Joint pain is one of the clinical signs associated with osteoarthritis. Osteoarthritis (OA) affects roughly 27 million Americans (almost 1 in 10 people). It can range from mild, occasional soreness to severely limiting normal everyday activities. OA is more common as we age. OA is one of the leading causes of physical disability in the elderly population. The prevalence of OA is expected to increase in the coming years with the aging population and prevalence of obesity continuing to rise.
Joints are made up of bones, ligaments, cartilage, tendon, and muscles. Each of these tissues play a different role in maintaining the joints. When one or more of these tissues begin to falter, it can lead to OA.
Joints are places where two bone or a bone and cartilage connect. Joints are classified into 3 distinct categories:
Fibrous: adjacent bones are connected via fibrous tissue. These are immobile joints, like skull sutures.
Cartilaginous: bones are connected via fibrocartilage or hyaline cartilage. These can allow little movement
Synovial: the joint surfaces are not directly connected, but can come into contact within a joint cavity, filled with synovial fluid. These are the joints that are most mobile, and make up most of the joints in the body, including the limbs. Based on the joint shape, they can move in different ways.
Unfortunately, there is no cure for OA, but there are treatments, including the use of analgesics and lifestyle modifications, available to help minimize symptoms.
Inflammation tends to be one of the major underlying causes for OA. Usually this is due to an outright injury or repeated joint use overtime. OA is a progressive joint disorder, meaning the condition tends to get worse with age. The pathogenesis of OA happens through a variety of pathways, including aging of chondrocytes (the cartilage cells found in joints), lack of collagen and other structural components (like glycosaminoglycans, or GAGs), and inflammation.
Some risk factors associated with OA are:
- Inflammation (of the joint due to injury or chronic)
- Poor biomechanics (poor joint loading)
- Genetic predisposition
- Being female
Additionally, other type of arthritis, like psoriatic arthritis, can lead to joint pain via an autoimmune reaction.
- Joint pain
- Joint stiffness
- Joint swelling
- Limited joint mobility
- Crepitus (cracking or popping sound) when in motion
The conventional treatments for OA include pain medications (like NSAIDs) and corticosteroid injections. These treatments can have unwanted side effects and can actually make the condition worse over time. Luckily, there are integrative approaches to joint pain that do not come with the dangerous side effects.
Consuming an anti-inflammatory diet, maintaining a healthy weight, stretching, low-impact exercise, proper hydration, and getting enough of the right nutrients all play a role. Some of these include vitamin D, omega-3 fatty acids, curcumin, magnesium, and collagen.
Avoiding Inflammatory Foods
Inflammation is a key component in joint pain, so it is crucial to remove inflammatory foods. Some of the major pro-inflammatory foods include processed sugars and grains, conventionally-raised soy, eggs, processed vegetable oils, and dairy. Conventionally raised animal products (meats and dairy), contain toxins like antibiotic and vaccine residues and pesticides. All of these can promote inflammation in the body.
These basics give you these baseline of where to get started:
- Eat real foods, with at least 50% of each plate being vegetables.
- Eat a diet primarily of vegetables, fruits, nuts, seeds, lean proteins, and healthy fats.
- Choose pasture-raised, organic, grass-fed, and/or wild animal meats and fish.
- Eat and assortment of different-colored vegetables and fruits (eat the rainbow).
- Drink clean water.
- Eat fermented foods to balance your gut flora, like kimchi and sauerkraut.
- Cut out inflammatory foods, like simple carbohydrates, sugars, processed foods, and candies.
- 80% of the time eat right, allowing yourself 20% “wiggle room.”
- Drink lemon water in the morning, it helps boost metabolism and liver function.
- Look for foods that are high in fiber (whole foods) and low in sugar.
- Eliminate all packaged foods, if possible.
- Be sure to read ALL ingredient labels.
- Never eat out of a box or bag.
- Eat greens at least twice per day.
- Choose organic foods as often as possible.
- Listen to your body!
Additionally, there are certain supplements that can effectively reduce the symptoms associated with OA.
Turmeric (and its Active Component, Curcumin)
Turmeric has been touted for its anti-inflammatory properties for many years now. Turmeric is a yellow spice most noted for giving curries they yellow hue. Actually, turmeric comes from a root and is then ground down into powder form, which is available in many grocery stores today. It has been a staple in Indian cuisine for ages. While its color is incredibly vibrant, its flavor is pretty mild, and has mustard undertones.
