Osteoarthritis is a leading cause in disability as it a very common occurrence which causes joints to degenerate throughout the body of affected patients.
Frequently Asked Questions
- 1What is Arthritis / Osteoarthritis?
- 2What are the symptoms?
- 3What is the progression of OA?
- 4What are the conventional therapies or OA?
- 5How is Osteoarthiritis managed at Health Renewal?
- 6What integrative supplements are recommended?
- 7What in office treatments can be done at Health Renewal?
- 8Can a wellness gene test be done at Health Renewal?
- 9Why should one not self-medicate?
- 10How do I get started?
- 11How do we treat this at Health Renewal?
- 12What should you bring along to your appointment with your Health Renewal doctor?
- 13What is the cost of the extended consultation with the Health Renewal doctor?
- 14How often should I see the integrative Doctor at Health Renewal?
- 15Health Renewal tip: How does one prevent Osteoarthritis?
- 16Health Renewal's 10 Inspiring Quotes For Healthy Living:
This disease is a leading cause in disability as it a very common occurrence which causes joints to degenerate throughout the body of affected patients. It is a very progressive disease which is characterized by structural damage which leads to reduced functionality of joint. In the USA alone this disease affects over 20 million people! Osteoarthritis(OA) normally targets the load- and stress-bearing joints first, such as the hips, knees and lumbar spine, but it can become a problem in any freely moving joint.
Pain is not the first tell-tale sign of Osteoarthritis as the cartilage that is affected does not have any free nerve endings to signal to the brain there is damage occurring. Because pain, and a reason for concern, is only identified very late as the disease progresses, this is a leading contributing factor for OA to only start receiving treatment very late, and therefore not having very successful reverse rates. The reason for poor healing rates is that destroyed cartilage in adults has very low repair capacity since blood flow to the areas is very limited.
The risk factors to look out for when wanting to prevent the onset of OA include keeping your weight under control (obesity puts a lot of extra strain on joints), preventing constant exposure to high-impact sports and joint trauma. Being aware of a family history of OA, advanced ageing and female gender can lead to early detection through performing regular test.
The protective cartilage between joints erode, which results in the raw surfaces of the adjacent bones coming into contact, leading to gradual bone erosion as these bones scratch, bump and grind together during every day movement. The knock on effect results in the destruction or deformation of most of the structures of the affected joint, which can decreases mobility as this situation if often accompanied by long-lasting inflammation (and potential pain).
What often happens is that after bone is destroyed due to OA there are bone growth spurs next to existing joint margins. It is believed that these "outgrowths" can assist in stabilising the joints, but it is also associated with increased pain levels. The reason for the pain, which various greatly between patients, is that these new grown bone margins rub against other bones, nerves and or soft tissues, causing patients to deal with mild to severe pain with any form of movement.
Typically any pain experienced with OA will be worse when the patient performs any physical activity, however as the disease becomes worse a patient might even experience pain when in resting position. Stiffness tends to be a bigger problem early in the mornings, but often alleviated shortly after waking. Unfortunately, after any prolonged period of inactivity there can be stiffness in the joints. As a result, in cases of advanced OA, patients often report both physical and psychosocial disability, which is contributing to the fact that (along with cardiovascular disease, OA causes more cases of disability among elderly patients.
Unfortunately there is no cure for this disease. The majority of focus for treatment is to alleviate the symptoms of pain and to maintain a level of joint function for patients struggling with Osteoarthritis.
Physical activity and exercise and other non-invasive forms of physiotherapy can help maintain mobility. There are various advantages and significant health benefits for OA patients including preventing obesity and reducing body weight, conserving physical function, and contributing to normal joint health. Make sure your exercise program contains both elements of muscle strengthening and range-of-motion movements for joints which are affected by OA - this will help a great deal for improving the joint mobility and function. Similarly, aerobic activity can also be incorporated for specifically reduction in knee OA symptoms. For patients who can`t, or won`t, partake in vigorous exercise we recommend 30 minutes of brisk walking every day, at least 3 times per week. Even very mild physical activity can improve OA symptoms and improve the patients` quality of life.
