Osteoarthritis and Healthy Aging

      Treating aging-related symptoms to support healthy aging is Westyo Acupuncture & Herb expert's specialty. 

What disorders are treated?

      Aging-related discomforts including:   

• Menopause
• Osteoarthritis pain, such as the neck, lower back, hip, knee, heel pain.
• Waking up to urinate at night.
• Sleep difficulty/insomnia.  
• Anxiety and depression.
• Poor memory
• Fatigue
• Stroke prevention and post-stroke recovery
• Infections, such as shingles, cold/flu, cough, etc.

How to relieve osteoarthritis joint pain, increase mobility, have a better quality of life?

1. Homework

• Calcium high foods, such as black sesame, leafy green vegetables, like Chinese broccoli. As dairy products can be beneficial if one's Yin is deficient. If one has damp phlegm accumulated inside of the body, better stay away. https://ods.od.nih.gov/factsheets/Calcium-Consumer/   
• Beneficial lifestyle, such as exposure to sunlight, go to bed and rise up according to the seasons' change, and avoid overexertion physically and mentally
• Exercise physically and mentally, like walking, meditation, Tai Ji, Qi Gong, Yoga, etc.
• Stress management, open-minded, humble, and kind to others and self

2. Professional Help

      Acupuncture and Chinese herbs.

      Many knee surgeries are saved through the conservative treatment from our Westyo Acupuncture & Herb clinic expert!

      The following article discusses osteoarthritis pain, the most common joint pain. It is an example of the integrative healthcare approach, combining the best from east and west medicine. 

 Osteoarthritis

an integrative medicine approach

Weiyan Liu, L. Ac. (Illinois), MS, MD (China)

Etiology

Neck pain, lower back pain, hip pain, knee pain, and heel pain are the most common osteoarthritis pain. Osteoarthritis is also known as degenerative joint disease. With aging, the bone loses its density and osteoporosis happens. A bone spur may form around the joint. Cartilage, the rubbery cushion covering around the ends of the bones allows bones to glide over one another. Cartilage consists of water, collagen, proteoglycans, and chondrocytes. With aging cartilage gets thinner and thinner. The bone ends under the cartilage rub together, causing pain, swelling, and loss of motion of the joint. These overall degenerations with aging “wear and tear’ are the main causes of osteoarthritis pain, the most common form of joint disorder. 

Even though all the joints in the body are going through degeneration with aging, the weight bearing joints, the neck, lower back, hip, knee, heel are the main locations of pain occurrence. In osteoporosis, the bone is not as strong to hold body weight as it did younger. A person gets shorter and shorter. Overweight puts more stress on the joints and worse the osteoarthritis pain. Long day working in standing position, climbing up and down, bending back and forth, squatting, etc. require more exertion of the involved joints. Osteoarthritis tends to run in families.

Symptoms

Pain and stiffness in the joints are the general symptoms. To minimize joint pain, the body recruits some muscles to keep the body in some position. This can lead to muscle and ligament pain involved. The pain is often worse after exercise and when weight or pressure is put on the joint, like standing, walking, etc. Resting a while can ease the pain. But later the pain may appear while resting. There may be some crackling sound when moving the joint. Some people experience morning pain and stiffness. It may subdue after awhile of daily activity moving around. Some people might not have symptoms at all, even though x-rays show the joints aging.

Exams and tests

The physical exam may find the joint has a limited range of motion, pain with movement, tenderness around or in the joint.

No specific blood test is available for the diagnosis of osteoarthritis right now. Sometimes a blood test is ordered to rule out certain joint pain, like rheumatoid arthritis, gout, etc.

An x-ray shows a loss of the joint space due to the thinning of the cartilage, a bone spur may appear. In severe cases, there is damage to the ends of the bone. But there often is a big difference between the severity of osteoarthritis as shown by the x-ray and the degree of pain and disability patients feel. X-rays may not show early osteoarthritis damage until much cartilage loss has taken place.

