With the increasing problems of obesity and cardiovascular diseases attributed to sedentary lifestyle, physical exercise has touted as the solution to lots of health problems. But can physical exercise also have some adverse effects on health? German and American researchers presented results at Radiological Society of North America (RSNA) in Chicago last year that indicated that high levels of physical activity can cause cartilage damage and lead to osteoarthritis.

According to Dr. Christoph Stehling, a researcher in the US and in Germany:

“Our data suggest that people with higher physical activity levels may be at greater risk for developing knee abnormalities and, thus, at higher risk for developing osteoarthritis.”

Osteoarthritis is the most common form of arthritis, affecting about 27 million people in the US. It is a degenerative joint disease that causes pain, swelling and stiffness.

The researchers looked at 236 study participants (100 men and 136 women) with ages ranging from 45 to 55. The participants were asked to complete the Physical Activity Scale for the Elderly (PASE) questionnaire and based on their PASE scores, were classified as low, middle-, and high-activity groups. A person of high activity level would typically engage in several hours of walking, sports or other types of exercise per week, as well as yard work and other household chores. The participants were then subjected to magnetic resonance imaging (MRI) that looked at musculoskeletal structures of the knee.

The study results revealed the following knee abnromalities in some of the participants:

• meniscal lesions
• cartilage lesions
• bone marrow edema
• ligament lesions

The frequency and degree of knee damage seems to be associated with the level of physical activity based on PASE scores.

Dr. Stehling continues to say

“The prevalence of the knee abnormalities increased with the level of physical activity… In addition, cartilage defects diagnosed in active people were more severe.”

In addition, certain activities, especially weight bearing activities such as walking or running cause more damage than other activities. The researchers do not necessarily advocate a sedentary lifestyle, which can be also detrimental to musculoskeletal health. Instead, they recommend non-weight bearing activities such as swimming and cycling. These activities are beneficial to cardiovascular health without causing cartilage damage.

The study authors concluded:

•High levels of physical activity may result in knee damage and eventually arthritis for middle-aged men and women.

•MRI showed evidence of knee abnormalities, including cartilage damage and ligament lesions, in active adults with no pain or other symptoms

People with arthritis may have problems with performing simple daily tasks. But how does rheumatoid arthritis affect a person’s capability to use a keyboard and therefore their performance at work? This is the question that researchers from the University of Pitt decided to address.

The researchers followed up 45 patients listed in the University of Pittsburgh Medical Center (UPMC) Arthritis Network Registry. The participants were most women with an average age of 55, and had been suffering from rheumatoid arthritis for about 17 years. Half of participants are employed full or part-time, and everybody in the group of working participants used computers in their jobs.

The researchers evaluated the hand function of the participants using the Keitel Hand Function Index (KHFI) and the Arthritis Hand Function Test (AHFT) and the abilities to use a standard keyboard and mouse using the Assessment of Computer Task Performance (ACTP).

The KHFI included 11 performance test items to measure active ROM of the thumb, fingers, writs, forearms and elbows. The AHFT consisted of 10 test items to evaluate pure and applied strength and dexterity in a variety of hand tasks.

The results of the study are quite encouraging:

• 73% of participants have been trained in touch typing and used the computer an average of 18 hours per week
• Participants with rheumatoid arthritis have comparable skills to non-impaired individuals in terms of keyboarding speed.
• Participants who were trained in touch typing had faster typing speeds than those using a visually-guided (“hunt and peck”) method, with or without rheumatoid arthritis.
• The ability of using a mouse is slightly impaired in workers with RA and the impact of this impairment on job productivity still needs to be evaluated.

These results are indeed good news for those with rheumatoid arthritis. Previous studies have reported that rheumatoid arthritis can impair people’s abilities to perform their jobs so that those suffering from this condition have higher rates of work disability, premature work cessation, and reduced hours on the job.

However, this study indicates that computer work is not greatly affected by rheumatoid arthritis According to figures from the U.S. Census Bureau, the number of workers using computers increased from 46% in 1993 to 56% in 2003 with figures expected to continue climbing higher.

Thus people with rheumatoid arthritis skilled in computer work especially touch typing need actually not fear for significant impairment that may cost their jobs.

According to lead author Dr. Nancy Baker:

“With more arthritic workers using computers, understanding the associations between hand function impairment and peripheral device (keyboard and mouse) limitations is essential and the focus of our current study.”