Pharmacologic Treatment and Other Therapies
Paracetamol tends to be the first-line pharmacologic therapy for treatment of osteoarthritis(OA). If this treatment does not work, there are alternative treatments to use, depending on the patient specific profile. Factor influencing this choice is usually treatment success, and normally the use of one (or a combination of) the following options:
- Topical non-steroidal anti-inflammatory drugs (NSAIDs)
- Oral NSAIDs
- Topical capsaicin
- Intra-articular corticosteroid and hyaluronic acid injections
- Opioids (pain reliever)
OA is managed with a combination of prescription medications and nutraceuticals. The treatment package will be patient specific to address the individual needs.
One can positively influence the symptoms of OA by supplementing your diet with targeted nutrients which fight against cartilage degradation, consistent with this disease. The upside of treating OA with nutritional products is that there are very limited, if any, side effects. This might be a contributing factor to why 20% of patients prefer alternative treatment methods above conventional medication.
Nutritional alternatives for Joint Structure Support:
Glucosamine– Glucosamine is a component which helps to trap water in the matrix of joint cartilage, which results in increased flexibility and resilience so the joint can function properly. In addition, researchers believe that glucosamine may assist in the repairing of damaged cartilage by stimulating synthesis of chondrocytes which also plays a crucial role in maintaining joint lubrication.
When compared to placebo, it is found that glucosamine sulfate is superior for relieving the severity of OA symptoms, making it more tolerable for patients. It is recommended that treatment should be for at least 8 weeks before a test for efficacy is conducted, due to the fact that cartilage take such a long time to synthetizes.
Chondroitin-this is a structural component similar to glucosamine, which is believed to help in the management of OA symptoms due to its ability to maintain viscosity in joints, stimulate cartilage repair, and reduce cartilage destruction. Chondroitin has been shown to improve hand pain and stiffness in OA patients, and other clinical trials have shown that chondroitin may have structure-modifying effects on OA of the fingers, as well as the knee. This treatment also has a slow response, thus requires 2-3 weeks for therapeutic response.
Hyaluronic acid(HA)-HA is secreted by chondrocytes and used as a basic building block for cartilage synthesis. It is believed that HA is useful in the management of OA because it interferes with pain mediators and decreases the production of key enzymes which are responsible for digesting and destroying healthy cartilage tissue which attributes to painful OA.
MSM Sulphur Compounds-Compounds that contain Sulphur, such as Methylsulfonylmethane(MSM), are commonly present in various fruits, vegetables, grains, and also in the human body. It is believed that these Sulphur containing compounds may reduce pain in affected joints and inhibit the deteriorating changes of OA. This is done by the Sulphur stabilizing the affected cell membranes and attacking damaging free radicals that can lead to inflammation and subsequent pain. In clinical trials, MSM was found capable of reducing both pain and swelling in patients suffering from OA. Using MSM does not have any significant side effects and is generally well tolerated. The treatment with MSM can also have significant improvement for knee joints, to improve functionality and lessen pain, if taken for a minimum of 12 weeks.
Omega-3 Fatty Acids-This nutrient is most commonly recommended for patients who consume a typical Western diet, which is high in pro-inflammatory omega-6 fatty acids. If ones diet includes high levels of Omega-6 fatty acids, this nutrient can be linked to causing bone destructions in OA patients, but by supplementing with Omega-3 fatty acids this can be combatted, as Omega-3 can reduce certain harmful proteins present in OA patients. For even better results it is recommended that Omega-3 fatty acids are combined with glucosamine to reduce stiffness levels in the mornings.
