Synotrex

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Osteo Support

120% of the recommended daily allowance of calcium. Contains ostivone which has been shown to increase the effectiveness of calcium supplements. Four tablets provide 1200 milligrams of highly bioavailable calcium.

Ostivone

Ipriflavone has been the subject of 60 clinical trials worldwide and has shown remarkable efficacy in maintaining healthy bone density. The compound improves the balance between bone building and bone breakdown.

Calcium/Magnesium

This high potency calcium product combines three different kinds of calcium, Vitamin D, Magnesium, and Boron into 1 capsule. Since bodies are different and handle calcium types differently, calcium citrate, calcium carbonate, and chelated calcium are all included. Provides a 2:1 calcium to magnesium ratio.

RealHeal Massage Oil

RealHeal is a blend of especially chosen aromatherapy oils well known for their healing, restorative and pain killing properties. Used for relieve of arthritic and rheumatic conditions.

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Syn-flex®

Liquid Glucosamine is very beneficial in easing the pain of arthritis and effectively assists in rehabilitating damaged cartilage. Syn-flex provides a pharmaceutical quality glucosamine with eleven other synergistic ingredients in liquid form. This allows for maximum absorption and bioavailability.
Smooth orange flavor.

Grape Seed Extract

High-tech antioxidant far more powerful than vitamins C, E and beta-carotene. Other grape seed extracts often use potentially dangerous chemicals which can leave residues and strip away many of the nutrients.

Super Antioxidant

One of the most progressive antioxidant formulas. Contains potent compounds that neutralize both water-soluble and lipid-soluble free radicals. Cellular breakdown from increased oxidant activity is a primary contributor to the aging process.

Antioxidant Boost Liquid

Helps neutralize free radicals that can lead to illness and disease. Liquid form means you get superior absorption for greatest effectiveness. Includes Grape Seed Extract with potent OPC's. Powerful liquid combination of outstanding ingredients.

Desert Burn ZA 750™

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Desert Juice™

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Osteoarthritis

by © Arthritis Research Campaign 2006

Some Common Questions Answered

What does the future hold?

Rheumatoid arthritis and osteoarthritis are quite different diseases. Whereas osteoarthritis rarely occurs before the age of 40, many people develop rheumatoid arthritis in their 20s or 30s. Many joints are involved – the synovium is badly inflamed and this damages all the tissues in the joint. The affected joints are painful, often very stiff, and appear warm, tender and swollen with fluid (not with extra bone growth). Blood tests show widespread inflammation that affects the body generally, often causing anaemia, weight loss and tiredness. X-rays show that the bones are thin and eroded, rather than the bony spurs and calcification that show up in osteoarthritis. (See arc booklet 'Rheumatoid Arthritis'.)

What does the future hold?

Although osteoarthritis is often painful and upsetting, it usually does not cause crippling arthritis or severe deformity of joints. For most people it will be more of a nuisance than a major problem.

It does not lead to rheumatoid arthritis or other forms of joint disease. It will not spread all over your body. It has no link with cancer or other serious diseases.

The pain sometimes gets easier as time goes by, and most people with osteoarthritis have little disability. Try not to fear the future unnecessarily as this can be worse than the actual arthritis. People with osteoarthritis can do a lot to help themselves and often only need occasional advice from doctors and therapists. Modern medicine and surgery have much to offer, particularly for the few who do get severe joint damage.

Can any special diet help?

A large amount of research is being done on diet, nutrition and osteoarthritis. Many books, articles and advertisements claim benefits for particular diets or food supplements, but at the moment most are not supported by strong evidence.

There is, however, evidence that the supplement glucosamine can produce some improvement in osteoarthritis. For information on other aspects of diet, including oily fish and fish oils, see the arc booklet 'Diet and Arthritis'.

Particularly important in relation to diet is the fact that a great deal of evidence shows that being overweight increases the risk of developing osteoarthritis, especially of the knee. It also increases the risk of osteoarthritis progressing. Being overweight is also bad for your general health and increases the risk of developing heart disease, stroke and diabetes. So you should eat a balanced, healthy diet and keep your weight as close as possible to the ideal for your height and age.

Will rest or exercise help?

Joints do not wear out with normal use. In general, it is much better to use them than not to! However, you must strike a sensible balance between too much activity and too much rest. Most people with osteoarthritis find that while too much exercise worsens their pain, their joints stiffen up if kept still for too long.

For most people with osteoarthritis, the best advice is 'little and often' – a little rest, followed by a little exercise. For example, do the housework or gardening in short spells interrupted by short rests. Avoid sitting in one place for too long – get up and stretch the joints from time to time. Break up a long car journey with frequent stops to walk around.