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The 2009 Annual Scientific Meeting of the American College of Rheumatology (ACR) was held in Philadelphia in October. One of the main subjects of the research studies presented during the conference was advances in the management of osteoarthritis as featured in this Medscape report.

Osteoarthritis is the most common form of arthritis characterized by the breakdown of cartilage around the joints. Some of the symptoms are pain, swelling, stiffness, and impairment of motion and function. It affects the joints of the hands, knees, hips or spine. Although the causes of osteoarthritis are poorly understood, studies have identified the risk factors as:

• old age
• female sex,
• high BMI or obesity
• previous trauma
• malalignment
• genetic factors and
• biochemical changes in aging joint tissues

During the ACR meeting, several investigations of nutritional interventions for osteoarthritis were presented. Some of the nutritional therapies are summarized below.

Glucosamine for Knee Osteoarthritis

Glucosamine is a common nutritional supplement used for the management of degenerative joint disease. It is available over the counter. At the ACR meeting, the results of the Joints on Glucosamine (JOG) trial that evaluated the effect of glucosamine on knee osteoarthritis were presented, with disappointing results.

“…no differences were observed in the progression of cartilage lesions between the treatment and placebo arms over the 24-week study. Moreover, glucosamine did not reduce levels of urinary type II collagen fragments, a biomarker for cartilage turnover. Taken together, these data suggest that glucosamine does not inhibit structural progression in knee OA, although this study is limited by its relatively small sample size and short follow-up, especially in light of the fact that OA lesions develop and progress over several years. “

Avocado-soybean unsaponifiables (ASU) for Hip Osteoarthritis

The nutraceutical made from Avocado-soybean unsaponifiables (ASU) is a popular osteoarthritis pain remedy especially in Europe. It is made from extracts of avocado and soybeans.  Results of a 3-year trial that investigated the efficacy of ASU to prevent progression of hip osteoarthritis indicated a weak benefit that needs to be confirmed by more studies.

“At 3 years, no differences were observed between the placebo and ASU-treated groups in the primary outcome, which was change in joint space width. However, a statistically significant 20% reduction in progression, defined as > 0.5 mm reduction in joint space width, was observed in the treatment arm. No effects were observed on patients’ symptoms and ASU was generally well tolerated. Interpretation of the findings from this study is limited by the high patient dropout rate from the study of 41% and a failure to observe a significant difference in the primary outcome. Additional studies are needed to conclusively determine whether ASU has structure-modifying benefits in hip OA and could delay the need for joint replacement procedures.”

Antioxidants

Antioxidants are very popular supplements against cardiovascular diseases. But do they have beneficial effects in inflammatory diseases such as osteoarthritis? Unfortunately, years of study haven’t answered this question. One study reported at ACR meeting

“Higher intake of the antioxidants beta-carotene, vitamins E and C, and selenium were not associated with a reduction in the incidence of severe OA. Surprisingly, an association between high selenium intake and knee and hip OA was observed. This intriguing observation, which could influence how one counsels patients on the use of antioxidant supplements, needs to be confirmed with additional studies.”

It is well-known that fish oil is beneficial to cardiovascular health. Fish oils are rich in long-chain omega-3 fatty acids docosahexanoic acid (DHA) and eicosapentaenoic acid (EPA), the so-called “good fats.”

New research evidence suggests that fish oil may also help treat other chronic diseases, especially inflammatory conditions such as rheumatoid arthritis.

According to Medline Plus Encyclopedia,

Rheumatoid arthritis is a form of arthritis that causes pain, inflammation, stiffness and loss of function of the joints. It can affect any joint but is common in the wrist and fingers. More women than men get rheumatoid arthritis. Unlike osteoarthritis, which the common arthritis that comes with old age, rheumatoid arthritis can occur in young adults starting between ages 25 and 55 years. There are different grades of rheumatoid arthritis. It can last only for a short period of time; it can come and go. The severe form can last a lifetime and can lead to disability. Aside from the joints, rheumatoid arthritis can also attack the eyes, mouth, and lungs.

