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Arthritis: Is the conventional treatment effective?

The issue to be discussed in this edition involves two things that are extremely common in our westernized healthcare system. Nonsteroidal Anti-inflammatory Drugs (NSAIDs), such as aspirin, ibuprofen (Motrin/Advil), and naproxen (Aleeve), are some of the most commonly used over the counter drugs particularly when it comes to pain management and other sorts of inflammatory processes, such as osteoarthritis (your typical arthritis, OA) aka degenerative joint disease (DJD), the most common joint disease. With the frequency and commonplace for the public to reach for an NSAID when they are having joint pain, one would think there is an abundance of evidence supporting their usefulness. However, that is not the case. A six year study looking at 1,700 people with hip and knee arthritis found a 240% increase in the progression of hip arthritis and a 320% increase in the progression of knee arthritis compared to individuals who rarely used these drugs (1). The authors of this study did note it was unknown if this was caused by a true deleterious effect on cartilage or because of excessive mechanical loading following pain relief from these products and remains to be investigated. These findings aside, routine use of NSAIDs has been found to increase the risk of GI bleeds, high blood pressure, and heart disease.


So what can someone with arthritis do to help combat the pain associated with degeneration? Well one of the major risk factors for OA in the knee in particular is obesity. The best way to avoid obesity is to live an active lifestyle and eat a well balanced diet. One study in particular looked at pain levels and quality of life in obese patients with knee OA. Patients were assigned to three different treatment groups: diet, exercise and diet & exercise. The diet consisted of limiting a patient’s calorie intake to 800-1000 calorie deficit based on their expected caloric usage. The exercise was an hour a day for three days out of the week. Fifteen minutes spent walking, twenty minutes weight training, another fifteen minutes doing walking (or other aerobic exercise), and ended with a ten minute cooldown. The results from the study found the diet and exercise group compared to the exercise group had less inflammation, less pain, better function, faster walking speed, and better physical quality of life (2).


While the combination of diet and exercise can have a positive impact on slowing the progression of arthritis, there is still more that we haven’t addressed. Chiropractic adjustments have also been shown to help with hip or knee OA in patients (3). As some of you know, health is more than just the physical aspect, so it should be of no surprise that the best treatment for one of the most common ailments is an approach targeting your diet, activity, and adding in chiropractic care.






Sources

  1. Reijman M, et al. Anti-Inflammatory drugs and radiological progression of osteoarthritis? The Rotterdam Study. Arthritis and Rheumatism. 2005;52;3137-42.

  2. Messier, S. P., Mihalko, S. L., Legault, C., Miller, G. D., Nicklas, B. J., DeVita, P., Beavers, D. P., Hunter, D. J., Lyles, M. F., Eckstein, F., Williamson, J. D., Carr, J. J., Guermazi, A., & Loeser, R. F. (2013). Effects of intensive diet and exercise on knee joint loads, inflammation, and clinical outcomes among overweight and obese adults with knee osteoarthritis: the IDEA randomized clinical trial. JAMA, 310(12), 1263–1273. https://doi.org/10.1001/jama.2013.277669

  3. Brantingham, J. W., Bonnefin, D., Perle, S. M., Cassa, T. K., Globe, G., Pribicevic, M., Hicks, M., & Korporaal, C. (2012). Manipulative therapy for lower extremity conditions: update of a literature review. Journal of manipulative and physiological therapeutics, 35(2), 127–166. https://doi.org/10.1016/j.jmpt.2012.01.001

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