Krill-This is an important food source, high in Omega-3 fatty acids, which is shrimp-like crustacean found in cold water. For OA patients that struggle with inflammation it is important to supplement with 300mg of krill oil on a daily basis. After a month’s use it will reduce pain by 30%, stiffness by 20% and improve functionality of affected joints by up to 23%!
Undenatured Type-II Collagen–Recent discoveries have revealed that gradual destruction of joints in OA leads to the exposure of joint collagen, which triggers an immune response that launches an autoimmune-like inflammatory attack on the joint. UC-II functions as a "switch" to turn off this immune response. It does so by inducing what immunologists call specific oral tolerance–the desensitization of immune response to specific agents via an orally administered intervention.
Curcumin-Is a plant phenolic compound which has potent anti-inflammatory and anti-oxidant characteristics. It has been researched and found that Curcumin might be a viable alternative to NSAIDs, and can be a good complimenting treatment to other OA medications. The reason for Curcumin`s effectiveness when treating OA patients might be due to its ability to weaken nuclear factor kappa B signaling, which will reduce the production of inflammatory mediators and restrict cartilage destruction. As this is a chronic disease the use of Curcumin will be recommended as a long-term complementary management supplement for OA symptoms.
Herbs such as Ginger, Boswellia and Korean Angelica all improve symptoms of OA.
Vitamin D 3-Vitamin D is a pro-hormone kind of an essential hormone called 1,25-dihydroxy vitamin D, which is also known as calcitriol. After Vitamin D has been converted into calcitriol, it has the ability to inhibit inflammation by adapting some of the genes responsible for producing pro-inflammatory mediators.
Evidence suggests that patients with OA have a decreased level of vitamin D 3 in their blood, when compared to healthy patients; this was especially true of younger osteoarthritis patients (younger than 60). Health Renewal recommends that routine vitamin D 3 deficiency tests are performed for all patients with pain complaints. If vitamin D levels are found to be low, supplementation of Vitamin D3 may improve pain levels experienced. Blood levels of 25-hydroxyvitamin D 3 should be kept between 50 and 80 ng/mL for optimal health.
Antioxidants- It is vital to include ample anti-oxidants in the daily diet to prevent the negative of effect of destructive free-radicals in the body. The oxidative stress caused by these free-radical scavengers can cause inflammation and pain in joints. Some anti-oxidants to consider include Vitamin C and astaxanthin.
Green Tea Extracts: Green Tea contains the vital element Epigallocatechin gallate (EGCG), which is the major and most active biological component. This component was shown (in an in vitro study) to protect human chondrocytes from inflammatory damage and hence an important supplement for any OA patient to consider.
- Carboxytherapy in the affected areas, done once a week may improve the symptoms of OA.
- Body Renewal Medical Weight loss program, offered at Health Renewal, is a medical weight loss solution which uses hCG off label to safely reduce weight-especially dangerous abdominal fat. If the program is strictly adhered to, 10 to 12 kilograms of resistant fat can be safely lost in 4 to 6 weeks.
A multi-gene DNA test can routinely be added to assessment of:
- blood cholesterol and
- glucose levels,
- blood pressure and
- body mass index (BMI) as part of Wellness Programs offered by healthcare practitioners.
It includes analysis of variation in clinically useful genes that may contribute to:
- abnormal cholesterol levels,
- homocysteine accumulation,
- blood clotting,
- iron overload and
Some of these abnormalities contribute to the development of type II diabetes, obesity and hypertension. Oxidative stress, detoxification of carcinogens and oestrogen exposure are also important considerations in this context.
This pathology supported genetic test is performed in conjunction with assessment of any food allergy or intolerances known to be associated with many chronic disorders. The results of the genetic test are combined with clinical indicators and lifestyle factors to identify a combination of risk factors that may lead to disease development or progression, if left untreated.