Rheumatoid arthritis is an autoimmune disease, e.g. the body’s immune system attacks its own tissues. I Researchers from the University of London and Harvard Medical School report that consumption of fish oil can reduce inflammation associated with rheumatoid arthritis. Inflammation occurs when the body’s immune system targets healthy tissue by mistake leading to white blood cells sticking to the endothelium (blood vessel lining). The human body converts DHA in the fish oil into Resolvin D2, which has some anti-inflammatory properties. Resolvin D2 causes the endothelial cells to produce small amount of nitric oxide, a chemical signal that discourages the white blood cells from sticking to the endothelium, thus preventing inflammation.

According to study leader Mauro Perretti, Professor of Immunopharmacology at Queen Mary, University of London

“We have known for some time that fish oils can help with conditions like arthritis which are linked to inflammation. What we’ve shown here is how the body processes a particular ingredient of fish oils into the chemical Resolvin D2. This seems to be a very powerful chemical and a small amount can have a large effect.”

The study suggests that fish oil, DHA and Resolvin D2 could form the basis of new treatments, not only for rheumatoid arthritis, but also for other inflammatory diseases. An additional advantage of fish oil is that it is natural, does not come with side effects associated with anti-inflammatory pharmacologic agents such as suppression of the immune system and increased cardiovascular risks.

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Many people wear copper bracelets and magnetic wrist wraps to counteract the pain that comes with arthritis and other musculoskeletal disorders. The practice is called magnet therapy. Magnet therapy come in different forms, e.g. magnetic bracelets and other accessories you can wear on your body but can also include drinking magnetized water. Magnetic therapy is used in a wide range of ailments which include (source: Magnetic Therapy Council UK):

• Arthritis
• Bowel Disorders
• Chronic Fatigue Syndrome
• Diabetes
• Fibromyalgia
• High Blood Pressure
• Insomnia
• Migraine
• Osteoporosis
• Poor Circulation
• Repetitive Strain Injury
• Sciatica
• Spondylosis

Researchers from the University of York finally conducted the first randomised placebo-controlled study on the efficacy of these accessories in the management of pain caused by osteoarthritis.

The researchers looked at 45 people over the age of 50 or more who were diagnosed with osteoarthritis, the most common form of arthritis. Each study participant wore four devices in a random order over a 16-week period – two wrist straps with differing levels of magnetism, a demagnetised wrist strap (placebo) and a copper bracelet. The study found no clinical significant differences between the devices in terms of their effects on pain, stiffness and physical function.

According to study leader Stewart Richmond, a Research Fellow in the Department of Health Sciences at the University of York,

“It appears that any perceived benefit obtained from wearing a magnetic or copper bracelet can be attributed to psychological placebo effects. People tend to buy them when they are in a lot of pain, then when the pain eases off over time they attribute this to the device. However, our findings suggest that such devices have no real advantage over placebo wrist straps that are not magnetic and do not contain copper.”

Previous studies have indicated that the bracelets give some relief for arthritis patients. The results of this study contradict those previous reports. However, this design of this study is more reliable, this being the first randomised placebo-controlled trial for this therapy. However, one of the limitations of the study is the small sample size.

Magnet therapy is one of the leading alternative therapies for arthritis worldwide. It is a rapidly growing business with an estimated worldwide sales of $4 billion US.

According to Stewart

“Although their use is generally harmless, people with osteoarthritis should be especially cautious about spending large sums of money on magnet therapy. Magnets removed from disused speakers are much cheaper, but you would first have to believe that they could work.”

Your knee is a very essential anatomical part in order to be mobile. That is why the bones of the knee are well-protected by the tibio-femoral cartilage. However, the protective cartilage sometimes gets damaged due to a wide range of factors, leading to pain, loss of mobility and even disability. Cartilage damage can lead to osteoarthritis, a progressive and painful disease caused by breakdown of the cartilage. It is the most common form of arthritis, afflicting approximately 27 million Americans.

According to lead researcher Dr. Frank Roemer

“Osteoarthritis is a slowly progressive disorder, but a minority of patients with hardly any osteoarthritis at first diagnosis exhibit fast disease progression. So we set out to identify baseline risk factors that might predict rapid cartilage loss in patients with early knee osteoarthritis or at high risk for the disease.”

The researchers looked at 336 people with 347 osteoarthritic knees. The majority of the study participants were women (65.2%), with an average age of 61.2 years and an average body mass index (BMI) of 29.5. The participants were followed up for 30 months. During this period, cartilage loss was monitored using whole organ magnetic resonance imaging. The results showed that

• 20.2% of participants had slow cartilage loss during the follow-up period
• 5.8% experienced a rapid rate of cartilage loss.

