Is osteoarthritis a disease of wear and tear? Well, that is what I learned in medical school
30 years ago. Now, we know better, and the answer is NO. Osteoarthritis is not a wear and tear of the
cartilage. The cartilage is this layer that protects
the bones. Today, I will explain to you what osteoarthritis
is and what you can do to prevent it and improve the pain from it. So, let’s talk about ostoarthritis
Osteoarthritis is a condition that affects the cartilage that protects the bones. But it is not caused by putting too much weight
on the joint, using the joint, moving the joint, or exercising that joint. We used to think that too much weight was
the cause of osteoarthritis because the most affected joints are knees and hips. But the true cause of osteoarthritis is not
that the person is using the joint too much. People can have osteoarthritis in any joint
of the body, even the shoulders, the hands, the fingers, the neck, anywhere. Osteoarthritis is caused by slow, low-grade
chronic inflammation. Inflammation means that the immune system
is sending cells and they produce substances that destroy the cartilage. But what causes this chronic inflammation? And does anti-inflammatory work? Nobody knows exactly what causes this chronic
inflammation. There are genetic factors involved. There is new knowledge that the fat tissue
in our body, known as adipose tissue produce adipokines. The first adipokine was discovered in 1994,
and it is called leptin. Now, scientists have discovered more than
100 types of adipokines. These adipokines are produced in the fat tissues
of our body, so obesity leads to osteoarthritis not because it puts more weight on the joints. If that was the case, obese people would have
osteoarthritis only in the weight-bearing joints, but also have OA in the hands, neck,
and other joints of the body. The adipokines, when in excess, they create
a pro-inflammatory state in the body. Then, this pro-inflammation is what starts
destroying the cartilage, little by little. We know that obese people who lose weight
improve their symptoms of osteoarthritis, and the reason is not because they are putting
less weight on their joints, but probably because there are producing less adipokines. Before I continue, please remember that this
video is for educational purposes only and is not intended to replace medical advice,
and if you have osteoarthritis, please talk to your doctor. If there is an emergency please go to the
nearest emergency department or call an ambulance. This takes us to the second factor that helps
osteoarthritis. Movement. You probably heard me say this many times:
Motion is Lotion. Yes, moving the joint, putting weight on the
joint, using the cartilage is really good for the health of the cartilage. I use the analogy of honey. If the honey is crystalized and cold, it is
sticky. But if you stir it up, and warm it a little
bit, it gets fluid and clear. That is what the synovial fluid in our joints
does. The more we move, the more synovial fluid
is produced, and the nutrition to the cartilage is brought by the synovial fluid. When the person puts weight on the joint,
the cartilage absorbs the nutrients that are in the synovial fluid. Astronauts who go to space do not put weight
on their joints, because there is no gravity in space, and their joints have less fluid
and the cartilage is thinner. On the other hand, people who practice sports
and to a lot of physical activity have thicker cartilages in the joints they use most. This shows that moving the joints is good
for a healthy cartilage. I have various other videos showing exercise
for osteoarthritis of the hips and knees, dancing, going up and down stairs and for
osteoporosis. Third, the pain that people feel from a joint
with osteoarthritis is not a good measure of how much damage there is in the joint. A person can have very tiny osteoarthritis
and a lot of pain. Another person can have super severe osteoarthritis
and do not have any pain at all. Here are some examples. Look at this neck x-ray. There is almost no osteoarthritis, but the
person has a lot of pain. Why is that? This person may have other problems around
the bones, it could be the pain is coming from the muscles like myofascial trigger points. But it can also be that there is a little
bit of pain coming from the osteoarthritis, but when this painful impulse enters the spinal
cord, and passes through the brain stem, and goes to the brain, it is amplified. That is because this person has central sensitization. Their pain system is sensitized, so their
pain is amplified. Not only that, but this person may have lost
the ability to block the pain. Did you know that we have our own endogenous
pharmacy? Our brain is able to suppress pain by releasing
powerful opioids like endorphins, enkephalins and dynorphins. But some people have lost the ability to suppress
pain. So, in this case, the small painful impulse
from this tiny osteoarthritis gets amplified in the spinal cord, it gets amplified in the
brain cortex, and is not suppressed here in the brain stem. So guess what? The person interprets this pain as very intense
pain. And yes, they feel it, it is real pain, but
the volume is turned up. Here is another person, this is a 92 years
male who fell and hit his head. He was taken to the emergency and they x-rayed
his head and neck. Fortunately, he did not have any neck fracture. But, the neck x-ray showed very severe osteoarthritis. It lost the normal curvature, there are lots
of osteophytes, no disc space, and the facet joints are very narrow. So, this is terrible osteoarthritis of the
neck. But did you know that this person never had
any neck pain, not even one day in his life. So, what is the solution to this problem? If you have pain and you were told this is
due to osteoarthritis, here are some practical things for you to do:
First, think seriously about losing weight. Even if you lose a few pounds or a few kilograms,
the number of adipokines your body will produce will reduce immensely, and maybe this will
reduce the progression of your osteoarthritis. Second, start exercising. The more you move the better the nutrition
to your joints. I highly recommend water exercises. You can move in all directions, there is resistance
and cardio training and you can relax in the water. But if you do not have access to a pool, a
lake, or a beach, then just start moving, dancing, playing sports, walking, biking,
anything. Remember, motion is lotion. Third, it is important to avoid central sensitization. There are many mind-body therapies that help
to retrain the pain system. You may watch my other video where I talk
about these therapies. And last, eat healthy, especially an anti-inflammatory
diet. This means more fish, olive oil, omega-3,
fruits, vegetables, and less processed foods, white flour, and sugars. I have a video with more details about anti-inflammatory
diets, another video about omega-3 and another about turmeric. Turmeric has some anti-inflammatory properties
and is great in Indian dishes, soups, chicken, and rice. There is a button here for you to share this
video. Send it to anyone you know that has osteoarthritis. Thanks for watching. Goodbye
