In this article we talk about three of the most common and debilitating conditions affecting the skeletal system, all of which can lead to significant pain and compromised quality of life. We discuss the two most well-known forms of arthritis and distinguish them from each other and then unpack the condition known as osteoporosis and the factors which can cause this condition.
Osteoarthritis (OA) is a degenerative condition where there is wear and tear in the joints, particularly the weight bearing joints such as the hands, feet, hips, knees, and spine. OA is the most common form of arthritis and typically occurs when the protective cartilage layer in our joints becomes damaged. Cartilage is a smooth, elastic, cushioning type of material that has a shock absorbing action. It covers the bony surface of each bone in a joint and in moveable joints such as the knee, and it allows the joint to move smoothly and freely. In larger joints like the knee, the cartilage is kept moist and lubricated by a special fluid called synovial fluid.
The first signs of osteoarthritis are microscopic pits and fissures on the cartilage surface, sometimes accompanied by inflammation. As this process worsens, the protective layer breaks down further and leaves areas of bone exposed and unprotected, leading to pain. Thinning of the cartilage cushion can be seen on an x-ray because the space between the bones of the joint becomes narrower as the layer of cartilage begins to disappear, essentially leading to a painful ‘bone on bone’ situation. Sometimes, to make matters worse, sharp bony growths begin to form in the joint too. These are called spurs or osteophytes, which project into the joint space, compromising the smooth motion of the joint further and leading to pain and inflammation. As the joint space disappears, the ligaments which stabilise the joint begin to loosen, causing further joint instability.
Typical features of OA include:
- A gradual onset of pain and stiffness, developing over months to years.
- Usually large weight bearing joints of the body e.g. knees, hips, spine.
- Typically, one or two joints are affected.
- The condition is limited to the joints and does not affect other parts.
- Movement of the joint becomes restricted, stiff, and painful. This is called loss of range of motion.
- Morning stiffness lasting less than 30 minutes.
- If the hands are involved, tender, hard swellings called Heberden’s nodes can develop. These are hard or bony swelling around the last joint before the fingertips.
- OA can also affect the joints on the feet causing painful, stiff feet especially when first standing up in the morning.
What causes OA?
Because OA is a degenerative condition, its development is often attributed to ‘wear and tear’, therefore typically it is more common in older patients. Other conditions linked to the development of OA include:
- Being overweight – i.e. more stress on weight bearing joints.
- Joints with a history of injury are more at risk of developing OA.
- Family history of OA.
- An acidogenic diet, i.e. a diet dominated by meat, dairy, sugar, refined foods and insufficient alkaline foods like fresh fruit and vegetables plus not enough water!
The lubricating synovial fluid in our large joints helps to nourish and protect cartilage, research shows that in patients with arthritis this fluid becomes too acidic which harms the very protective cartilage we need to keep our joints healthy. By drinking at least 1.5 to 2 litres of water daily and following alkaline diet, we can assist our body in controlling acidity.
Rheumatoid arthritis (RA)
Rheumatoid arthritis (RA), although also causing painful joints, is not caused by wear and tear, but is rather a form of autoimmune disease. Autoimmune disease occurs when our own immune system becomes over stimulated and begins to cause a destructive inflammatory reaction in our body. In the case of RA, it affects multiple joints. Therefore, unlike OA, RA can occur at any age and is much more common in younger patients. In RA, the autoimmune reaction causes inflammation of the lining of the joints called the synovium, whereby inflammatory immune cells flood the joint and synovial fluid and release enzymes that can digest bone and cartilage and can result in loss of bone shape and alignment leading to severe pain, stiffness, inflammation, swelling and reduced range of motion.
Typical features of RA include:
- RA affects younger patients and women more than men.
- Multiple joints can be involved usually in a symmetrical pattern i.e. pairs of joints on both sides of the body.
- Joints can rapidly become inflamed, painful and swollen i.e. a much more sudden onset of symptoms.
- RA can move from one joint to another.
- Morning stiffness typically lasts more than 30 minutes.
- The condition is not isolated to the joints i.e. it can affect the whole body. There can also be fever, fatigue, weight loss and other parts affected.
- Abnormal blood markers are found and can help confirm the diagnosis such as rheumatoid factor, anti-CCP, CRP, ESR.
What causes RA?
The exact cause of RA is less clear than that of OA, although it is clearly the result of an autoimmune disease, what triggers any autoimmune disease to start in the first place is very poorly understood. There is some evidence that certain infections can switch on the immune system and over stimulate it; certain medicines are also potential triggers as are traumatic events and stress.
Some researchers also propose that autoimmune conditions can be triggered in the intestine where more than 70% of all our immune cells are found. Factors which harm the natural healthy bacteria known as the gut microbiome is one potential factor linked with autoimmune disease.
Osteoporosis (OP) occurs when there is a reduction in the total mass and density of our bones. When bones loose density they become fragile or brittle and prone to fracture. Our bones provide structural strength and support to our bodies, and also provide protection to vulnerable organs beneath them; think of the ribcage protecting the lungs and heart and the skull safely housing our brains. In addition to this they are storage sites for crucial minerals, it’s these packed in minerals that give bones their hardness and strength. A healthy diet as we are growing up allows the body to pack the bones with minerals. We have the ability to build up bone density especially in our younger years, but also the ability to break it down, for example, sometimes when we don’t get enough minerals from our diet the body can borrow minerals from the bones, and unfortunately if too many minerals leave the bones, they loose their strength and result in osteoporosis (porous bones). Any condition which leads to ongoing demineralisation of the bones cause osteoporosis.