The researchers also identified the top risk factors that might influence the rate of cartilage loss, namely:

• preexisting cartilage damage at baseline
• evidence of tear or injury to the meniscus (the cartilage that cushions the knee joint)
• high BMI
• evidence of inflammation in the synovitis which lines the joints.

Of these, the high BMI is the only modifiable factor. Age, sex and ethnicity don’t seem to play a role in cartilage loss.

The rate of cartilage loss increased with increasing BMI. BMI is the ratio of body weight to height and a range of 18.5 to 25 is considered normal. BMI values above this range indicate being overweight or obesity. For every one unit increase in BMI, the likelihood of rapid cartilage loss increased by 11%

Dr. Roemer continues

“As obesity is one of the few established risk factors for osteoarthritis, it is not surprising that obesity may also precede and predict rapid cartilage loss. Weight loss is probably the most important factor to slow disease progression.”

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It is not only humans who suffer from osteoarthritis. Animals such as horses and dogs can have it as well. Osteoarthritis is a disease characterized by degradation of the articular cartilage, that results in pain, inflammation and loss of motion in the joint.

And like humans, animals also suffer from pain and restricted mobility that the disease brings.

Researchers at the University of Missouri have been searching for a feasible biomarker for risk of developing osteoarthritis and they might just have found one that works for dogs as well. According to James Cook, professor of veterinary medicine and surgery, and the William & Kathryn Allen Distinguished Professor in Orthopedic Surgery

“By developing methods for earlier diagnosis of osteoarthritis, prevention or even curative treatment strategies to manage the disease become more realistic. Biomarkers could detect the disease before pain and swelling occurs, and owners could take preventative measures, such as modifying activities or diet, helping their pets lose weight and strengthen their joints, to reduce the likelihood of their dogs developing osteoarthritis.”

The researchers looked for potential biomarkers in the synovial fluid, the fluid that lubricates the joints. It is believed that the synovial fluid responds rapidly to damage to the joints. The By taking samples from dogs, UM researchers found that the quantity and quality of synovial fluid exhibited some marked changes in canine patients with injured stifle joints. This is the joint in the hind limbs of dogs that is the equivalent joint to the human knee.

“At the MU Comparative Orthopaedic Laboratory, we are particularly interested in identification and validation of biomarkers that can detect early stages of osteoarthritis to provide accurate diagnostic and prognostic information prior to the onset of clinical disease for people and for pets,” Cook said. “Our team, led by Drs. Kuroki, Stoker and Garner, is making tremendous progress in developing simple tests on blood, urine and synovial fluid that show great promise for helping us diagnose impending osteoarthritis before it is too late to help the patient in the most effective manner.”

Like in humans, osteoarthritis in dogs is associated with age. It is estimated that 20% of middle-aged dogs and 90%of older dogs have osteoarthritis in one or more joints. In humans, the incidence is even much higher.

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Physical exercise is essential in maintaining joint health and in managing symptoms of osteoarthritis. But it doesn’t feel like it, as many arthritis patients would attest, making performance of simple daily activities challenging, much less compliance with prescribed exercise routines.

But a new type of therapy, the so-called activity strategy training might just be the help that patients with osteoarthritis of the hip and knee.

This is based on a study conducted by researchers at the University of Michigan Health System.

Taught by occupational therapists, this structured rehabilitation program is designed to educate patients about joint protection, proper body mechanics, activity pacing, and environmental barriers. For example, patients with joint pain caused by osteoarthritis learn techniques for walking around the house or outdoors, or even getting in and out of a car.

The study compared two strategies: the commonly prescribed regular exercise and health education sessions vs the activity strategy training (AST) plus regular exercise. The outcomes showed that AST was more effective in increasing and maintaining physical activity in osteoarthritis patients. The difference between the two strategies is probably that AST is more customized to the patients’ needs while structured exercise is not. Furthermore, AST addresses barriers to physical activity that may be specific to certain communities or environment, such as those found in senior homes, for example.

Osteoarthritis is “a degenerative disease that causes the breakdown of the cartilage in joints. Activity strategy training, however, is not commonly prescribed to patients with hip or knee osteoarthritis… Most physical activity programs for these patients only offer structured exercise, which has been shown to have short-term positive effects on arthritis pain and physical disability. But these effects usually fade soon after participation in the program ends.”

