Conquering Osteoarthritis in Clinical Practice
by Dr. Greg Fors, DC – Board Certified Neurologist DIBCN Posted On: 04/15/2011
According to the World Health Organization, degenerative joint disease (DJD) is one of the top 10 global disease burdens in the world today. Approximately 1 in 3 adults in the US between 25 and 74 years of age have radiological evidence of Osteoarthritis (OA) in at least one joint. In the US, 25% of all visits to primary care physicians and half of all NSAIDs prescriptions are for Osteoarthritis.
However, degenerative joint disease is not an inevitable consequence of growing older. It develops when trauma, and/or biochemical changes trigger a shift between joint cartilage synthesis and degradation.(1) Primarily, when the cartilage synthesis of any joint cannot keep pace with the background degradation of the cartilage, the joint will degenerate. Two very important factors in the joint play a primary role in joint deterioration. The first factor is the reduction in proteoglycan production in the joint cartilage. The second factor is the rate of production of inflammatory catabolic cytokines in the chondrocytes and synovial cells.(2) The driving force behind these two factors is multifactorial of course, but genetics plays a primary role, which is influenced by the macro and micro nutrient intake of the individual.
Low vitamin D levels are now linked to multiple health problems including degenerative disc disease of the spine.(3) A 2006 study showed that an inherited polymorphism of a vitamin D receptor in the spinal disc was associated with a high risk of degenerative disc disease and disc bulge developing, especially in individuals younger than 40 years.(4)