Osteo-arthritis of the knee and hip

GrannyMayOz

Hi Everyone,

My husband, David, has been diagnosed with these 2 conditions. His knee also has a baker's cyst and he's having an MRI on Sunday to see if the cyst has been caused by a meniscal tear. Even if there is a tear, the surgeon would prefer not to operate, though keyhole surgery is a possibility; depending where the tear is located.

He basically told David to see his GP and get prescribed some strong painkillers to take 3 times a day - until the pain is too great even with that, and then he'll be in for a knee reconstruction. Also to get a script for an anti-inflammatory.

His knee bothers him when he first stands up after sitting for a while - particularly if he's not been able to move his leg much while sitting, but otherwise he's really not in pain and doesn't want to start a life of pain-killers, along with whatever side-effects they may bring in the long term. He's just turned 60 and otherwise 100% fit and healthy.

The surgeon has said no more running, or even 'strong walking' (I'll call it). I asked if meandering was OK. For example we have a holiday (vacation) coming up in July and hope to walk quite a bit, and we can certainly idle along rather than stride out. That was kind of alright with him. So we've given David's treadmill to our son and bought a rowing machine (woot!) and David will still be able to keep fit. David can only walk about a kilometre (half a mile roughly) before he starts to change his gait though, so even gentle walking is going to have its limitations. We have walked as much as 20 kms (12 miles) in a day while on holidays. I guess that's gone for good.

So... what healthy options does he have to maintain his knee and hip in the best of health? Herbal supplements maybe to maintain what cushioning he does have in his knee and hip? He's LCHF as well, but not keto because he insists on having alcohol on weekends. He's changed from red wine and occasional beer to vodka (straight) in the hope that it's lower carb/healthier. Who knows. I'm not a drinker and don't understand; never will. I only know it's an addiction, which I had with food so I'm nobody to judge. But anyway, this is about what can be done for the osteo-arthritis, and if the answer is 'give up alcohol' I know he'll take the reconstruction surgery down the track

KarlaYP

Don't make opiate pain medications a long term daily thing. It will create a dependence that's worse than the original pain. They are okay for occasional use, but not daily for long periods of time, as the doctor is suggesting. Believe me David will know when he can't tolerate any more and will elect for surgery. Use the anti inflammatory meds, like ibuprofen and celebrex, as long as they do help some. Maybe trying a knee brace to help with walking?

As far a treating the osteoarthritis? I don't know if there is a treatment for it besides exercise. Someone may have, or know someone who has had experience with this. I'm glad he's getting an mri on the knee too. Hope they can find something to get him some relief!

GrannyMayOz

Thank you so much Karlotta. We've always been really healthy, so know nothing at all about these things.

Kitnthecat

If he is eating LCHF, then he is already well set up to combat the arthritis...he is already eating an anti-inflammatory diet. I have to wonder what your naturopath might recommend. I am wondering about more of a paleo autoimmune protocol. (I wish I could take him to see my chiropractor.) Maybe there's something natural that can be done to help in order to avoid the drugs which will mask the pain but may not help fix the issue. If surgery is an option, that might be good as well.

totaloblivia

Is arthritis an autoimmune disease? If so then this might help: http://www.amazon.co.uk/Wahls-Protocol-Radical-Autoimmune-Conditions-ebook/dp/B00DMCJOW8/ref=sr_1_1?s=books&ie=UTF8&qid=1431607664&sr=1-1&keywords=dr+wahls+protocol

sorry I didn't look in the AUS amazon (if you have one), but you'll see the book I mean

Dragonwolf

totaloblivia wrote: »

Is arthritis an autoimmune disease? If so then this might help: http://www.amazon.co.uk/Wahls-Protocol-Radical-Autoimmune-Conditions-ebook/dp/B00DMCJOW8/ref=sr_1_1?s=books&ie=UTF8&qid=1431607664&sr=1-1&keywords=dr+wahls+protocol

sorry I didn't look in the AUS amazon (if you have one), but you'll see the book I mean

Osteoarthritis is a "wear and tear" disorder. Rheumatoid arthritis is the autoimmune one.