For all health conditions, the nutraceuticals are individually tailored by the Health Renewal Doctor. The doctor will decide- based on your history, physical examination and blood tests what would be the best for you and your specific needs and/or deficiencies. It cannot be overemphasized that one must not self-medicate. Self-Medicating is done when a person takes prescription medication or nutraceuticals on their own without a doctor's supervision and/or consent. By not having a physical examination and blood testing done by a qualified and practising integrative medical practitioner, you could be not treating vital deficiencies or conditions such as elevated blood pressure, high sugar level, high stress levels (that can lead to adrenal burnout ) and high blood clotting factors that could lead to heart attacks and stroke. In addition, aggressive program of dietary supplementation should not be launched without the supervision of a qualified physician. Several of the nutrients suggested in this protocol may have adverse effects. There is no single supplement prescribed to clients as there is no magic bullet that can support all the essential nutrients that one's body needs. Today's food is not functional and we need to supplement in order to maintain optimal bodily functions and nutrition.
Make an appointment to consult with your Health Renewal Doctor who is an integrative doctor and he / she will assist you in determining your risk factors and how best to prevent any problems or conditions that you may be susceptible to. The importance of early management of any condition cannot be overstated. Once certain conditions set in and damage to organs occurs, complete recovery may be difficult to attain. Best results for prevention and longevity is early detection of a possible problem combined with conventional treatments, nutritional supplements and a healthy diet and lifestyle.
The initial medical consultation at Health Renewal will be approximately 45 minutes. As this is a prolonged medical consultation, the initial consultation fee will be R 975 on arrival (for non loyalty programme members) you will have to complete an in depth questionnaire before the consultation so please arrive 20 minutes before the time. During the 45 minute consultation your Health Renewal doctor will obtain a FULL medical history from you to determine your personal risk. A physical examination will be done after which the Doctor will decide which blood tests need to be requested from your local pathology laboratory. If you have a medical aid, these should be able to be claimed as well.
Once your blood results are received, they will then be analyzed by your Health Renewal doctor who will begin working on a unique prescription plan for you with the compounding pharmacy. At your pre-scheduled second appointment 2 weeks later, the results and examination findings will be discussed with you. This will determine what abnormalities or deficiencies exist and you will be advised on your treatment options. These options may range from prescription medications, nutraceuticals, bio-identical hormonal creams / tablets or alternatively to having bio-identical implants / pellets inserted.
In office treatments such as carboxytherapy may also be recommended for certain conditions such as hair loss, erectile dysfunction ED, menopause or PMS. If you need to lose weight our Body Renewal Medical Weight loss program may be recommended. All these recommendations will be summarized on a sheet / print out which you can take home with you. The nutraceuticals offered at Health Renewal are of superior quality (Solgar) and are not rancid nor contain Hg (mercury ) or PCB'S (which is very important for Omega 3 Essential fatty acids EFA's). They are also free of gluten, preservatives, wheat, dairy, soy, yeast, sugar, artificial flavor, sweetener and colour. We have a great professional team made up of doctors, trained and registered nurses and therapists to support you at any time.
1. You are kindly requested to bring any supplements that you are currently taking, along to your consultation. The doctor can check the ingredients in take this into account when prescribing a treatment plan for you.
2. Also, if you have had any blood work done in the past 6 months, please bring the results along to the consultation. Should you not be in possession of the hard copies, please request these results from the lab you visited. Usually your ID number is sufficient.
Depending on the exact prescription given, you may be required to return to the doctor within 1-4 months’ time, in order to ensure optimum hormone levels are achieved. This will be determined by a repeat blood test and may be requested by your Health Renewal doctor.
You should ensure that you are current with your gynaecological visits/breast exams/mammograms (for female patients) and prostate exams (for male patients) as recommended by your GP/gynaecologist.
- The fee for the initial consultation and evaluation of 45 minutes is R975. A deposit of R400 is required up front in order to secure your consultation with the doctor. This advance payment goes towards your consultation fee. Proof of payment needs to be received one week in advance of appointment email. Please see banking and contact details below. This consultation fee may be claimed back from your medical aid depending on which kind of medical over you have.