Activities that cause severe pain afterwards are probably best avoided. If for some special reason you do need to do a lot extra, it can help to take a painkiller before you start. Even if it does cause extra pain you are unlikely to damage the joint, but your doctor or therapist will give you more advice if you are worried. (See arc leaflet 'Keep Moving'.)

Can swimming or pool treatment help?

Swimming can be a very good way of exercising and keeping fit as it causes little pain. Water supports the body's weight so that little force goes through the joints as you exercise. Also, warm water relaxes muscles and joints and is very soothing, allowing joints to move more freely. If you have osteoarthritis of the hip or knee you may find this particularly helpful.

Prescribed exercises in a hydrotherapy pool can help get muscles and joints working better, without undue pain. Supervised swimming in natural spa waters is an ancient treatment – it is the exercise that helps rather than any healing properties of the water itself. (See arc leaflet 'Hydrotherapy and Arthritis'.)

Will my osteoarthritis affect sex, marriage or my family?

Osteoarthritis is not catching and cannot be given to family or friends. It should not affect your marriage or partnership or your family. However, sexual intercourse may be painful, particularly for women with osteoarthritis of the hips. Using different positions can often help. If you have problems, consult your doctor and see also the arc booklet 'Sexuality and Arthritis'.

If you have nodal osteoarthritis with knobbly fingers, your children have an increased chance of developing it in their middle life. This is particularly true for girls, who have about a 30–50% chance of inheriting it from an affected mother. There is a smaller risk of passing on the tendency to develop knee osteoarthritis. No test can show whether you have inherited the tendency for nodal or knee osteoarthritis. However, if a parent has nodal or knee osteoarthritis, the children, especially the females, have an added incentive to exercise regularly and avoid getting overweight.

Does the weather really affect osteoarthritis?

Painful joints are often sensitive to the weather. They tend to feel worse when the atmospheric (barometric) pressure is falling, such as just before it rains. This helps to explain how people with osteoarthritis can predict rain, and why joint pains seem linked with the damp.

However, there is no evidence that different climates have any long-term effect on osteoarthritis or its outcome. The weather may temporarily affect symptoms but not the arthritis itself. There is no point in moving to a different area in the hope of curing osteoarthritis. Osteoarthritis occurs all over the world, in all types of climate. (See arc booklet 'Introducing Arthritis'.)

Can heat help?

Warmth applied to the affected area often relieves the pain and stiffness of osteoarthritis. Heat lamps are popular, but you can get a similar effect more cheaply with hot-water bottles (be careful, though – it is easy to burn yourself with either). There are also many creams, available at the chemist, which can produce localised heat.

These measures make no long-term difference to the disease, but they can give you temporary pain relief. Used carefully they are safe and soothing.

Are manipulations or complementary medicines worth trying?

Back and neck pain are often helped by manipulation from chiropractors or osteopaths, although the use of manipulation for osteoarthritis in other areas is limited. However, many people still seek advice from these practitioners, but you should make sure that the practitioner is fully trained and registered.

'Complementary' medicines seem to help some people with osteoarthritis. A few, like acupuncture, have a proven short-term pain-relieving effect. But many do no more than produce a 'placebo' effect (as when someone receiving a simple sugar pill actually believes it is making them better). There are many good complementary practitioners, but sadly a minority seem to exploit people's suffering. We have no proof that copper bracelets or other such measures can affect osteoarthritis, but faith in them seems to help some people. (See arc booklet 'Complementary Therapies and Arthritis').

Who should I listen to?

Many well-meaning people offer advice. Magazines and the media are full of articles on arthritis and its treatment. Some offer 'new hope', others offer a special diet or medicine with 'miracle' properties. Unfortunately, there are no miracle cures or easy answers. Discuss things with your doctor and think about the advice in this booklet before spending money on new ideas.

Keeping your spirits up

Depression, low morale and poor sleep can all make pain worse. They can all influence the way pain is experienced and lower your threshold to pain.

If someone is depressed, their pain often feels worse and they have more difficulty coping with it. They might go to their doctor and be given bigger doses of tablets to relieve that pain. But sometimes what the person needs is help for the depression and the demoralising effect of arthritis. If the depression is lifted, the pain often becomes less and the person is better able to cope with their osteoarthritis.

A positive and hopeful approach is half the battle, though this is easier said than done. Make every effort to make life fuller and more interesting than before. Your morale will drop after too much rest and inactivity, whereas hobbies and interests take your mind off your problems. Sleep is important – it is best not to take naps during the day but to save all your sleep for night-time, taking a painkiller last thing if necessary. If you have previously enjoyed vigorous activity and sport you may have to develop less active pastimes, but there is no reason to let osteoarthritis get you down or stop you doing most everyday activities.