@GrannyMayOz Hyaluronic Acid is a dream come true for wear and tear issues -- http://www.amazon.com/dp/B000S97MOU/ I kid you not, even if it costs $100 or something crazy to ship to you, it's well, well worth it. He'll likely be pain-free before that bottle is finished (it's a two month supply, since the dose is two capsules). As long as there's still cartilage there, it should improve his state.

Unfortunately, I can't speak for baker's cyst, though, but if there's a tear, it might help with that.

wabmester

Glucosamine is a popular supplement. The jury is still out on effectiveness, but it seems to work on dogs.

GrannyMayOz

Thank you all so much!
@Kitn Yes, we will go to Mauricio for sure. Just waiting to see what the MRI shows, which involves seeing the surgeon again for interpretation. Though if there's a letter we'll copy it before handing it over It's all going nice and fast because we see the surgeon again on Wednesday. He's a really nice guy too.
@totaloblivia Yes, there is an Australian Amazon. The English/USA sites pretty much redirect me whether I want it or not.
@Dragon Thank you, I will source some of that somehow. It sounds just the sort of thing I'd hope for!
and @Wabmester both thank you and LOL (by which I'm imagining a dog's tongue lolling out of its head on a hot day).

GrannyMayOz

All the Aussie Amazon site has is books about it, which is no surprise to me at all. I can only see 'apps, games, books' as the sum of departments available! Now to try and find if our Customs would let it in if I order from the US or UK.

Aahh, better still, I've found some on ebay that comes from Melbourne or Sydney (3½ or 5½ hours flight away), but that'll do nicely. Should get here mid next week.

lizpitts

Do you know why the doctor wants to put off the surgery? Doesn't make sense to me to go on heavy duty pain meds when the knee replacement is going to be necessary eventually. I had a knee replacement a year ago after limping in great pain for 2 years. Wish I'd done it earlier.

TribalmamaEmily

Hyaluronic Acid is naturally found in bone broth, Shirataki, and Satoimo Root. Our bodies however need magnesium to synthesize hyaluronic acid. People with zinc deficiencies produce low levels of hyaluronic acid. Many people use cortisol or hydrocortisone to reduce inflammation note that these both stop the body from producing hyaluronic acid at large doses.

HA is still up for much debate. It does have proven benefits for joint lubrication and most notably skin rejuvenation but i was looking into it a while back due to it being in skin products (i make my own soap, moisturizers and personal care products) and it was a no-no for those pregnant. There are claims that it also spreads cancer; meaning if you already have cancer cells and you injest HA it will multiply the cancerous cells. Others claim that it bloats them enough to stop taking it although thy love what it does for their skin.
~Just FYI.

tlmeyn

I have osteo in both knees. If his cartilage is not too far gone, physical therapy has helped on of my knees dramatically. The left knee is too far gone, but the right knee, after about 6 months of therapy has gained I don't know how many degrees (as much as 30) of mobility back. My therapist is rather aggressive, it's painful, but at least I am avoiding surgery in both knees. There are exercises that may help and my therapist recommends stationary biking.

I know it's terrible. I have been living with it for a long time (over 20 years) If only someone had recommended physical therapy when it first started, instead of trying to give me cortisone (which I refused after the first shot) and pain killers, then I would be in much better shape. Please try to look into it as an option.

Dragonwolf

TribalmamaEmily wrote: »

Hyaluronic Acid is naturally found in bone broth, Shirataki, and Satoimo Root. Our bodies however need magnesium to synthesize hyaluronic acid. People with zinc deficiencies produce low levels of hyaluronic acid. Many people use cortisol or hydrocortisone to reduce inflammation note that these both stop the body from producing hyaluronic acid at large doses.

HA is still up for much debate. It does have proven benefits for joint lubrication and most notably skin rejuvenation but i was looking into it a while back due to it being in skin products (i make my own soap, moisturizers and personal care products) and it was a no-no for those pregnant. There are claims that it also spreads cancer; meaning if you already have cancer cells and you injest HA it will multiply the cancerous cells. Others claim that it bloats them enough to stop taking it although thy love what it does for their skin.
~Just FYI.

