Regenerating The Joints in Osteoarthritis

“As long as the various members and parts of that organism are coordinated and cooperating in harmony, we have as a result the expression of life in its fullest degree.” —~‘Abdul-Baha

When we live free of pain and in optimum physical function, we find ourselves joyful and full of life.… But when we experience pain, stiffness and immobility, life becomes less joyful and more heavy. We feel burdened and hopeless. Those who suffer from the chronic pain of osteoarthritis sometimes may feel they are stuck; that they have no options for short-term or longterm relief. On the contrary, modern day regenerative medicine is finding new ways of healing the pain, the stiffness, and the swelling by treating the inflammation and stimulating the regeneration of the joint.

How Common is Osteoarthritis?

Arthritis can often be debilitating, depressing, demeaning, and demoralizing. It is estimated that one in four persons in US suffer from arthritis and majority of those have osteoarthritis. More than half of the those with osteoarthritis tend to be younger than age 65 and more commonly women than men (14). The incidence of osteoarthritis in US continues to increase quickly.

Surprisingly, severe joint pain from arthritis often inflicts middle-aged adults between the ages 45 and 65. We see people with chronic lifestyle-based diseases, such as diabetes, heart disease, obesity, poor health and psychological distress, suffer more commonly with osteoarthritis. It is estimated that 50% of all people with knee osteoarthritis will have at least one total knee replacement during their lifetime (14).

How does osteoarthritis occur?

For decades, osteoarthritis was regarded as the old man’s joint disease caused by wear and tear and injury, and often found in athletes, manual workers, dancers, etc. More recent research however, shows that osteoarthritis is the result of not just trauma but of chronic inflammation (15). Yes, inflammation, seems to be the cause of every chronic and acute disease.

In osteoarthritis, we see chronic inflammation caused by repetitive injury or trauma, but most importantly we see the inflammation caused by not only local but also systemic inflammation. For instance, in people with chronic stress, metabolic syndrome, which includes pre-diabetes, high cholesterol, high blood pressure and enlarged abdominal girth, or in obesity, osteoarthritis presents commonly as a result of the chronic inflammation induced by these conditions. In other words, any condition that is the result of chronic inflammation potentially can manifest itself as osteoarthritis as well (15).

More causes of inflammation

The process of stress and aging leads to an imbalance between the inflammatory and anti-inflammatory systems within the body. During chronic stress and aging, tissues breakdown faster than they can repair themselves leading to the progression of local and systemic inflammation. Hormonal imbalance, furthermore, in which estrogen deficiency or estrogen dominance, insulin resistance, and/or adrenal dysfunction occurs in both men and women for example, produces an inflammatory acidic milieu within the body promoting osteoarthritis (16). Estrogen, and insulin are pro-inflammatory while hormones like progesterone and testosterone tend to be less inflammatory. Such an acidic and pro-inflammatory state promotes degeneration of tissues including joints.

Obesity or higher body fat-to-muscle ratio establishes an environment of inflammation as do chronic infections (16). Chronic infections produce biotoxins, neurotoxins, mycotoxins and endotoxins which are their byproducts, toxins and remnants. These toxins often inflicting people with mold, chronic tick borne infections, chronic viral infections, parasitic infections, and chronic bacteria along with depleted healthy gut microbiome, lead to chronic inflammation. Stealth infections such as those found in infected root canals, or in the jaw bone, for example, can release biotoxins throughout the body, again creating a chronic inflammatory environment which promotes arthritis.

These toxic environments within the body produce an pro-inflammatory cascade of cytokines response causing degeneration of tissues. The resulting pro-inflammatory immune particles often land in areas of the body that have been traumatized, injured, or scarred, such as the joints. The resulting chronic inflammation in the susceptible joints over decades leads to the degeneration of cartilage and joint. After years of insult from chronic inflammation and degeneration, pain, swelling, and stiffness of the joint or multiple joints occurs.

So what can we do to prevent the risks of osteoarthritis, reduce the suffering and pain and minimize our risks for osteoarthritis?

Imagine you walk into a room that is flooded. You can spend the rest of your life cleaning up the water and the resulting decaying particles. But wouldn’t it be smarter, to identify the leaks and fix them as well so that you don’t have to continually clean-up the flood for the rest of your life. And even better would be to repair the floor and give it a polish. That is exactly the difference between treating the symptom versus treated the root causes, and the difference between conventional treatment of osteoarthritis and a regenerative integrative approach to the treatment of osteoarthritis.

Addressing the pain is not enough when it comes to osteoarthritis. Taking pain meds, steroid injections, even localized hyaluronic acid injections to help with the pain does not restore or slow the degeneration of the joint. In fact, cortisone injections, even though they may improve pain temporarily, often promote further degeneration of the joint longterm. Because we now know that osteoarthritis is the result of chronic systemic inflammation, we must identify the causative factors of inflammation, remove them and then help the body re-establish its balance and stimulate its healing and regenerative properties.

Change our lifestyle to reduce risks

Majority of modern-day system inflammation is caused by our lifestyle, daily habits and our nutrition. Preventing system inflammation by controlling blood sugar and insulin, improving our exposure to environmental toxins, improving estrogen metabolism, eating a highly dense nutritious food, incorporating regular low impact exercises to improve oxygenation to joints, managing our stressors, meditating daily, and practicing good dental hygiene are some of the ways we can keep systemic inflammation down to reduce our risks for osteoarthritis. The good news is that as we incorporate these practices, we also reduce our risks for heart disease, diabetes, cancer and more.

Get to the root cause!