The researchers went on to urge osteoarthritis patients to take a proactive role in their therapy. According to lead author Susan L. Murphy

“People with osteoarthritis need to be their own agents of change. They can do so much to manage symptoms and stave off functional decline caused by osteoarthritis just by being physically active. The bottom line is to find ways to help people create and maintain these healthy habits.”

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One of the causes of arthritis is an autoimmune disease that causes the body to go into a self-preservation mode and attack healthy tissues, believing they are a threat to its well-being. While there is no known exact cause of autoimmune deficiencies, information on rheumatoid arthritis points out that some environmental factors may be involved. It is also thought that viruses, bacteria or fungus has some role in its development, information on rheumatoid arthritis targets the treatment more than the cause.

Unlike osteoarthritis, which generally affects older people as a degenerative disease, information on rheumatoid arthritis points out this disease can attack not only the cartilage in the joints, but also the bone structure. When pain usually associated with arthritis is experienced, it is sometimes difficult to pinpoint the exact cause of the pain, but thorough diagnosis by the doctor can determine if is a natural progression of cartilage loss or an internal strike by the body’s immune system that is causing the problem.

The repeated inflammation of bone tissue cause the pain to come and go, making diagnosis difficult. Exploratory x-rays and CAT-scans can help determine the cause. Additionally, information on rheumatoid arthritis suggests that the degeneration it causes is symmetrical, meaning if one hand is affected, the same effect will be experienced in the other hand as well.

No Known Cure For Rheumatoid Arthritis

There is no known treatment to totally stop the progression of this type of infection, but many drug therapies used in the initial stages have been shown to help reduce the frequency of inflammation as well as damage to the joints and other organs. Most of the information on rheumatoid arthritis is aimed at treating the pain and stopping the spread of the inflammation and two different classes of drugs are most often used.

Anti-inflammatory drugs are often used to help reduce the pain in affected joints and to help reduce swelling. Non-steroidal Anti-inflammatory drugs are often used in place of regular aspirin due to the lower dosage requirement to achieve the same effects. Additional information on rheumatoid arthritis accepts the idea that long-term use of long-acting drugs to prevent bone deformity may also be needed.

While the first line drugs work against the inflammation and pain, these second line drugs, which can take months to show signs of working, are the prevent the crippling effects of bone deformity. Newer drug therapies work biologically to halt the progression of inflammation, and are many of the same drugs used to fight the effects of cancer.

It can be scary going to the doctor, but you can be in and out quicker if you are able to give your doctor accurate descriptions of you problem. Be sure to tell him or her when the problem started and if there are any times the pains seems worse. Also knowing these common arthritis symptoms will make you realize when to make a doctor’s appointment or not. Generally, the earlier your doctor knows about your arthritis symptoms, the earlier you can be accurately diagnosed and get effective treatment.

Joint Pain

Now this is the biggie of arthritis symptoms. Arthritis is an umbrella term for over 100 types of inflammations of the joints. Joints, in this case, do not refer to any herbal smokes, but to the natural hinges of your body. Joints and therefore, joint pain, are in your wrists, ankles, hips, neck, fingers, knees and shoulders. This is usually a pain you’ve never had before while performing tasks that you never before had any problems doing, such as opening a bottle or turning the pages of a book or walking up a flight of stairs.

Joint Stiffness

This is another of the major arthritis symptoms to look out for. Limbs and joints that previously not hurt while moving not only hurt, they refuse to move. This can be varied such as a hand refusing to uncurl from a fist position you made as you slept to not being able to move a leg. You move (or can’t move) more like the Tin Man in The Wizard of Oz before he gets his dose from the oil can. This can get better throughout the day, and often gets worse in the cold.

Physical Joint Changes

These are other common arthritis symptoms, although they do not happen to everyone with the beginnings of arthritis. The painful places of your body become visibly swollen, more red or discolored and very tender, often to the point where the only thing they will tolerate touching them is air.

Other Tips

In order to diagnose you and get you the help you need as quickly as possible, your doctor will also need to know your medical history and the medical histories of your parents and siblings, if possible. If they are willing to talk about it, ask and write down what your parents or sibling remember about when their arthritis started and what type of arthritis it was diagnosed as. Remember to thank them.