Osteoarthritis: Symptoms, Causes, Treatment & Natural remedies

What is osteoarthritis?

Osteoarthritis (OA) is the most common form of joint disease and the pain caused because of it is too severe and it can last lifelong. OA was earlier noticed in older people, but now the scenario has changed drastically and it is also prevalent in the younger generation. Unlike other forms of arthritis, osteoarthritis affects only joints and not any of the internal organs. The disease mainly affects the joint cartilage and the bone tissue next to the cartilage. The most commonly affected joints are hands, hips, big toes, knees and spine.

What causes osteoarthritis?

The exact causes of osteoarthritis are unclear but there are multiple factors such as age, sex, obesity, genetic factors etc. which are thought to cause this disorder.

Osteoarthritis symptoms often develop slowly and worsen over a time period. Few of the signs and symptoms of osteoarthritis include:

• Swelling in joints
• Pain in joints
• Tenderness in joints
• Loss of flexibility and inability to move joints
• Crepitus, or a grating sensation when the joints move
• Stiffness in joints after sleep or after rest.

Risk factors that may lead to osteoarthritis include:

• Gender: Women are more prone to OA
• Obesity: Obese individuals are at more risk to face Osteoarthritic pain
• Age: Most commonly prevalent in people over 50 years
• Bone deformities: Previous joint surgery or injury, or abnormal joint alignment
• Physical demanding occupations: Jobs that place repetitive stress on a particular joint
• Other diseases: People with rheumatoid arthritis are more likely to develop osteoarthritis.

Treating OA

There is no cure for osteoarthritis; however, your symptoms can be effectively managed with following:

1. Exercise: Regular exercises can actually help to reduce some of the symptoms (pain, stiffness) and improve your joint mobility and strength.
2. Weight management: Weight loss can also help to reduce   pain and increase the ability to exercise.
3. Medications

• Non-steroidal anti-inflammatory medicines or NSAIDs- such as ibuprofen, Diclofenac are designed to be taken at low doses for short periods.
• Paracetamol: It provides only short-term pain relief for osteoarthritis.
• Corticosteroid (steroid) injections: An alternate option for people who haven’t found relief from other treatments (eg. weight loss, exercise)
• Nutraceuticals: They are dietary compounds which have a role in the balance of anabolic and catabolic signals in joints. Glucosamine, Chondroitin Sulfate, and Hyaluronic Acid are the few examples. AlsoOne of the best nutraceutical products available for the management of OA is Avovida..

Avovida is a mixture of unsaponifiable portion of Avocado & Soy phytosterols and this synergistic combination has been clinically shown to have a chondroprotective effect by maintaining a healthy inflammation response, thereby supporting mobility and flexibility in joint cartilage.
Avovida restores the normal cartilage structure by stimulating the proteoglycans and collagen synthesis and is characterized by its potent anti-inflammatory effects. At the clinical level, Avovida reduces pain and stiffness while improving joint function, resulting in decreased dependence on analgesics.

The composition is as follows:

Each HPMC capsule contains:
Avovida …….300 mg
It is recommended to take one capsule a day for relief from osteoarthritis symptoms.

Key features:

• Proprietary blended oil extract made of a 1:2 ratio of avocado to soy unsaponifiables
• Helps to maintain healthy joints and cartilage

Key Data Findings:

• Avovida is a promising substitute to NSAIDs due to its better patient compliance (Once a day) and WOMAC score (Improvement in pain, stiffness and difficulty in walking).
• Avovida has structure modifying properties as it acts by inhibiting cartilage degradation and promoting cartilage repair.
• Avovida reduces the need for NSAIDs in patients suffering from osteoarthritis.

Treatment Guidelines

The guidelines from the arthritis foundation include strong recommendations and conditional recommendations based on the expert judgements, published evidences and patient opinions.

Strong recommendations:

• Educational, behavioral and psychosocial approaches: Weight loss, exercise, self-management programs to build fitness skills.
• Mind-body and physical approaches: Exercise, use of medical devices such as Canes, orthotic devices and twist braces
• Pharmacological approaches: Use of oral NSAIDs (Etoricoxib and diclofenac), Steroid injections, etc.

Conditional recommendations:

• Educational, behavioral, and psychosocial approaches: Cognitive behavioral therapy.
• Mind-body and physical approaches: Yoga, balance training, medical devices
• Pharmacological approaches: Topical NSAIDs (Diclofenac sodium 1% gel and Diclofenac epolamine 1.3% patch), Topical capsaicin, chondroitin sulfate, tramadol etc.

Use of Pharmacological approaches i.e. Topical or oral NSAIDs are associated with a lot of side effects and can cause stomach upset, cardiovascular problems, liver and kidney damage and bleeding problems.⁹  Drawbacks of joint replacement therapies are that the artificial joints can wear out or come loose and might eventually need to be replaced.¹⁰ Taking into consideration the problems associated with use of NSAIDs and going under replacement therapy the need of natural solution is most promising as it will be more effective and safe to use. Avovida is one of the best nutraceuticals for joint pain.

References:

1. Wieland HA, Michaelis M, Kirschbaum BJ, Rudolphi KA. Osteoarthritis—an untreatable disease?. Nature reviews Drug discovery. 2005 Apr;4(4):331-44.
2. Roos EM. Joint injury causes knee osteoarthritis in young adults. Current opinion in rheumatology. 2005 Mar 1;17(2):195-200.
3. https://www.asterhospitals.in/blogs-events-news/aster-medcity-kochi/what-you-need-know-about-osteoarthritis
4. https://msk.org.au/osteoarthritis-blog/
5. https://www.webmd.com/vitamins/ai/ingredientmono-1578/avocado-soy-unsaponifiables-asu
6. Blaine Christiansen, Simrit Bhatti, Ramin Goudarzi, Shahin Emami; Cartilage. 2015 Jan; 6(1) : 30-44
7. Maheu E, Mazières B, Valat JP, Loyau G, Loët XL, Bourgeois P, Grouin JM, Rozenberg S. Symptomatic efficacy of avocado/soybean unsaponifiables in the treatment of osteoarthritis of the knee and hip: a prospective, randomized, double‐blind, placebo‐controlled, multicenter clinical trial with a six‐month treatment period and a two‐month followup demonstrating a persistent effect. Arthritis & Rheumatism: Official Journal of the American College of Rheumatology. 1998 Jan;41(1):81-91.
8. https://www.arthritis.org/diseases/more-about/guidelines-for-osteoarthritis-treatments
9. https://www.mayoclinic.org/diseases-conditions/osteoarthritis/diagnosis-treatment/drc-20351930
10. https://www.caringmedical.com/prolotherapy-news/avocado-soybean-unsaponifiables/