pain
are the non-steroidal anti-inflammatory drugs (NSAIDs).
Unfortunately, routine, long-term use of NSAIDs has a number of
disadvantages. There is concern that they may be toxic to articular
cartilage and accelerate the course of osteoarthritis. Because of
this, a number of non-drug alternatives have been suggested in the
treatment of osteoarthritis, including glucosamine
sulphate/hydrochloride, chondroitin, hyaluronic acid, bromelain,
omega 3 polyunsaturated fatty acids and vitamin/mineral
supplements. The rationale for the use of these supplements is
based on a deficiency in some key natural substances in the
affected joint. Thus, it is assumed that these supplements act as a
natural ‘building block’ or assist in promoting
regeneration of the cartilage matrix. Glucosamine compounds have
been closely examined in the scientific literature, attracting a
great deal of attention in the papers. Glucosamine is a natural
substance found in the body and plays an important role in the
health and resilience of cartilage.
Glucosamine supplementation has been shown to regenerate
cartilage and produce some anti-inflammatory effects. There are
very few side effects of glucosamine and, as such, it is widely
recommended to limit cartilage degeneration and promote repair to
help maintain healthy joints.
Individuals with a predisposition to osteoarthritis often suffer
from a generalised vitamin deficiency. Research has shown that
vitamin supplementation, particularly vitamins C, B1, B6, B12, D
and E, may exert a beneficial effect on the symptoms experienced in
degenerative joint disease. The action of these vitamins is not
clear; however, their role as antioxidants and/or precursors for
repair may be important mechanisms in reducing degeneration and
promoting repair of cartilage. Thus, vitamin supplementation may
assist in the maintenance of healthy joints.
Conclusions
Joint disease causes pain, stiffness and decreasing functional
capacity. Osteoarthritis is the most common type of arthritis that
affects nearly nine million people in the UK. The causes of
degenerative joint disease are multifactorial; however, inactivity
and obesity are two important lifestyle factors that we can easily
affect. Maintaining activity and a healthy weight will reduce the
progression of joint disease and alleviate symptoms in diseased
joints. Furthermore, nutritional supplements including glucosamine
and vitamins can assist in limiting degeneration and promote
regeneration of cartilage. Unlike pharmacologic drugs in the
treatment of joint disease, nutritional supplements are slower
acting, taking a longer time to improve symptoms and joint
health.
Adopting a healthy lifestyle through exercise and diet can help
to avoid the inevitable and significantly improve quality of
life.
back to the top »