- A second follow up consultation is essential in order for the doctor to assess your blood work and prescribe a personalised treatment plan for you. Another deposit of R400 will be required to secure the second consultation.
- All subsequent follow up consultations with the doctor will be charged at R650 for 30 minute consultations. This may be amended from time to time at the practice’s discretion.
- You may pay for your consultation by cash, credit card or EFT.
- BIHRT prescriptions must be paid for prior to ordering, as each patient’s prescription is unique to his/her own needs, and you will receive an invoice advising you of the cost.
- The patient is responsible for paying all consultation and prescription fees to Skin, Body and Health Renewal – regrettably we do not accept medical aid.
- An added bonus is that not only improving your health and well being , any nutraceuticals purchased will go towards loyalty points at any Skin, Body and Health Renewal branches
After your initial visit to a Health Renewal Doctor, you should follow-up with him or her 2 weeks after having had your blood investigations done. Depending on the results of the blood investigation, one could expect to follow up with your doctor every 3 months to assess progress on your new treatment protocol.
The importance of early management of any condition cannot be overstated. Once certain conditions set in and damage to organs occurs, complete recovery may be difficult to attain. Best results for prevention and longevity is early detection of a possible problem combined with conventional treatments , nutritional supplements and a healthy diet and lifestyle.
Lifestyle modification and exercise
The Fitness and Arthritis in Seniors Trial found that both aerobic and resistance exercise were beneficial for patients with knee OA. Partaking in a combination of pool exercises, biking, swimming, and aerobic dance can all be recommended. Strength training can help prevent the atrophy that comes when joint loading is not occurring regularly. Flexibility can counterbalance the limitations on range of motion and flexibility that OA imposes. There is some evidence that tai chi and yoga can also be beneficial in OA.
Because increased weight increases the risk of OA, not to mention the risks of developing multiple other chronic diseases, patients who are overweight or obese should be encouraged to lose weight. Body Renewal Medical Weight loss program diet is a medical weight loss solution which uses hCG off label to safely reduce weight-especially dangerous abdominal fat. If the program is strictly adhered to, 10 to 12 kilograms of resistant fat can be safely lost in 4 to 6 weeks.
Evidence remains limited as far as the direct links between diet and osteoarthritis. While an anti-inflammatory diet is reasonable to consider, most of the evidence of benefit is inferred from knowledge of how various food components influence inflammation in vitro. The anti-inflammatory diet is safe, healthy, and likely to prevent development of other chronic diseases; therefore it is worth recommending to patients.
Research regarding the effects of manipulative therapies on OA has only recently begun to emerge. A 2006 study of Swedish massage in 68 patients with OA of the knee found statistically significant improvements in pain, range of motion, and function. A study involving 252 patients receiving 20 sessions of chiropractic manipulation for OA of the lower back showed that manipulation was superior to heat therapy alone.
The Anti-Inflammatory Diet is an overall list of foods that affect inflammation:
This diet requires patients to eat more foods that are:
- high in Omega-3 fats: such as cold water fish like salmon, sardines, herring and mackerel
- ground flax seeds or flax oils; walnuts and leafy green vegetables.
- Allium vegetables such as onions and garlic
- dark leafy vegetables such as spinach and Romaine lettuce
- yellow, orange and red vegetables such as peppers, carrots and butternut
- Black and green teas
- citrus Fruit
- foods that are high in fibre
- spices that contain anti-inflammatory compounds such as Ginger, Rosemary, Turmeric, Oregano, Cayenne, Clove and Nutmeg
- Herbs that have anti-inflammatory properties include Boswellia, Willow bark and Feverfew
Foods that are high in anti-oxidants:
When dieting to improve the symptoms of OA:
- Avoid eating foods high in trans- and omega-6 fats which include red meats; dairy products; partially hydrogenated oils; corn, cottonseed, grape-seed, peanut, safflower, soy, canola and sunflower oils
- Avoid foods with a long shelf life (chips and crackers).