Some case histories

Here are three case studies which show some typical patterns for people with osteoarthritis. Everybody's case is different, but these are typical experiences. They will give you an idea of how people manage with osteoarthritis.

Mary is a 64-year-old housewife. She remembers that her mother (who died a few years ago) had knobbly fingers and sometimes complained of her rheumatism. When Mary was 52 she first noticed some discomfort and swelling in the joints at the ends of her fingers. For a few years several of these joints were quite painful and often red and tender. The base of her thumbs also became troublesome, and her knees became creaky and uncomfortable.

Her hands are much less of a problem now. They cause very little discomfort, although some fine movements (such as with buttons and needlework) are sometimes difficult and take a little longer to do. Her knees stiffen up in the evenings, and get uncomfortable after walking for too long. They give more trouble on some days than on others.

Mary occasionally takes paracetamol for her knees and is not on any other treatment. She regularly does the knee-muscle exercises which the practice nurse taught her, and she enjoys swimming with her neighbour twice a week. She describes her osteoarthritis as a 'bit of a nuisance', but it hasn't interfered with her life in any major way. She feels well and leads a full family and social life.

John is a 68-year-old retired salesman. When he was 25 he injured his knee playing football. It 'locked' and was very painful for several weeks. His doctor sent him to an orthopaedic surgeon, who removed part of John's damaged cartilage (meniscus). He still had quite a lot of pain and he had to have a second operation on the same knee a few years later (when he was 30). After that, John had no real problems for many years. His knee occasionally ached and was sometimes stiff, but it didn't stop him from doing anything.

About 10 years ago he noticed that the discomfort and the stiffness were getting slowly worse. As time went by the knee became quite painful on exercise and started to swell a little. By the time he was 64 (and coming up to retirement) it was getting difficult to climb stairs properly, and John couldn't walk more than about half a mile without a lot of pain.

His doctor examined the knee, took an x-ray, and told John he had osteoarthritis with some calcium crystals in the joint, caused by his old injury and operations. He was given some pain-killing tablets (paracetamol) and NSAID cream which helped, and some physiotherapy to strengthen his weakened thigh muscles. This made walking and climbing stairs much easier.

Since his retirement John hasn't had to rush around so much, and is finding things easier. His many hobbies include gardening, which he manages, and some home decorating. He says it is fine as long as he 'takes it gently'. He uses the tablets and cream most days, and carries on with the regular exercises he was taught. John gets more pain on certain days, particularly when it is damp, and his knee often stiffens up if he sits in one place for too long.

Barbara is a sprightly 71-year-old. She is very proud of her 'new hip joint'. Her arthritis troubles started about 20 years ago, with an ache in her groin and the front of her right thigh. The thigh pain slowly got worse and her leg became stiffer. She started to limp and had some very bad days when both her right hip and knee felt very painful.

Barbara's doctor told her she had osteoarthritis of the hip and gave her some tablets, which didn't make much difference. He called in a physiotherapist who told her that, because of the arthritis, her right leg was shorter than the left. Barbara was given a walking stick and slight raise on the heel of her right shoe to compensate for the shortening of her leg. She also had some hydrotherapy. These measures made life a good deal easier and she was able to manage well for several more years. However, about 2 years ago the pain got worse again and started to disturb her sleep.

In spite of more tablets and physiotherapy, Barbara's pain became quite severe and she couldn't get to sleep at nights. Her doctor referred her to a surgeon who took some x-rays, said she had very bad hip osteoarthritis, and put her on the waiting list for a hip replacement. Barbara asked about the knee pain, but the surgeon explained that this was coming from the hip and that her knee joint was fine.

Several months later Barbara went into hospital. She was on her feet a few days after the operation and was out of hospital a week later. It took her about 6 months to fully get over the operation and realise how good she was going to be. Her pain has gone, and although she still has some stiffness in the hip and has to be a little careful, she tells us that she is a 'new woman'. She doesn't use a stick any more and is no longer having to take tablets.

What does research mean for the future?

We do not yet know the causes or the cure for osteoarthritis. However, recent research (much of it funded by arc) is uncovering the mechanisms which lead to joint damage as well as the factors which control the healing response. For example, we now know some of the chemicals which thin out the cartilage in osteoarthritis, and we are now testing new drugs that inhibit the actions of these chemicals.

Our research teams are also searching for the genes that may result in osteoarthritis. When these are identified we may be able to prevent or improve this common condition. We hope that ongoing work such as this will lead to new treatments to limit the processes that cause damage to the cartilage and improve natural healing.