The evidence about its link to cancer is that there are elevated levels of HA associated with cancers (http://www.ncbi.nlm.nih.gov/pubmed/25134379). Correlation does not equal causation, though (http://www.denvernaturopathic.com/news/sardiHA.htm). Animal studies actually suggest that HA is higher in people with cancer, because it's the body's response to cancer in an effort to heal it (http://knowledgeofhealth.com/humans-can-mimic-newly-discovered-cancer-proof-state/).

In other words, the conclusion that HA causes cancer, because HA is present in higher levels of people with cancer is like saying white blood cells cause infection/sickness, because people who are sick have elevated white blood cell counts.

That said, as someone with degenerative disc disease, I'll take the small risk of cancer over not being able to move, being in constant pain, and facing the very real and nearly inevitable possibility that my discs will break down to the point that I'll either need invasive, risky surgery to put metal rods in, or end up doing something that results in them shifting and me getting paralyzed from the waist down.

The effectiveness for OA, though, is pretty undeniable -- http://www.ncbi.nlm.nih.gov/pubmed/15785261, http://www.hindawi.com/journals/tswj/2012/167928/

TribalmamaEmily

@Dragonwolf, I never said HA *causes* cancer, I specifically stated that there are claims (studies as well) that report it multiplies cancerous cells, when one already has them.
And i do feel this is important to note.
I never meant to discredit your experience with HA. I even mentioned that it is proven effective. But there are other things to consider in addition to comfort. And sure we all have the right to choose, I just believe in the right to dicern wisely. I also believe healing can only come from seeking the root cause of an issue in order to seek a proper remedy.

Dragonwolf

TribalmamaEmily wrote: »

@Dragonwolf, I never said HA *causes* cancer, I specifically stated that there are claims (studies as well) that report it multiplies cancerous cells, when one already has them.
And i do feel this is important to note.
I never meant to discredit your experience with HA. I even mentioned that it is proven effective. But there are other things to consider in addition to comfort. And sure we all have the right to choose, I just believe in the right to dicern wisely. I also believe healing can only come from seeking the root cause of an issue in order to seek a proper remedy.

That's why I posted the study in question, as well as articles that suggest such concerns are ill-founded.

Any connections with cancer at all are correlations, regardless of whether the claim is that it causes it or makes it grow faster. The only connection found right now is that people with cancer have elevated HA levels, which is as meaningful as saying people with the flu have elevated white blood cell counts.

In cases like degenerative disc disease, and potentially osteoarthritis, the root cause is essentially HA deficiency. HA is what makes our joints (and our eyeballs) squishy, and lubricates a number of other cells and connections. In these cases, HA supplementation arguably is the proper remedy.

TribalmamaEmily

@dragonwolf, i am sorry but i just don't think a person's health is as black and white as that.
Yes, a person could indeed be HA deficienct. But the root cause *could be* that the person was first magnesium or zinc deficient therefore making them inable to synthesize hyaluronic acid or produce very low levels of it. And if that person was to only take HA, it may not work for the person who is also magnesium deficient because their body can not synthesize it. Additionally, down the road there would enevitably be other issues in which would arise from being magnesium and or zinc deficient.
(Which is why i included in my original post how one can get HA naturally and how magnesium and zinc levels effect HA.)
There are many articles suggesting the conncetion between HA and progressing cancer is bogus. Just as there are many studies suggesting "that when you add extra HA to a culture of CD44 positive breast cancer cells they grow and spread faster." (sited from http://onlinelibrary.wiley.com/doi/10.1002/(SICI)1097-0215(19990702)82:1<77::AID-IJC14>3.0.CO;2-Q/full)
From my original post can you not see I am just being unbiased, diplomatic if you will. HA may indeed be the best choice for one but perhaps not the best for another. Having researched it a bit myself not too long ago I thought it appropriate to share my findings. I am however truly glad to hear that HA is working out for you!
As we age i realize our bodies are not working as optimally as they once did...we all gotta go sometime. So i can certainly understand taking HA in order to function and avoid surgery (which i personally am against).

