Treatment of Degenerative Joint Disease | Osteoarthritis
In this article Ross Hauser MD will explain the non-surgical advantages of Prolotherapy for the treatment of Degenerative joint disease, osteoarthritis.
Degenerative joint disease (DJD), most commonly known as osteoarthritis, is a painful degenerative condition that results in the deterioration of cartilage tissues that support the weight-bearing joints in the body. Once the cartilage is thinned or lost, the constant grinding of bones against each other causes pain and stiffness around the joint. Abnormal and excess bone formations called spurs grow from the damaged bones, causing further pain and stiffness. Statistics show that degenerative joint disease affects 80% of people over the age of 60.
It is important to note that, although associated with old age,osteoarthritis and degenerative joint disease are not simply a result of the aging process, nor are they a result of general wear and tear on joints, as some believe. These conditions almost always begin as a ligament weakness resulting from injury.
Joints are composed of two bones covered with articular cartilage, which allows the joint to glide, and ligaments, which hold the two bones together. Healthy articular cartilage and ligaments enable the bones to glide evenly over one another. If the ligaments become weak, the bones will glide in an uneven manner. One area of the bone will bear additional weight on the articular cartilage when the joint is stressed. This uneven distribution of joint stress creates an even greater strain on the weakened ligament. Eventually all ligaments of the joint become lax and the joint becomes more and more unstable. As a result, articular cartilage breakdown occurs, causing a grinding or crunching noise when the joint is moved—as well as pain!
Ligament Laxity as origin for Osteoarthritis / DJD
An article published in Gerontology negates the fact that wear and tear is the origin of osteoarthritis and conducts an literary review to prove that osteoarthritis starts with ligament damage. Reviewing numerous research articles, the authors conclude that subchondral bone (the bone just beneath cartilage) changes precede any cartilage change associated with osteoarthritis.
These bone changes are due to a loss of tension on bone at the ligament/bone insertion. In other words, ligament laxity causes bone changes that in turn cause cartilage change and damage. Ligament laxity is due to ligament damage.
When discussing knee osteoarthritis, the authors point to the importance of joint stability in the development of osteoarthritis. All joints consist of a complex system of stability. The cascade of joint degeneration, however, begins with instability at the ligament site: They state:
“It should be remembered that the knee joint functions as an organ with every tissue contributing to its mechanical stability. Ligaments, subchondral bone, menisci and joint capsule all subserve the need for stability. . . the earliest change appears to be at the ligament-bone insertions site. However, we propose that it is a change in the ligament that leads to an alteration in the tension on the bone at the bone-insertion site which precipitates bone remodeling (injury to subchondral bone) [emphasis added].1
Taking account of the progression of osteoarthritis, it becomes clear that the ligament integrity or lack of integrity is what needs to be treated to prevent further joint destruction and this applies to all joints:
“The health and integrity of the overlying articular cartilage depends on the mechanical properties of its bony bed. Ligament injury precedes the subchondral bone changes and these changes occur before articular cartilage degeneration. ‘The proposed reversal of the current concepts of the aetiology of osteoarthritis from cartilage to bone and ligament suggests that research and therapeutic strategies could be effectively redirected.”1
Prolotherapy Treatment for Osteoarthritis
Traditional pain management medicine continues to search for drugs, devices and surgical procedures to eliminate the chronic pain associated with osteoarthritis and degenerative joint disease.
The standard osteoarthritis treatments involve symptom management such as nonsteroidal anti-inflammatory medications, cortisone shots and even surgery to provide pain relief. Cortisone and other steroid shots have adverse affects on bone, cartilage and soft tissue healing. Unfortunately, many people suffering from chronic pain look for quick relief without thinking about the long-term, potentially harmful side effects that could occur. The problem with cortisone is that, although immediate pain relief is possible, it inhibits nearly every aspect of healing, making the pain condition worse.
All of these treatments are anti-healing and can cause further degeneration of arthritic joints. The study points out the need for therapeutic strategies to be redirected. Since the etiology of osteoarthritis is ligament damage it would make sense to strengthen injured and lax ligaments, which is possible through Prolotherapy.
Prolotherapy is an injection technique that induces a mild inflammation thereby stimulating the body to repair weakened ligaments and cartilage. The inflammation dramatically increases blood supply to the ligament and initiates the body’s immune system to lay down new tissue to strengthen injured ligaments. Prolotherapy gives your tissues the resources that are needed to heal. Prolotherapy can reverse joint damage and alleviate osteoarthritis pain permanently.
The science behind joint repair
The body contains three different types of cartilage:
- articular, which covers joint surfaces;
- fibrocartilage, which is found in the knee meniscus and vertebral disk; and
- elastic cartilage, which is found in the outer ear.
They are distinguished by structure, elasticity and strength. Cartilage is a complex, living tissue that lines the bony surface of joints. It provides shock absorption, enabling the joints to withstand weight bearing through the range of motion needed to perform daily activities as well as athletic endeavors. Articular cartilage damage is the most common type of cartilage damage, and can occur as a result either of injury or degeneration caused by wear and tear. Depending on the extent of the damage, and the location of the injury, articular cartilage cells may heal. However, articular cartilage has no direct blood supply, so it has little or no capacity to repair itself. If an injury penetrates the bone beneath the cartilage, the underlying bone provides some blood to the area, improving the chance of healing.
How does degenerative joint disease cause pain?
When ligaments can no longer stabilize joints, muscles and tendons will tense, often increasing a person’s pain. When these soft tissues can no longer do the stabilizing work, the bony surfaces rub against each other.