Identifying and correcting the root causes is often a complex process and a necessary component of truly healing. The ground work to clean up and correct the inflammation resulting from toxins, infections, emotional stressors, hormonal imbalances, chemical and metal exposures, food intolerances, gut microbiome, etc can take time, patience and is an exercise in learning to truly love and respect oneself and others as we engage in creating new lifestyle and dietary habits and spiritual exercises. Self diagnosis and treatment of the many complexities of imbalances within the body is insufficient and can be dangerous. We often miss our own blind-spots as our emotions and mind potentially produces a veil to our physical reality. The process of investigation and correction of the root imbalances, therefore, must be performed by a knowledgeable and enlightened physician who can identify and guide the individual through their blind-spots towards healing.

As root causes and systemic imbalances are being evaluated and treated, the local joint must also be treated. This is like cleaning up the water, repairing the damage and giving it a polish aspect of the treatment for osteoarthritis. At this stage, we often investigate the benefits of ozone therapy, platelet-rich plasma, peptides, exosomes, and/or stem cell therapy, or any combination of any of these. For the purpose of this conversation, we will focus mainly on ozone therapy, and platelet-rich plasma.

Ozone therapy for joints?

Every cell requires oxygen to function, to replicate itself and to grow. Without the essentials of oxygen, cells die. Tendons, ligaments, and cartilage in and around joints have insufficient blood flow. Lower blood flow to joints means less oxygen and less nutrients which translates to slower healing process. Simply, by injecting ozone (O3), three atoms of oxygen in one molecule, to the joint region, a more reactive form of oxygen is uptaken by the tissues of the joint and utilized to regenerate its cells, repair the damage, and improve its function. O3 inhibits the pro-inflammatory cytokines which often damage joints and cartilage. Ozone improves cellular anti-oxidant activity, corrects Redox and supports cartilage health (4).

In a randomized, double-blinded placebo controlled clinical trial looking at 98 patients with osteoarthritis, those who received ozone injection versus placebo, had significant improvements in pain, function, mobility and quality of life (3). Other studies have looked at the ozone for reducing inflammation and improving joint function in osteoarthritis joints (5, 6).

Now, let’s briefly look at PRP.

PRP stands for platelet-rich plasma. PRP extracted from one own’s blood contains platelets, growth factors, and immune cells. These cells have been found to have a profound effect on tissue healing, regeneration, and in inflammation reduction. Once extracted from one’s own blood, the plasma is then injected into the region or into the osteoarthritic joint to promote its healing, helping reduce its inflammation and pain while promoting stabilization of the joint from further degeneration. PRP appears to be chondroprotective (7, 9). PRP containing lower amounts of white blood cells (WBC) appears to be more protective against osteoarthritis degeneration, stimulating stronger tissue and stem cell regeneration.

PRP contains multiple growth factors, with the most abundant being platelet-derived growth factor (PDGF), transforming growth factor (TGF-B1), vascular endothelial growth factor (VEGF) and epidermal growth factor (EGF) (8). The various components of PRP appear to stimulate mesenchymal stem cells (MSCs) to generate as well as chondrocytes to grow. These factors help the body synthesize type II collagen. PRP also appears to suppress inflammatory cytokines, thereby reducing inflammation and pain in the joint (7).

Hyaluronic acid is one of the more commonly used conventional injection therapies for osteoarthritis. In a clinical study comparing hyaluronic acid injections with PRP, those who received PRP had more pain relief and improved function one year later than those who had received the hyaluronic acid injections (10).

Then, What About PRP with Ozone?

Novel research has been looking at the benefits of PRP with ozone therapy in osteoarthritis. The bottom line is that when PRP is ozonated or combined with ozone in patients with osteoarthritis, there is faster recovery and better outcomes with function, and pain (11). And in another study, ozonated PRP showed improvements in tendon to bone healing (12). In a 2018 European study, 120 patients with knee osteoarthritis were given either PRP, ozone or combined ozone and PRP. All three groups did well after 3 injections given weekly. However, the group that had the most pain relief and improved function was the PRP with ozone group (13). PRP and ozone treatments have been shown to be safe.

Conclusion:

Regenerative therapies are proving to be valid options for the treatment of degenerative and inflammatory conditions such as osteoarthritis. Osteoarthritis is not only a local inflammatory condition but it signals a chronic systemic inflammatory condition. Evaluating and addressing the root causes of the chronic inflammation is imperative for improving long-term outcomes and prevention of osteoarthritis. To address the local degenerative and inflammatory condition of osteoarthritis, regenerative therapies, such as ozone and PRP are proving to be promising in reducing pain and inflammation, stabilizing the joint, improving function and quality of life. Of course, more research is further needed in the field of regenerative medicine.

How Common is Osteoarthritis?

How does osteoarthritis occur?

More causes of inflammation

So what can we do to prevent the risks of osteoarthritis, reduce the suffering and pain and minimize our risks for osteoarthritis?

Change our lifestyle to reduce risks

Get to the root cause!

Ozone therapy for joints?

Now, let’s briefly look at PRP.

Then, What About PRP with Ozone?

Conclusion:

References:

Let's find the root cause —
not just treat the symptoms.

How Common is Osteoarthritis?

How does osteoarthritis occur?

More causes of inflammation

So what can we do to prevent the risks of osteoarthritis, reduce the suffering and pain and minimize our risks for osteoarthritis?

Change our lifestyle to reduce risks

Get to the root cause!

Ozone therapy for joints?

Now, let’s briefly look at PRP.

Then, What About PRP with Ozone?

Conclusion:

References:

Let's find the root cause — not just treat the symptoms.

Let's find the root cause —
not just treat the symptoms.