Curcumin (the active ingredient, has been found to specifically target pro-inflammatory enzymes and other inflammatory factors that can influence genomic expression. It has many other health benefits as well. Because of its many benefits, it would be wise to add such a unique spice to your cabinet. Unfortunately, however it is not well absorbed at all. However, if you add some black pepper, it will increase the absorption rate!
Chondroitin sulfate is needed for cartilage tissue to function at its best. It provides structure, resistance, and elasticity to human cartilage. Chondroitin sulfate is made of a combination of proteins and GAGs, and play a major role in cartilage formation. Some studies have shown supplementing with chondroitin sulfate can increase joint function, reduce pain, and slow OA progression. This is thought to be due to chondroitin sulfate suppressing inflammatory mediators, inhibiting collagen breakdown in the joints, and stimulating production of more cartilage matrix.
Glucosamine sulfate is a naturally occurring substance in the body and found in high quantities in cartilage. Glucosamine sulfate is a building block of both cartilage tissue and synovial fluid. Synovial fluids is needed to reduce joint friction and provide lubrication for healthy, painless joint movement. One study suggest glucosamine supplementation in combination with chondroitin sulfate as more effective.
Speaking of collagen, that is the next intervention on the list today. Collagen is a structural protein, and can be found in ligaments, tendons, cartilage, bone, skin, and hair. Collagen helps give the body structural support. To date, there are about 28 different types of collagen known, but there are five types that are most common.
Type I: skin, tendon, vasculature, organs, bone (main component of the organic part of bone)
Type II: cartilage (main collagenous component of cartilage), nucleus pulposis, vitreous body
Type III: reticulate (main component of reticular fibers, skin, and vessel walls), commonly found alongside type I
Type IV: forms basal lamina, the epithelium-secreted layer of the basement membrane
Type V: cell surfaces, hair, lung, cornea and placenta
Collagen can provide chondroitin sulfate and glucosamine sulfate, promoting your body’s ability to repair and build new cartilage and supporting good joint health. It also contains hyaluronic acid, which is a gel-like substance foundsurround joint tissues and nerves. Hyaluronic is a major component of the synovial fluid found in the joint spaces, serving as a cushion and joint lubricant.
Supplementing with collagen is an effective approach to repairing and strengthening joints, cartilage, ligaments, and tendons.
Vitamin D is a key nutrient for joint health. Vitamin D deficiency has been associated with decreased cartilage thickness and increased rates of OA.
We know vitamin D supports immune function because deficiencies lead to increased rates of the flu and colds. It also regulates inflammation, decreases the rates autoimmune diseases and cancer, and promotes cellular maturation.
There is a large (and growing amount of evidence) showing vitamin D deficiency is incredibly common, affecting at least 50% of adults and up to 80% of all infants. The optimal range is between 50-80ng/mL (125-200nmol/L). Most practitioners agree somewhere between 1,200 IU and 2,000 IU is the optimal range to increase vitamin D levels to normal levels long-term. Doses up to 2,000 IU have been researched to be safe for long-term use.
Omega-3 Fatty Acids
Many Americans consume too many omega-6 fatty acids, which can result in a relative omega-3 deficiency. Omega-6s can be found in many vegetables oils and meats. Consuming high amount of Omega-6 fatty acids (and not enough omega-3 fatty acids) is associated with an increased risk of over 60 different conditions, including joint pain and tenderness. An imbalanced omega-3:6 ratios can lead to increased inflammation, altered immune function, increased insulin resistance, and increases susceptibility to cellular damage via free radicals. When this ratio is corrected (and the correct ratio ranges from 1:1, which is ideal, to about 1:3), the opposite effects occur.
There a variety of integrative therapies at your disposal when it comes to joint pain. A multifactorial approach, including an anti-inflammatory diet, maintaining a healthy weight, stretching, low-impact exercise, proper hydration, and supplementing correctly can all be effective in improving and preventing joint pain going forward.
Though based in research, personal, and clinical experience, the opinions in this article should not be taken as medical advice. The information is designed for educational purposes only and is not designed to diagnose, treat, or cure disease. Botanical medicine and nutraceuticals should be treated with the same caution and care as pharmaceuticals, as both have the potential for strong, potentially adverse effects and allergic reactions. Please consult a trained, licensed health care practitioner before proceeding.