- Avoid foods high in simple carbohydrates such as white breads of bagels; English muffins; instant rice; rice and corm cereals
- Avoid foods that are more likely to trigger intolerance reactions (which can vary from person to person) such as dairy, wheat, eggs, artificial flavours and colours (Aspartame, FD and dyes).
Here are ten quotes from great thinkers to challenge, motivate and inspire us to exercise, eat right and live healthier lives: Health and intellect are the two blessings of life.
- “After joyfully working each morning, I would leave off around midday to challenge myself to a footrace. Speeding along the sunny paths of the Jardin du Luxembourg, ideas would breed like aphids in my head—for creative invention is easy and sublime when air cycles quickly through the lungs and the body is busy at noble tasks.” ― Roman Payne, Rooftop Soliloquy
- “When you got a condition, it's bad to forget your medicine.” ― Frank Miller, Sin City, Vol. 1: The Hard Goodbye
- “Sorry, there´s no magic bullet. You gotta eat healthy and live healthy to be healthy and look healthy. End of story.” ― Morgan Spurlock, Don't Eat This Book: Fast Food and the Supersizing of America
- “[G]rowing into your future with health and grace and beauty doesn’t have to take all your time. It rather requires a dedication to caring for yourself as if you were rare and precious, which you are, and regarding all life around you as equally so, which it is." ― Victoria Moran, Younger by the Day: 365 Ways to Rejuvenate Your Body and Revitalize Your Spirit
- “You will know if you are too acidic if you get sick often, get urinary tract infections, suffer from headaches, and have bad breath and body odor (when you do not use antiperspirant). Acidosis is the medical term for a blood alkalinity of less than 7.35. A normal reading is called homeostasis. It is not considered a disease; although in and of itself it is recognized as an indicator of disease. Your blood feeds your organs and tissues; so if your blood is acidic, your organs will suffer and your body will have to compensate for this imbalance somehow. We need to do all we can to keep our blood alkalinity high. The way to do this is to dramatically increase our intake of alkaline-rich elements like fresh, clean air; fresh, clean water; raw vegetables (particularly their juices); and sunlight, while drastically reducing our intake of and exposure to acid-forming substances: pollution, cigarettes, hard alcohol, white flour, white sugar, red meat, and coffee. By tipping the scales in the direction of alkalinity through alkaline diet and removal of acid waste through cleansing, and acidic body can become an alkaline one." - Natalia Rose, Detox for Women: An All New Approach for a Sleek Body and Radiant Health in 4 Weeks.
- "Bear in mind that some substances that are alkaline outside the body, like milk, are acidic to the body; meaning that they leave and acid reside in the tissues, just as many substances that are acidic outside the body, like lemons and ripe tomatoes, are alkaline and healing in the body and contribute to the body's critical alkaline reserve.” ― Natalia Rose, Detox for Women: An All New Approach for a Sleek Body and Radiant Health in 4 Weeks
- “In a massive, long-term study of 17,000 civil servants, an almost unbelievable conclusion emerged: the status of a person's job was more likely to predict their likelihood of a heart attack than obesity, smoking or high blood pressure.” ― Matt Ridley, Genome: the Autobiography of a Species in 23 Chapters
- “If one’s life is so unsatisfying that an unhealthy activity brings a shred of happiness, it is nigh impossible to give it up unless something that brings greater happiness can be enjoyed in its stead. (28)” ― Prem Prakash, The Yoga of Spiritual Devotion A Modern Translation of the Narada Bhakti Sutras
- “May you be ordinary, as the poet once wished the new-born baby.” ― Julian Barnes, The Sense of an Ending
- “It is in the balancing of your spirituality with your humanity that you will find immeasurable happiness, success, good health, and love.” ― Steve Maraboli, Unapologetically You: Reflections on Life and the Human Experience