@GrannyMayOz, sorry dear for hijacking your thread!

Dragonwolf

@TribalmamaEmily I apologize if I'm coming off more rough or defensive than I intend. I should rephrase that HA supplementation is a proper remedy, because in pretty much any health scenario, there are usually several options. It very well could be mangesium deficiency that causes the HA deficiency, but the magnesium deficiency is overshadowed by the issues caused by the HA deficiency. Since magnesium is used in far more processes than just HA synthesis, it would be reasonable, then, to supplement both, especially since the longer things like OA and DDD are allowed to progress, the more permanent the damage done, and once that permanent damage is done, no amount of HA will help. Unfortunately, HA as a supplement is less known than something like magnesium.

The study is quite fascinating, but I don't think it supports the idea that supplementing HA will spread cancer.

Hyaluronidase production by HMD CAL 51 cells was dramatically increased in comparison with the original CAL 51 and with the IP CAL 51 cell lines. This finding is in agreement with our observations showing that hyaluronidase production by human metastasis-derived cell lines of different origins was higher than that of the primary tumor-derived cell lines (Victor et al.,1997). We have also demonstrated that hyaluronidase levels were significantly enhanced in breast-cancer axillary metastases in comparison with the primary breast tumors (Bertrand et al.,1997). Other investigators have reported similar results. Cameron (1966) showed that metastatic process was associated with increased hyaluronidase production. Lokeshwar et al. (1996) reported that hyaluronidase activity in prostatic cancer was higher in malignant tumors than in normal tissue. These authors also demonstrated that the level of hyaluronidase was correlated with tumor grade.

HA production by HMD CAL 51 was, as for hyaluronidase activity, markedly increased in comparison with the established CAL 51 and with IP CAL 51. This finding is in agreement with Turley et al. (1991), who reported that cells derived from metastatic melanomas released more HA than cells obtained from non-metastatic tumors. HA localization in hepatic metastasis showed that this polysaccharide was concentrated mainly in the invasion area. This latter observation also agrees with our finding (Bertrand et al.,1992) that HA amount was enhanced in the periphery of breast tumors in comparison with the center, suggesting that increased HA synthesis may be associated with the invasion process.

HA, which is concentrated around the metastasis, may play different roles, e.g., it may protect metastatic cells against viruses, bacteria, and immune-cell attacks.

This says that HA production goes up as tumors grow and metastasize, theoretically because the tumors themselves produce it. Again, that means you'll see higher levels of HA production in a body with cancerous tumors, and those levels will be higher still in someone whose cancer has metastasized. That may mean that supplementing HA may be contraindicated for a cancer patient (I don't think there's enough information yet to say for sure, but given the above action, it's reasonable to err on the side of caution in that regard). Again, we're, at least right now, back to the white blood cell correlary - X increases when Y happens, but that doesn't necessarily mean that the increase in X caused or contributed to Y.

However, there also appears to be more to it:

HN, like HA, was strongly expressed in the invasion area. HN is a 45- to 70-kDa glycoprotein which binds specifically to HA and which is associated with HA in connective tissue of several organs (Delpech et al.,1986). The increased co-localization of HA and HN in the invasion area may reflect increased binding of HA to HN, a hypothesis sustained by our earlier observations (Delpech et al.,1986): (i) HA and HN were usually found in the same areas in tissue; (ii) HN when extracted at pH 7 was always found associated with HA. (iii) HN binds with high affinity to HA, suggesting that HA and HN may act together on metastatic cells in the invasion area. Ponting and Kumar (1995) gave data supporting the idea that HN may be involved in metastatic-cell movements. The authors reported that HN was markedly present in extracellular matrix in the form of tracks deposited by migrating cells in vitro, so that HN deposition might be correlated with intensity of cell migration.

Perhaps it's the interaction of HA and HN that aids in cancer cell motion? In which case, it's not HA by itself that is a contributor to these issues.