Magnetic Resonance Imaging is necessary if x-ray findings are minimal, confirm damages to the soft tissues such as a ligament or the meniscus, a connective tissue pad in the knee.

Lifestyle change ---Homework

Stay active and exercise regularly can slow down the loss of calcium with aging and help keep the bone, joint, muscle, and overall health. Swimming is a good exercise since it minimizes the weight being put on the joints. Yoga and Taiji are good choices too.

Eat a healthy balanced diet. Reduce soft drinks, sugar, salt and fat, etc.  Increase some beneficial food, like black sesame, walnut, green vegetables, etc.

Weight control.

Get rested when there is pain. Do not overuse the painful joint. Lose weight if one is overweight to insure the joint bears less physical pressure.

Emotional stress management is an important aspect in human life. Long-term under high emotional stress accelerates the aging process. The severity of symptoms in osteoarthritis can be influenced greatly by attitude, anxiety, depression, and daily activity.

Treatment---help from the healthcare profession

Since degenerative osteoarthritis is aging-related, instead of curring it,  the treatments modern bio-medicine currently adopted are mainly pain management to achieve daily function.

Non-drug therapy

Acupuncture to relieve osteoarthritis pain has a long history in China and is getting popular in America. Researches have been done around the world. NIH osteoarthritis website cited this research: Berman BM, Lao L, Langenberg P, Lee WL, Gilpin AM, Hochberg MC. Effectiveness of acupuncture as adjunctive therapy in osteoarthritis of the knee: a randomized, controlled trial. Ann Intern Med. 2004 Dec 21;141(12):901-10.

Physical therapy and massage can help the muscle strength and joint blood circulation, improve the motion of stiff joints and reduce pain to some degree. 

Medication and pain control

Over-the-counter pain relievers acetaminophen (Tylenol) and nonsteroidal anti-inflammatory drugs (NSAIDs) are common painkillers. Types of NSAIDs include aspirin, ibuprofen, and naproxen.

Narcotic or central acting agents, such as tramadol, codeine, and hydrocodone, are reserved for short-term use because of the potential of physical and psychological dependence.

Nutritional supplements such as glucosamine and chondroitin sulfate

Anti-inflammatory hormone corticosteroids is injected into the joint to reduce swelling and pain. Suggestion for this short-term measure is not more than 2-4 treatments a year.

Artificial joint fluid (Synvisc, Hyalgan) can be injected into the knee to reduce pain.

Surgery

Severe cases of osteoarthritis might need surgery to repair or replace damaged joints. As the invasive nature of the surgery, think about it only when adequate conservative measures have proven ineffective.

Chinese acupuncture and herb medicine

Even though the joint can not back to its prime time, manage its pain, restore its function, can be achieved through slow down the aging, also termed as anti-aging, strength the bone and sinew with Chinese acupuncture and herb medicine. Tonifying Kidney antiaging is the main strategy. Lots of unnecessary joint surgery can be exempt.

The use of Chinese acupuncture and herbal medicine is based on the vast and sophisticated theory system of Chinese medicine.  The strategy applied to treat osteoarthritis is mainly tonifying Kidney, an anti-aging strategy since osteoarthritis is degeneration-related.  It not only manages the pain but also balances the muscles, strengths the bone and sinew.

In the growing process of the human body, Kidney function involves accordingly. <<yellow emperor's="" inner="" classic="">> states, “For female when she is 7 years old, Kidney qi grows strong. Milk teeth are switched by permanent teeth. The hair grows. When she is 2* 7 years old, heavenly essence emerges. The menstrual flow starts. A child can be bearded. When she is 3* 7 years old, Kidney qi is even. Wisdom teeth grow and all the teeth come out. ……When she is 7*7 years old, Ren channel is deficient. Chong channel is decline. Heavenly essence is gone. Female reproduction function is blocked. The appearance degenerates. No more conceiving ability. For male, when he is 8 years old, Kidney qi is exuberant. Hair grows. Milk teeth give way to permanent teeth. When he is 2*8 years old, Kidney qi is even. Heavenly essence comes. Essence qi is full and flood. Upon having sex with women, a child can come into being. When he is 3*8 years old, Kidney qi is even, tendon ligament and bone are strong and powerful. Wisdom teeth grow and all the teeth growth is finished. ……When he is 8*8 years old, teeth and hair fall off. The kidney is responsible for water. It accepts and stores the essence from five Zang six Fu. So when five Zang is plenty and flourish, the drainage to the Kidney is possible. Now the five Zang are all down the hill. Ligament, tendon, and bone are loose and degenerate. Heavenly essence is used up. So white hair appear, the body feels heavy, the gate is unsteady, no more offspring making ability.”

