As discussed in a previous post about osteoarthritis, aching joints can seem like an inevitable consequence of ageing. But that doesn’t mean that there are not measures we can take to help prevent arthritis from accelerating or treatments that can not help repair some of the wear and tear within our joints. After all, there is nothing more important to maintaining good overall health, than keeping active – especially as we age.
Diet and Exercise
There is not a lot about the human body that cannot be improved through proper diet and exercise. Excess weight puts a lot of pressure on our joints, especially our knees – it is estimated that just 10 extra pounds of body weight can add as much as 50-lbs of extra pressure on our weight bearing joints. Research is increasingly showing that excessive weight may actually be responsible for causing osteoarthritis, especially in those who were overweight in their 30’s and 40’s.
While exercise might seem counterintuitive to the treatment of osteoarthritis – who wants to exercise when their joints hurt! – it is crucial to maintaining mobility and reducing pain. But remember, our joints are one part of a complex musculoskeletal system, along with tendons, ligaments and muscle. Without strong, flexible muscles to support our joints and act as shock absorbers, they will inevitably suffer.
Research has shown that, despite a common misconception, moderate exercise does not increase the risk of osteoarthritis – it can actually prevent osteoarthritis pain with as little as two hours of moderate intensity exercise each week. We typically recommend a range of exercises for our patients that are specifically tailored to them – ones that focus on improving muscle strength, flexibility and endurance. Before beginning any new exercise regime, we recommend speaking with your doctor or a specialist about what exercises are right for you.
Another consequence of aging joints or injuries sustained to our joints, is that the cartilage surrounding them and the synovial fluid that forms our natural joint lubricant, begin to deteriorate – without them, we experience joint stiffness and pain. Hyaluronate is a naturally occurring molecule that is found within both our cartilage and synovial fluid – when we inject hyaluronic acid into joints, specifically knee joints, we are reintroducing the viscous lubricant that keeps our joints functioning at their best. Hyaluronic acid injections are typically performed in a series of five, scheduled approximately one week apart and they require regular maintenance to ensure that joint lubrication is maintained.
Platelet Rich Plasma (PRP) and Stem Cells
Perhaps the most exciting field of medicine is that of regenerative medicine – using our bodies natural healing abilities to heal ourselves. Platelets are cell fragments that serve a number of functions within our body, one of the most important functions is that of healing injured tissues. When an injury occurs in the body, platelets release chemical messengers that begin organizing and recruiting proteins intent on healing the area. As we age, or in areas of poor blood flow, these chemical signals get weaker and oftentimes the signal gets lost – our body never knows that an injury has occured and it never gets healed.
By injecting a concentration of our own platelets into areas where damage and deterioration has occurred, we are able to send an incredible loud signal for help and our bodies respond as they should – it remarkably begins healing the damaged tissue in the area.
Stem cells, on the other hand, are our bodies fundamental building blocks – they are responsible for every cell, tissue and organ within our body. Mesenchymal stem cells are primarily found in bone marrow and are responsible for promoting healing within the body, specifically in bones, muscle, and cartilage. When they are injected into a joint for instance, these cells can replace the specialized cells that have been lost or damaged – cells that are able to regenerate damaged tissue.
Using both PRP and Stem Cell treatments, we are able to initiate the body’s own healing response almost immediately. For most patients there are remarkable improvements in previously damaged tissues and deteriorated joints – the result being a significant improvement in both range of motion and pain levels.
We believe quite simply, that surgery should always be a last resort – to date, we have recommended less than a handful of our patients to an orthopaedic surgeon. Once a joint, muscle or connective tissues has been traumatised through surgical intervention – there is no going back, and increasingly research is showing that some of the most common surgeries actually cause, or significantly increase the severity of arthritis. Despite the fact that surgeries should only be performed in the most severe cases of osteoarthritis – when all other treatments have failed – the number of total hip and knee replacements is on the rise in the United States. There are currently over 400,000 total hip replacements and over 700,000 total knee replacements performed each year, with those numbers expected to increase by 171 percent and 189 percent respectively by 2030.
According to a 2018 article published in the Washington Post, up to one-third of those who received a knee replacement continue to experience chronic pain and one-fifth were dissatisfied with the results. The Arthritis Foundation warns against most types of surgical interventions, except in the most severe cases, recommending patients to seek a second opinion.
Living with Osteoarthritis
It is important to remember that all of us are ageing, inside and out, and there is no cure for osteoarthritis. Our goal is to ensure that our patients are able to continue to enjoy their quality of life and maintain a healthy and active lifestyle – with as little pain as possible. Living with arthritis means being vigilant about your health and the best way to do that is to be proactive in seeking the best treatment for you – in many cases, early intervention can prevent severe arthritis from occurring. Diet and exercise are the best place to start – whether it’s an after dinner walk or a water aerobics class. Arthritis doesn’t have to mean giving up the things we love.