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Osteoarthritis with Naturopathic Medicine
Osteoarthritis with Naturopathic Medicine
Osteoarthritis with Naturopathic Medicine
Osteoarthritis with Naturopathic Medicine
Osteoarthritis with Naturopathic Medicine
Osteoarthritis with Naturopathic Medicine
Osteoarthritis with Naturopathic Medicine
Osteoarthritis with Naturopathic Medicine
Osteoarthritis with Naturopathic Medicine
Osteoarthritis with Naturopathic Medicine
Osteoarthritis with Naturopathic Medicine
Osteoarthritis with Naturopathic Medicine
Osteoarthritis with Naturopathic Medicine
Osteoarthritis with Naturopathic Medicine
Osteoarthritis with Naturopathic Medicine
Osteoarthritis with Naturopathic Medicine
Osteoarthritis with Naturopathic Medicine
Osteoarthritis with Naturopathic Medicine
Osteoarthritis with Naturopathic Medicine
Osteoarthritis with Naturopathic Medicine
Osteoarthritis with Naturopathic Medicine
Osteoarthritis with Naturopathic Medicine
Osteoarthritis with Naturopathic Medicine
Osteoarthritis with Naturopathic Medicine
Osteoarthritis with Naturopathic Medicine
Osteoarthritis with Naturopathic Medicine
Osteoarthritis with Naturopathic Medicine
Osteoarthritis with Naturopathic Medicine
Osteoarthritis with Naturopathic Medicine
Osteoarthritis with Naturopathic Medicine
Osteoarthritis with Naturopathic Medicine
Osteoarthritis with Naturopathic Medicine
Osteoarthritis with Naturopathic Medicine
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Osteoarthritis with Naturopathic Medicine

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Addressing Osteoarthritis with Naturopathy and Holistic approaches. Also includes a reveiw of conventional treatment options. Presentation by Adam Rinde, ND, a Naturopath based in Kirkland, …

Addressing Osteoarthritis with Naturopathy and Holistic approaches. Also includes a reveiw of conventional treatment options. Presentation by Adam Rinde, ND, a Naturopath based in Kirkland, Washington.