In Chinese Medicine, the Kidney is responsible for water, maneuvers the bone, generates brain marrow, and responsible for reproduction. Its flourishing is showing on hair. It opens orifice in the ears, front and back Yin. Kidney function is closely related to aging. With aging, one, including male and female, may have to wake up to urinate at night. The bone becomes fragile and easily broken because of osteoporosis. Memory and the learning ability decline. Reproductive function reduced, Hair turns gray. Hearing is diminishing, etc.

Since osteoarthritis is related to the degeneration of the bone in the joint, tonify Kidney, strength the bone and sinew is the main method. Of course, there are other strategies that may be adopted according to the individual body situation, like nourish Yin, warm the Yang, tonify the righteous Qi, move stagnant Qi, resolve blood stasis, eliminate dampness and cold, unblock the channels, etc.

The selection of acupuncture points to treat joint pain is according to Chinese Medicine theory about pattern and channel diagnosis, and where is the joint pain located. Points like KID 3, 6, 10, SI 3, UB 62, UB 23, 40, 60, Ht 7, Ht 3, GB 30, 34, 40, Hua Tuo Jia Ji points, and local A-Shi points around the joints are commonly selected. 

Despite the joint pain, the patient may experience muscle pain. To minimize joint pain, the body automatically adopts a certain posture. With time moving on, the involved muscle overworked and tense up forming a painful tough ropy mass upon palpation. The unused muscles may decline to atrophy. Muscle imbalance appears. If this situation happens to the spin, the normal physical curvatures of the spin can be affected. Some parts of the spine may gradually become tilted or bent or protruded. Normal body posture balance lost. Transversely thread multiple needles across the painful ropy muscle is a good idea. Pay attention to the muscle motor points, which are located on that specific muscle. Or palpate along the muscle to find the tender spot, the A-Shi point. “Where is the pain, where is the point” is a strategy applied for general pain management.  

In Chinese Herb Medicine, the selection of formula is always following the pattern diagnosis. Modified DUO HUO JI SHENG TANG, TIAN MA GOU TENG YIN, ER XIAN TAN, etc. are the basic herb formulas used to treat osteoarthritis. The Kidney Yang tonic ingredients, like Ba Ji Tian, Xian Mao, Du Zhong, Xu Duan, Sang Ji Shen, etc. are the main ingredients used for the purpose of strength bone and sinew, resolve dampness, relieve pain.

Traditionally some of these herbs are used to increase libido. Menopause is related to hormone change and the degeneration of the reproductive system, which is one of the Kidney’s functions. Some of these herbs are important ingredients in treating menopause syndrome. Er Xian Tang is a formula developed for treating this aging phase of the female by Shanghai Shu Guang Hospital OB&GYN Department.

Hormone imbalance-related functional uterine bleeding, infertility and miscarriage, PCOS, dysmenorrhea, PMS, acne, etc. can also benefit from these Kidney Yang tonics. In addition, some of these herbs are chosen for cognitive function degeneration. The theory behind this is Kidney maneuvers bone and generates marrow. The brain is the sea of marrow.

Each person has his/her own unique body constitution. The human body’s Qi, blood, Yin, and Yang balance is a delicate system. The formula given to an individual person is specifically designed for the utmost fit. In the meantime, the human body is a dynamic balance, once a well-balanced formula does not fit for the same person forever. Following visit is needed to update the herb formula for a better fit.