Solving joint pain
Last edition we discussed how high levels of chondroitin sulphate (CS) help joints affected by osteoarthritis (OA). An excellent 2010 study “Chondroitin sulphate in the treatment of osteoarthritis“(Y. Herotin, PhD) identified the actions of CS on arthritic joints.
They identified more than 30 positive changes in arthritic joints with high doses of chondroitin sulphate. It is worth noting that the dosages in the study were much higher than in many joint products. Most products have around 250mg of CS whereas the study used 800mg or more. I generally commence therapy with 1500mg of high grade chondroitin.
The anti-inflammatory effects of high doses of CS appear to inhibit inflammatory chemicals including prostaglandins and COX-2 enzymes. These are the targets of anti-inflammatory drugs which is why they can be effective at reducing pain.
Secondly, high levels of CS appear to slow the rate of cartilage loss. One suggested mechanism is that CS appears to protect the chondrocyte cells responsible for maintaining cartilage.
Research showed that CS can actually prevent the death of chondrocytes which is the real driver behind cartilage loss.
Thirdly high levels of CS appear to be anabolic — it appears to be able to generate new cartilage. The mechanisms seem to be that CS stimulates chondrocyte cells to increase production of collagen and other compounds needed to make new cartilage.
I have been helping someone with OA in her knees, back and hands. She had been using a joint supplement heavily weighted towards glucosamine rather than chondroitin. We added a supplement with high levels of CS with noticeable improvements on this combination with less pain and more mobility. I am sure the extra curcumin and Omega 3 all helped.
Osteoarthritis is all about loss of cartilage, subsequent inflammation and changes to bone and joint structure. The result is pain and loss of mobility. The ends of bones such as the femur are covered in tough articular cartilage. It is commonly called gristle and may surprise that despite its tough appearance and texture it is actually 80 per cent water.
Cartilage is a combination of living cells, the matrix they produce plus water. These cells are called chondrocytes and their job is to secrete and maintain cartilage. They repair small amounts of damage as it occurs.
The matrix of cartilage is a combination of chondrocytes, water and the matrix of collagen, chondroitin sulphate and hyaluronic acid. The matrix binds the collagen and other protein fibres in place. The result is tissue that is both tough and flexible. The high water levels mean that it resists damage from compression and acts like a shock absorber.
Osteoarthritis starts when chondrocyte cells die. While there are a number of things that can damage chondrocytes the prevailing thought is that nitrogen free radicals damage chondrocytes to the point that they die.
If enough chondrocytes die the result is a loss of cartilage volume. This is then followed by unwanted inflammation in the joint capsule that further damages cartilage. Eventually the bone itself becomes compromised and the net result is pain and restricted mobility.
Nutritional therapy can be helpful especially in reducing inflammation, slowing the rate of cartilage loss and improving the function of existing cartilage. One client in his 80s had been told that he was ineligible for a knee replacement despite advanced and painful arthritis. After six months he has less pain, less swelling and much improved mobility.