As the condition develops, the bone around the affected joint thickens, and bony growths called osteophytes form. If the synovial tissue that lines the joint capsule becomes inflamed, fluid may accumulate within the joint. This causes pain and swelling in the joints and decreases their mobility. In later stages of the disease, decreased amounts of cartilage in the joints hinder movement.
Although natural medicine specialists such as Prolotherapy physicians see a clear link between ligament injury and degenerative joint disease, conventional medical practitioners cannot reach consensus on a cause of this condition. They identify certain factors that may increase the risk of developing the disorder, including repeated strenuous activity or reoccurring injury, excessive weight gain, and possibly heredity.
Surgery for degenerative joint disease
Finally, when all else fails, patients with osteoarthritis or degenerative joint disease are referred to a surgeon. Although surgery may provide temporary pain relief, this invasive treatment usually makes the condition even worse! Remember, osteoarthritis or degenerative joint disease is the result of an injury to a joint that was never allowed to heal. And healing is possible!
Anti-inflammatory medications, cortisone shots, arthroscopy and surgery used to treat osteoarthritis and degenerative joint disease all contribute to the downward spiral in the development of these conditions. All of these treatments help destroy the articular cartilage, which is the very structure that prevents us from getting arthritis and degenerative joint disease. It will be your choice; choose arthritis for your future or choose Prolotherapy.
Prolotherapy for Treating Degenerative Joint Disease
The way to alleviate pain from degenerative joints is to stimulate soft tissue, ligament and cartilage repair with Prolotherapy. Please see our research articular cartilage repair in the Journal of Prolotherapy.
Osteoarthritis and degenerative joint disease involve the deterioration of the articular cartilage that lines the joints and related changes in adjacent bones and joints. This deterioration occurs because the supporting structures of the joints, primarily the ligaments, become injured . . . NOT because of general wear and tear on the joints or as an inevitable part of aging! Ligament injury is the culprit.
Progression of degenerative joint disease
- A ligament is damaged through overuse or trauma, such as a sports injury or an accident.
- Because of the ligament’s poor blood supply, it does not heal (unlike muscles, which have a good blood supply and heal quite easily).
- Over time, the injured ligament weakens, like a stretched rubber band that has lost its elasticity.
- Since ligaments function as joint stabilizers, the injured ligament is no longer capable of doing its job.
- As a result, the muscles must compensate. They begin to ache and spasm and, eventually, the joint or vertebra in the area begins to compensate as well.
- Overgrowth of bone occurs to help stabilize the injured ligament, which leads to arthritis, and a whole new level of pain and disability.
Prolotherapy for degenerative joint disease
This downward spiral of pain can be halted and reversed only by stimulating healing at the source—the ligament. The only proven procedure that stimulates this kind of healing is Prolotherapy.
Recently Caring Medical doctors and researchers published their findings on Stem Cell Therapy, a part of a comprehensive Prolotherapy program for advanced arthritis. In this paper we were able to describe our experience with a simple, cost-effective regenerative treatment using direct injection of unfractionated whole bone marrow (stem cells from a patient’s own bone marrow), into osteoarthritic joints in combination with simple dextrose Prolotherapy. Seven patients with hip, knee or ankle osteoarthritis received two to seven treatments over a period of two to twelve months. All patients reported improvements with respect to pain, as well as gains in functionality and quality of life. Three patients, including two whose progress under other therapy had plateaued or reversed, achieved complete or near-complete symptomatic relief, and two additional patients achieved resumption of vigorous exercise. Learn more about stem cell therapy for osteoarthritis and Prolotherapy at pages on our website.
Prolotherapy is the safest and most effective natural medicine treatment for repairing tendon, ligament and cartilage damage is Prolotherapy. Prolotherapy stimulates the body to repair painful areas. It does so by inducing a mild inflammatory reaction in the weakened ligaments and cartilage. The inflammation causes the blood supply to dramatically increase in the ligament, alerting the body that healing needs to take place. In the simplest terms, Prolotherapy stimulates healing.
Furthermore, Prolotherapy offers the most curative results in treating osteoarthritis and degenerative joint disease. It effectively eliminates pain because it attacks the source: the fibro-osseous junction, an area rich in sensory nerves. What’s more, the tissue strengthening and pain relief stimulated by Prolotherapy is permanent!
Other Natural Medicine Treatments for Arthritis
Over the past several years additional information has accumulated regarding the use of glucosamine, chondroitin sulfate, and collagen II. These products are available without a prescription from health practitioners or local health food stores. They have been shown to be effective in pill form or via injection. Glucosamine can be extremely helpful in reducing pain from osteoarthritis and can also help prevent further deterioration of the joint.
Another useful medicine for joint pain is Capsaicin. This is available either as a generic or proprietary cream (known as Zostrix). When applied to a painful joint on a regular basis, joint-related pain and muscle spasms are decreased to a significant degree. Side effects, other than warmth, are very rare. These creams literally work to decrease the amount of pain chemicals that are present in the tissues surrounding the joint.
As good as some of these treatments are for pain, nothing comes close to the effectiveness of Prolotherapy. Prolotherapy is the only treatment that can stimulate the regrowth of the injured tissue. Prolotherapy can tighten the ligaments around a joint and can also be quite helpful in reducing joint pain immediately, through direct injection into the joint. Proper exercise can then be resumed in order to bring the strength and flexibility of the surrounding muscles to a normal level. The muscles then help to protect the joints from any further injury.