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  • 1. Osteoarthritis
    Adam Rinde, ND
    Naturopathic Physician
    Sound Integrative Health
    7/11/08 @ Natures Pantry
  • 2. Key Points
    Pain relief is available in a non-pill form!
    Joint replacement can be prevented
    You can take charge of your pain
  • 3. Osteoarthritis: Description
    Osteoarthritis: a disease effecting any joint with associated alteration of cartilage
    Also known as:
    Degenerative Joint Disease
    Osteoarthrosis
    Hypertrophic Osteoarthritis
    .
  • 4. Osteoarthritis
  • 5. Osteoarthritis
    Primary Osteoarthritis:
    Associated with gradual aging-related destruction of cartilage in joint-space.
    Secondary Osteoarthritis
    Usually secondary to trauma/overuse, repetitive strain, and subsequent faulty repair and regeneration of cartilage.
  • 6. Epidemiology of OA
    The #1 joint-causing disorder that begins asymptomatically in the 20’s and 30’s and becomes extremely common by the age of 70.
    By the age of 40 most people have some change in weight bearing joints, although relatively few have symptoms.
    OA affects almost all vertebrates
  • 7. Osteoarthritis: Epidemiology
    occurs in whales, dolphins, and porpoises.
    Does not occur in Bats which hang upside down.
    This finding suggest that it is an ancient Paleozoic mechanism of repair and remodeling rather than a disease in the usual sense.
  • 8. Osteoarthritis: how does it happen
    A Cartilage trauma combined with
    Faulty repair
    Faulty regeneration
    Faulty remodeling
    Leading to
    Deformed cartilage
    friction
    Loss of function
  • 9. OA Symptoms
    Gradual onset usually involving one or a few joints
    Pain is the earliest symptom and is usually worsened with exercise and relieved by rest
    Morning stiffness follows inactivity but lasts <15-30 minutes and lessens with movement
    As OA progresses joint motion diminishes, tenderness and crepitus sensations appear and flexion contractures may occur.
    Pathologic changes can cause joint enlargement
  • 10. OA symptoms
    OA of the cervical and lumbar vertebrae
    can lead to myelopathy or radiculopathy
    Hip OA is
    Characterized by gradually increasing rigidity and loss of range of motion.
    Pain may be felt in the inguinal (groin) area or referred to the knee
    Knee OA
    Cartilage is lost in the medial aspect in 70% of the cases
    The ligaments become lax and the joint less stable with local pain arising from the ligaments and tendons
    Tenderness on palpation and pain on passive motion are relatively late signs
    Hands
    the base of the thumb, where the thumb and wrist come together (the trapezio-metacarpal, or basilar, joint)
    at the end joint closest to the finger tip (the distal interphalangeal or DIP joint)
    at the middle joint of a finger (the proximal interphalangeal or PIP joint)It also often develops in the wrist.
  • 11. Osteoarthritis: Diagnosis
    Diagnosis is confirmed by x‑rays.
    Report may describe degree of joint space narrowing
    Subchondral Sclerosis
    Presence of osteophytes
    Periodic X-rays useful in tracking progress of therapies.
  • 12. Treatment Options for Osteoarthritis
  • 13. Therapeutic Goals
    Preserve Quality of Life by reducing disability
    Reduce Pain and Inflammation
    Prevent/Arrest cartilage degeneration (joint space narrowing)
    Utilize conservative therapies for long-term management
    Reduce reliance on NSAID Or Opiods
    Prevent need for higher invasive therapies
  • 14. OA Treatment Strategy
    Reduce aggravating factors promoting destruction of joint cartilage
    Restore and maintain healthy joint biomechanics
    Reduce pain and modulate chronic inflammatory state.
    Stimulate healthy cartilage regeneration and repair
  • 15. OA Treatment: Ergonomics
    Consider home devices such as grab bars in the tub enclosure, raised toilet seats
    Avoid soft deep chairs and recliners from which arising is difficult
    Avoid pillows under the knees as this encourages contractures
    Sit in straight chairs without slumping
  • 16. OA Treatment :Ergonomics
    Sleep in a firm bed with a bed board
    Use a car seat designed for comfort
  • 17. OA treatment: Exercise
    Exercise/Physical therapy:
    Daily stretching important
    Local application of moist heat especially before exercise s
    Perform postural exercise
    Resistance Training
    Quadriceps strengthening important (for Hip and Knee)
    Try not to immobilize (stay active)
    Rest every 4-6 hours in the daytime to allow rehydraton of cartilage and balance with exercise and use
  • 18. OA treatment: Exercise
    Cardiovascular Exercise to promote weight reduction/weight management
    At least 5 days per week of 30 minutes at 70% of your maximum Heart Rate
    Choose low impact forms of exercise
    Walking, Golf, bicycle, elliptical, swimming,
    cross country skiing nordic-track
    Water jogging
  • 19. Manual Therapy
    • Muscle Release Therapy
    • 20. Active Isolated Stretching
    • 21. Neuromuscular Reeducation
  • Therapeutic Exercise
    • Re-conditioning compensated muscle groups
    • 22. Building a strong foundation of joint support
    • 23. Reducing excess force on joints
  • Acupuncture
    May promote healing
    May provide pain relief and improved joint function
  • 24. Diet: Low-inflammatory
    Omega-3-rich diet
    Wild-caught salmon
    COD
    Organic Vegetables and Fruit
    5-7 servings are fruits and vegetables a day
    Kiwi, Papaya, Pineapple
    Limited Chicken and Cow Intake
    Avoid Food Sensitivities (especially Nightshades)
    Fiber rich (at least 30 g/day)
    Low processed foods
    Low simple sugars
    No Transfats
  • 25. Neutraceuticals for OA
    Glucosamine and Chondrotoin Sulfate
    Niacinamide
    May raise liver enzymes
    Vitamin D (check levels through your Dr.)
  • 26. Polyunsaturated Fatty Acids (PUFAS)
    Fish Oil
    Contains omega-3 essential fatty acids
    Choose mercury free
    Marine Lipid Extract
    Perna canniliculus
    Green lipped mussels
    Another form of PUFA’s
    Always discuss Fish Oil supplementation with your Dr. as Fish Oil may interact with Blood Thinners.
  • 27. Supplementation: Cartilage protective/stimulatory?
    Avocado Soybean Unsulfoniables (ASU)
    A phytosterol that has been studied reduce pain and inflammation in OA.
    It may protect further cartilage damage.
  • 28. Anti-inflammatory Proteolytic enzymes
    Bromelain
    Papain
    Rutin
    Peptizym
  • 29. OA treatments;Botanical Medicine
    Anti-inflammatory herbs
    Devils Claw
    Willow Bark
    Ginger
    Turmeric
    Note: some of these may interact with anti-coagulants, check with physician
  • 30. Antioxidant Supplementation
    Usually can be obtained through a quality daily multivitamin
    Vitamin C
    Vitamin A
    Vitamin K
    Vitamin E
    Selenium
    Zinc
  • 31. Reduce InflammationIntraarticular Injections
    Prolotherapy
    growth factors or growth factor stimulator injections
    Viscosupplemention
    Hylagen (injectable synthetic hyularonic acid)
    FDA approved for knee injection
    Show effective for Knees (not yet for hips)
    Corticosteroid Injections
  • 32. Drug interventions
    Simple Analgesic
    Acetaminophen (Tylenol) OTC pain relievers
    Can prolong the halflife of warfafin
    NSAID
    Cox-2 Inhibitors (Celebrex)
    Know the warnings (ie. Cardiovascular/Gastroinestinal)
    Be assessed for risk of GI bleeding before taking
    Know the risks of taking long term
    Know when they are beneficial and when they are not.
    Try and use for the shortest amount of time possible at the lowest effective dose.
    Tramadol
    Synthetic Central Acting Opoid
    Used for severe pain
  • 33. Surgery
    Knee Arthroplasty
    Replacement usually has road-life of 10-12 years
    Hip Arthroplasty
    Usually last 20 years
  • 34. OA resources
    Arthritis Foundation-Local Chapter
    National Institute for Arthritis,Skin, and Musculoskelatal Disorders.
    Health Clubs (International Health and Racquet Club)
    Vitalchoices.com
    Pioneer Grocery
  • 35. Adam Rinde, ND
    Contact Information
    Appointments: 425-889-5894
    Email:drrinde@soundintegrative.com
    Sound Integrative Health

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