It is especially important to pay attention to this disease, not only because it can be disabling, but also because probably the most important single lifestyle factor that prevents major fatal diseases is exercise. It is crucial that we keep our joints in as good condition as possible, so that we can be as active as we choose in order to maintain healthy cardiovascular systems and many other vital systems in our bodies.

Injuries, overuse, excessive weight or pressure on the joints, or biochemical changes in the joint cartilage can trigger the process that causes deterioration of the cartilage, the lubricated cushion that keeps the joints working smoothly and freely. If old cartilage is degraded faster than new cartilage is formed, the result is deterioration. In early stages, not enough proteoglycans, glucosaminoglycans and collagen are produced to rebuild cartilage. As the cartilage thins and loses its elasticity, it becomes more prone to damage due to excessive use and injury. Then inflammation can occur. Bone exposure from loss of cartilage causes minute fractures and over-growth of bone with sharp edges within the joint. This then leads to pain, stiffness, swelling and deformity.

Conventional medical therapy such as non-steroidal anti-inflammatory drugs (NSAIDS) can reduce pain and inflammation, but they do not slow the deterioration of the joints, and in fact they cause more degradation of the cartilage if they are used regularly for a long time.

As with other chronic disease, it would make the most sense to prevent these changes from happening, and after they begin to occur, to provide the best support for the cartilage to repair itself.

One important support is proper exercise. Since there is no blood circulation in the cartilage, the cells can only get nourishment by a sponge-like action that comes from squeezing and releasing the cartilage through weight-bearing or other force-producing exercise. The pressure on the joint also has to be not excessive or too repetitive; therefore, obesity and activities that are too repetitive can cause harm. For example, running on hard pavement without properly cushioned shoe soles more than 10 miles per week could cause repetitive injury. Other similar excessive wear on joints could do the same.

What are some of the biochemical factors that promote cartilage deterioration? Dr. Sutter points out that free radical damage is being implicated increasingly in this disease, and research has shown that antioxidant nutrients do protect against degradation of cartilage.

If this is so, then all the other preventive measures that prevent free radical generation, applicable in most other degenerative diseases, could be applied here. Avoiding excess chemical and radiation exposure, avoiding high-fat foods and fried foods, managing and decreasing stress, improving detoxification ability, reducing allergic reactions, preventing diabetes and insulin resistance, and minimizing the use of prescription and non-prescription drugs, all are things that can reduce free radical damage. Eating foods high in antioxidants, such as colored fruits and vegetables, and taking antioxidant supplements also helps quench free radicals.

Also, any nutrient that prevents inflammation could slow or reverse the inflammatory stage of this cartilage deterioration. Foods high in ogega-3 fatty acids such as fish and vegetables, certain nuts and flax oil, and foods low in saturated fat could reduce tendencies for inflammation.

Drs. Alan Gaby, M.D., and Jonathan V. Wright, M.D., have found in their experience that some people are sensitive to foods in the nightshade family such as potatoes, peppers, tomatoes, eggplant, etc., and that they improve in arthritis symptoms when avoiding them.

I have found in my practice that several people were sensitive to other foods that, when eliminated, made the arthritis symptoms disappeared, in this case often the food was orange juice. It can be useful to do an elimination diet to try to detect which specific foods may be causing flare-ups of pain and inflammation for that particular person.

Dr. Sutter lists many nutrient supplements that can decrease free radicals, reduce inflammation, and supply building blocks for the cartilage cells to use to make new cartilage.

Glucosamine sulfate and chondroitin sulfate supply material for making more glucosaminoglycans, proteogllycans and synovial fluid, for building new cartilage. Vitamins E and C are important antioxidants that prevent free radical damage. Niacinamide helps to reduce inflammation by slowing the synthesis of nitric oxide (NO), which is a potent trigger for the degradation of cartilage. N-acetylcysteine, a nutrient also produced by the body, helps to reduce inflammation and increase production of the body’s own antioxidant, glutathione. Selenium assists vitamin E in antioxidant activity. Zinc, copper and manganese are needed for production of the body’s own antioxidant, superoxide dismutase (SOD).

Human studies have shown effectiveness in reducing symptoms of osteoarthritis with these aforementioned supplements. Several herbs have also been found in human studies to reduce symptoms, probably by reducing inflammation. These are ginger and turmeric (common kitchen spices), and boswellia serrata, a traditional Ayurvedic anti-inflammatory herb related to frankincense.

The amounts of the supplements our recommends are as follows: (Note: Caution should be exercised if turmeric or ginger is used in combination with drugs that prevent blood clotting, and niacinamide in these doses recommended should be done under a physician’s supervision, possibly with blood tests for liver function.)

Glucosamine sulfate — 500 milligrams three times daily.
Chondroitin sulfate — 400 milligrams two to three times daily.
Vitamin E — 400 to 800 IU per day.
Vitamin E — 500 milligrams three times daily.
Niacinamide — 500 milligrams two to three times daily.
N-acetylcysteine — 200 milligrams two to three times daily.
Selenium — 200 to 400 micrograms per day.
Zinc — 5 milligrams three times daily.
Copper — 2 milligrams per day.
Manganese — 20 milligrams per day.
Boswellia standardized extract — equivalent to 150 milligrams boswellic acids three times daily
Turmeric standardized extract — equivalent to 150 milligrams curcuminoids three times daily
Ginger standardized extract — equivalent to 10 milligrams gingerols three times daily

There are several homeopathic remedies that also have been useful in osteoarthritis.

Physical therapy can be useful in designing the proper exercise and activities to do for a person suffering from arthritis.

There is much we can do by way of natural therapies that can prevent or reduce osteoarthritis and its pain and inflammation, a disease for which it was once thought there was nothing that could be done for it.