Doctors and research workers have changed their attitude a great deal in recent years. They now see real possibilities of understanding and controlling osteoarthritis in the future. They no longer see osteoarthritis as an inevitable part of ageing or a 'wear and tear' disease, but more as a major challenge and an important problem that they can solve.

Glossary

Calcification – deposits of calcium crystals in soft tissues.

Capsule – the tough, fibrous sleeve around a joint. Its inner layer is the synovium.

Cartilage – strong material on bone ends that acts as a cushion. Its slippery surface allows smooth movement between bones.

Chondrocalcinosis – calcification of cartilage.

Collagen – the main substance in the white, fibrous connective tissue which is found in tendons, ligaments and cartilage. This very important protein is also found in skin and bone.

Deformity – abnormal growth or swelling of a joint.

Femur – the upper leg or thigh bone – the longest bone in the body.

Hallux rigidus – osteoarthritis of the big toe joint with a stuck, rigid toe (often painful).

Hallux valgus – osteoarthritis of the big toe joint with angulation of the toe.

Heberden's nodes – firm swellings of the end joints of fingers, often painless when fully formed – the hallmark of nodal osteoarthritis.

Ligaments – tough, fibrous bands anchoring the bones on either side of a joint and holding the joint together.

Menisci (singular meniscus) – free rings of cartilage, like washers, lying between the cartilage-covered bones in the knee. Each knee has an inside (medial) and an outside (lateral) meniscus.

Nodal osteoarthritis – a form of osteoarthritis that often runs in families, characterised by knobbly finger swellings (Heberden's nodes) and a tendency to get osteoarthritis at several sites (especially knees, big toes).

Osteophytes – overgrowth of new bone around the sides of osteoarthritis joints, also known as 'spurs'.

Patella – the kneecap, a small bone that helps the front thigh muscles work the knee.

Perthes' disease – inflammation at the head of the thigh bone (femur) which causes pain and limping, usually in boys aged 5–10 years. It can restrict blood supply to the bone leading to poor growth and deformity and can cause osteoarthritis to develop in later life.

Pseudogout – a sudden attack of a hot, painful, very swollen, red joint, caused by calcium crystals in the joint (mainly the knee).

Pyrophosphate arthritis – a type of osteoarthritis in which crystals of calcium pyrophosphate form in a joint (see calcification and chondrocalcinosis). The crystals can cause pseudogout.

Radiated pain – pain that is felt some way away from the joint causing the trouble (for example, pain in the thigh and knee from an osteoarthritic hip).

Spondylosis – osteoarthritis of small joints in the neck and back – commonly present in all of us, often without causing any symptoms.

Synovial fluid – the fluid produced by the synovium to nourish and lubricate the joint.

Synovium – the capsule's inner layer that produces synovial fluid.

Tendons – strong fibrous 'guiders' or cords that anchor muscles to bone.

Tibia – the lower leg or shin bone – the second largest bone in the body.

Useful addresses

The Arthritis Research Campaign (arc)
PO Box 177
Chesterfield
Derbyshire S41 7TQ
Phone: 0870 850 5000
www.arc.org.uk

As well as funding research, we produce a range of free information booklets and leaflets. Please contact the address above for a list of titles or, on this website, see Publications for People with Arthritis.

Arthritis Care
18 Stephenson Way
London NW1 2HD
Phone: 020 7380 6500
Helplines: 020 7380 6555 (10am–4pm Mon–Fri)
or freephone: 0808 800 4050 (12pm–4pm Mon–Fri)
www.arthritiscare.org.uk

Offers self-help support, a helpline service (on both numbers above), and a range of leaflets on arthritis.

Disabled Living Foundation (DLF)
380–384 Harrow Road
London W9 2HU
Phone: 020 7289 6111
Helpline: 0845 130 9177 (10am–4pm Mon–Fri)
www.dlf.org.uk

Offers advice and information on equipment to help you in daily activities.

Dial UK (Disability Information & Advice Line)
St Catherine's
Tickhill Road
Doncaster DN4 8QN
Phone: 01302 310123
www.dialuk.org.uk

back to page 1:  Osteoarthritis

About the Author

© Arthritis Research Campaign 2006. All rights reserved. A team of people contributed to this publication. The original text was written by an expert in the subject. It was assessed at draft stage by doctors, allied health professionals, an education specialist and people with arthritis. A non-medical editor rewrote the text to make it easy to understand and an arc medical editor is responsible for the content overall.

This publication has been made possible because of voluntary donations given to the Arthritis Research Campaign. Printed copies can be ordered on this web site or by writing to arc Trading Ltd, James Nicolson Link, Clifton Moor, York YO30 4XX, United Kingdom.