What causes osteoporosis?
- Menopause – oestrogen helps maintain bone density, and when these levels drop, minerals begin to leak out of the bones and are lost via urine, making osteoporosis more common in women than men.
- Lack of weight bearing exercises – being immobile or not exercising enough leads to loss of bone minerals.
- Smoking and excessive alcohol consumption increases bone mineral loss.
- Acidogenic diet – when the body is too acidic, the body robs the bones of alkaline minerals to neutralise acid. When this happens too often or on an ongoing basis, especially in women after menopause, bones demineralise with time.
- Poor diet or poor absorption of nutrients such as calcium and minerals from the intestine.
- Vitamin D deficiency.
- Family history.
- Medicines such as corticosteroids when used long term.
What are the symptoms of OP?
Unfortunately, there are few early warning signs when the bones first begin to demineralise. In many cases, the first obvious feature could be an unexplained fracture. At this stage, osteoporosis may already be extensive and difficult to treat, therefore, all women when near menopause should have a bone density scan to screen for early stages of OP known as osteopenia. Active treatment at this stage can prevent the onset of osteoporosis.
Advanced features of OP include:
- Unexplained fractures.
- Unexplained skeletal pain especially hip or back pain.
- Stooping and rounding of the shoulders.
- Loss of height – due to osteoporosis of the spine.
Natural products to support the Musculo Skeletal System:
A.Vogel Multiforce® is a source of calcium, magnesium, phosphorus, and potassium, as well as citrate and bicarbonate salts (alkalising minerals) and has a systemic alkalinising effect. It supports the body’s acid buffering mechanism by providing essential alkaline minerals required to combat a typical acidogenic diet (high in animal protein and low/deficient in fruit, vegetables and minerals) and lifestyle, thereby assisting in addressing the negative consequences thereof such as osteoarthritis and osteoporosis.
A.Vogel Multiforce® has been clinically proven to improve the symptoms of osteoarthritis of the hands in which patients experienced significantly less pain, tenderness and stiffness of their fingers and hands due to the systemic alkalising effect.
THRESHHold® RealMSM tablets contain 1000mg OptiMSM®, a 4 times heat distilled – 99.9% pure MSM with lowest water and impurity content (the purest form of MSM available) and the only MSM with a FDA GRAS rating on the market. THRESHHold® RealMSM is non-allergenic, Kosher and Halal certified, non-GMO, gluten-free, allergen-free, non-shellfish derived and classified vegan. It provides MSM in an evidence based, clinically active dose and has no known drug interactions or contraindications.
THRESHHold® RealMSM is used as an anti-inflammatory and assists in the temporary relief of pain, swelling, redness, inflammation, and difficult mobility of joints in patients with arthritis. It improves range of motion and physical function in arthritic patients, supports recovery from exercise and reduces post-exercise muscle soreness and joint pain.
THRESHHold® +Gel is a topical gel to assist with the temporary relief of pain, swelling, redness, discomfort and reduced mobility of soft tissue and joints as a result of minor injury, overuse and strain.
A.Vogel Urticalcin assists with the maintenance of healthy calcium levels. Ingredients address healthy absorption and assimilation of calcium and minerals necessary for healthy bones, teeth, hair and nails, and assists the body in managing acidity levels.
Useful links and references:
- Arthritis Foundation of South Africa - https://www.arthritis.org.za/
- Collins, J.A., et al. 2013, Oxygen and pH-sensitivity of human osteoarthritic chondrocytes in 3-D alginate bead culture system. Osteoarthritis and cartilage . 21(11): p. 1790-1798. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3807787/
- Geborek, P., et al.1989. Synovial fluid acidosis correlates with radiological joint destruction in rheumatoid arthritis knee joints. J Rheumatol. 16(4): p. 468-72. https://pubmed.ncbi.nlm.nih.gov/2746586/
- Lanham-New, S.A., The balance of bone health: tipping the scales in favor of potassium-rich, bicarbonate-rich foods. J Nutr, 2008. 138(1): p. 172s-177s. https://pubmed.ncbi.nlm.nih.gov/18156420/
- National Osteoporosis Foundation of South Africa. https://osteoporosis.org.za/Arthritis
- OptiMSM Research Publications summary. https://optimsm.com/optimsm-research/
- Tucker, K.L., et al., Potassium, magnesium, and fruit and vegetable intakes are associated with greater bone mineral density in elderly men and women. Am J Clin Nutr, 1999. 69(4): p. 727-36. https://pubmed.ncbi.nlm.nih.gov/10197575/
- Van Velden DP, Reuter H, Kidd M, Müller FO. 2015. Non-allopathic adjuvant management of osteoarthritis by alkalinisation of the diet. Afr J Prm Health Care Fam Med. 7(1), Art. #780, 7 pages. http://dx.doi.org/10.4102/phcfm.v7i1.78