This is awesome research, but even the writer says that it was a study to find a cancer cell that reliably grows and metastasizes, so that HA's role in the process can be studied:

In conclusion, i.p. injection of the human breast-cancer cell line CAL 51 provides a useful model for studying invasion and metastasis formation in nude mice. Metastasis formation was obtained in almost all mice injected, allowing cytological and histochemical study of the metastases in vivo, and characterization of metastasis-derived cultivated cells. The passage of the CAL 51 cells from the primary state to the metastatic state was characterized by a marked increase of HA and hyaluronidase production, and expression of HA and HA-binding sites. These data demonstrated that the CAL 51 model could be useful for studying the involvement of the hyaluronan system in invasion and metastasis formation.

In other words, it was the cancers being studied in this study, not the Hyaluronic Acid. The CAL 51 cells metastasized in 90% of the subjects, with no other intervention. It opens the door to further study, and does provide some good information, but I think it's disingenuous to attempt to draw any conclusions about HA supplementation in general from it.

KnitOrMiss

Plus science and medicine practically reinvent themselves about every 10 years or so... So wait a bit, all the ideas will change! LOL

GoPerfectHealth

I have osteoarthritis in both knees and have had a knee replacement. You can try supplements but eventually they won't help much. There have been times when I took pain NSAID'S around the clock, which helped quite a bit. Regarding activity, I think you can do whatever you can tolerate. With knees you may eventually reach the point of no return. I am very happy with my knee replacement. I waited far too long. I feel like I could walk across the country on it, and look forward to getting the other one done so I can do just that.

GrannyMayOz

Thank you everyone for sharing your experience and knowledge, it's all really helpful.

TribalmamaEmily wrote: »

@GrannyMayOz, sorry dear for hijacking your thread!

Not at all. You and @Dragon are both sharing from your heart, and a place of concern and I value that very much You don't have to agree. Medicine always has opposing ideas and data, and I appreciate knowing both sides.

Foamroller

Anecdotal, this worked for ME on bad knees: LCHF. Lots of fatty type pork rinds, not the very bubbly type. Astaxhantin supplement. Hilly walking has strengthened ligaments and tendons. Don't overdo it, gradual increase pressure. And working on stronger hamstrings/posterior chain. Sitting all day gives short, weak hams and glutes. Can cause muscle imbalances that destabilize the knee. If walking is painful, try lunges and balancework. Ofc I also do careful foamrolling and I like yoga, cause it's relaxing, which is good for almost everything in life.

Even if he's LCHF, consider lowering carb level for 3 months. Starches are inflammatory. Anti-inflammatory medication only alleviate the symptoms, but can invite more inflammation. Use only in emergencies. I was advised by specialist in hospital to avoid NSAIDs altogether. Good luck!

Edit: Forgot to say that improving cardio vascular health is very important too! Joints like knees are very susceptible to injury, cause there is little bloodflow to those tissues for repairs. Having a good cv health, low Beats Per Minute at rest is a measure of cv function. The lower BPM, the more efficient, less energy the heart spends to pump blood around. Depending on your hubby's form: Do short High Intensity sprints 1x a week on a stationary bike. (easier on knees). For example: 20 seconds x 5 with 1 minute rest in between. Up to 25 secs etc when it feels easy. Short sprints are probably one of the easiest and fastest ways to improve blood pressure as well.

There are apps to make it easy. I use Interval timer from goggle play store and Runtastic Heart Rate measure. But if you want to splash out on tools, the new Garmin Forerunner 225 has an optical HR (without chest strap) so you can see your heart rate at any moment.

GrannyMayOz

Thank you @Foamroller. He's in good condition - or was until this laid him up from road jogging a couple of months ago. He continued on his treadmill until about a month ago when even a fairly short run left it worse. He then did hill walks at a good pace on the treadmill. But we've now given that away and bought a rowing machine.

His resting pulse is low 60s with excellent BP 117/84 at the most recent test a few days ago. Oh, and we have heart rate monitor straps that talk to Sports Tracker on our phones.

He's a bus driver so, unfortunately, most of his work day is anchored to a chair, but he's pretty active outside of work hours and tries to walk as much as he can between trips. Sometimes he only has a couple of minutes each time though.

He wants to avoid all the pain killers etc as much as possible.