Shared care uses cookies to enhance your experience of our site. See Shared Care's Cookie Policy

Advertisement

The foremost symptom of OA is joint pain caused by the loss of articular cartilage, a protein matrix responsible for lubricating and cushioning the joint. Typical progression of the disease follows this sequence: pain while the joint is under stress; pain when the joint has been held in one position for a period of time (the so-called movie-goer's knee); and finally, pain even while the joint is at rest, during sleep. The joints most affected by OA are the knees, hands and hips.

OA therapy involves procedures that are either surgical (the replacement of the joint by plastic or metal parts) or non-surgical. Joint replacement (arthroplasty) is a major surgery and is the treatment of last resort, when all other therapies have failed to provide relief. Because of the danger to individuals with underlying risk factors, arthroplasty is often not available to the elderly or the obese, the two groups most commonly affected by OA.

Painkillers are often prescribed to alleviate the pain that accompanies OA. Tylenol, Ibuprofen and Non-Steroidal-Anti-Inflammatory-Drugs (NSAIDs) are common pharmacological treatments. Such medications carry the risk of liver damage and gastro-intestinal side effects, including internal bleeding.

Alternative treatments include physical therapy such as low-impact exercise designed to improve the strength of muscles surrounding the joint. Acupuncture can be an effective alternative treatment when used in conjunction with diet and lifestyle changes, as well as a course of natural supplements.

Natural remedies that go beyond pain relief and actually help repair the joint have gained in popularity as a treatment for OA. Independent studies have shown promise for the combination of glucosamine and chondroitin sulphate. Currently, over 5 million Americans take these substances as a means of relieving the symptoms of OA.

Does Obesity Cause Osteoarthritis?

Obesity and Knee OA

Obesity and Hip OA

The hip joint receives an exerted force that is more evenly distributed and lighter than that felt by the knees. While the connection between obesity and hip OA is not as pronounced as with knee OA, studies have shown that obese people are still at higher risk of developing osteoarthritis of the hip [ref4].

The Nurses' Health Study has collected data from 121,700 female registered nurses, providing a wealth of information since the study's commencement in the mid 1970s. Data analyzed from that study has shown that being overweight early in life corresponded to a greater likelihood of having to undergo a hip replacement (arthroplasty) due to the effects of OA.

A Norwegian cohort study of 1.2 million people compared BMI data collected between 1963-1975 with arthroplasty data from 1987-2003. Around 28,000 hip replacements were due to hip OA. The study found that a BMI over 32 translated to a greater likelihood (3.4 times) for a total hip replacement as compared to a BMI lower than 21 [ref5].

Obesity and Hand OA

It is perhaps in the area of osteoarthritis of the hand that scientific studies create the strongest correlation between obesity and OA. This is because hand joints are non-weight-bearing and the force exerted upon them is not greater in obese individuals than in people of normal weight.

And yet, a longitudinal study of 1,276 participants conducted in Michigan over a period of 23 years showed obesity to be a strong predictor of hand OA, implying that factors other than pressure exerted on the joints could be the cause. Scientists suggest that a systemic factor secreted in the blood of obese subjects may alter the metabolism of articular cartilage, accelerating its breakdown. Obese postmenopausal women, the group suffering from the greatest incidence of hand OA, may have an endocrine factor caused by excess adipose tissue.

Which Causes Which; Obesity or OA?

The connection between obesity and OA raises questions of causality; which one came first? While it is possible that joint pain leads to reduced activity and ultimately to weight gain, the Framingham Heart Study, a longitudinal study conducted in Framingham, England from 1949 to 1985, shows that it is obesity that leads to osteoarthritis, not vice versa. The study collected data from 1420 subjects. Those who were overweight at the age of 37, exhibiting no signs of OA, showed an increased likelihood of developing the disease by the age of 73. This clearly shows that excess weight precedes the development of OA.

Summation

References

1.  Insurer and out-of-pocket costs of osteoarthritis in the US: evidence from national survey data.Kotlarz H, Gunnarsson CL, Fang H, Rizzo JA.Arthritis Rheum. 2009 Dec;60(12):3546-53
2.  Cooper C, Snow S, McAlindon TE, et al. Risk factors for the incidence and progression of radiogradiographic knee osteoarthritis. Arthritis Rheum 2000;43:995–1000
3.  Anderson JJ, Felson DT. Factors associated with osteoarthritis of the knee in the first national Health and Nutrition Examination Survey (HANES I). Evidence for an association with overweight, race, and physical demands of work. Am J Epidemiol 1988;128:179–89
4.  BMI Independently Predicts Younger Age at Hip and Knee Replacement. Gandhi R, Wasserstein D, Razak F, Davey JR, Mahomed NN. Obesity (Silver Spring). 2010 Apr 8.
5.  The impact of body mass index on later total hip arthroplasty for primary osteoarthritis: a cohort study in 1.2 million persons. Flugsrud GB, Nordsletten L, Espehaug B, Havelin LI, Engeland A, Meyer HE. Arthritis Rheum. 2006 Mar;54(3):802-7.

Other Helpful Things

[top of page]

Natural Cures from Shared Care's Smallprint

Advertisement

[top of page]

Please see Community Forum Notes about comments on this page.