Knee Arthritis On Rise

Nearly Half of U. S. Adults Will Develop Disease Per Study

Painful knee arthritis, a leading cause of hospitalization and disability for the condition, is soaring. During their lifetimes, 45 per cent of Americans will develop knee osteoarthritis (OA) in at least one knee by age 85, according to a study sponsored by the U.S. Centers for Disease Control and Prevention (CDC).

The study identified two major risk factors for developing knee osteoarthritis: Obesity (including overweight) and Age. The researchers said these risks underscore the immediate need for greater use of clinical and public health interventions==, especially those that address weight loss and self-management==to reduce the impact of having knee OA.

Study authors explained from their findings that the risk of developing knee arthritis rose significantly with weight:

  1. Normal weight: 35%
  2. Overweight: 44%
  3. Obese 65%
"Simply put, people who keep their weight within the normal range are must less likely to develop symptomatic knee osteoarthritis as they get older, and thus much less likely to face the need for major surgical procedures such as knee replacement surgery," Dr. Joanne Jordon of the University of North Carolina, one of the researchers, said in a statement.

The study was conducted on 3,068 North Carolina adults age 45 and older by the CDC and the University of North Carolina.

The authors found there were no significant differences in knee arthritis risk associated with sex, race or education level. The people in the study were interviewed and were given an exam that included x-ray images of their knees.

The study, Lifetime risk of symptomatic knee osteoarthritis, was published August, 2008 in the journal Arthritis Care and Research.

2016 study: 62.5 percent of arthritis patients use dietary supplements

Research shows increasing numbers of Americans in record numbers are successfully using natural arthritis pain remedies for their daily lifestyle and overall health. These patients often choose self-managed natural pain relief supplements when conventional drug therapies are of concern or have not provided acceptable results.

One 2016 study, using a nationally-represented sample of 4,606 participants from the 2011-2012 National Health and Nutrition Examination Survey (NHANES), showed that 62.5 percent of adults with arthritis reported taking at least one dietary supplement within the past 30 days. This compared to 49.0 percent of adults without arthritis who used supplements.

Among 721 arthritis participants that included knee arthritis were taking at least one supplement, 15.1 percent indicated at least one of their supplements was 'for healthy joints, arthritis', compared to only 7.7 percent of participants without arthritis Glucosamine and/or chondroitin were the most common types of supplements used to improve joint health in arthritis.

(Glucosamine has been widely used for knee pain relief).

Study conclusions: Given that more than three out of five individuals with arthritis regularly use dietary supplements, health practitioners should be prepared to discuss potential benefits and risks of supplementation for the management of pain and function in arthritis. The research, Dietary Supplementation is More Prevalent Among Adults With Arthritis in the United States, was authored by Patrick Wilson and published December 2016 in the journal Complementary Therapies in Medicine.

What is knee osteoarthritis?

Osteoarthritis is the most common arthritis type, and when it affects the knee, as opposed to other joints, it is more apt to cause symptoms, including pain and stiffness, and functional limitation.

Knee osteoarthritis is often called degenerative joint disease (DJD) or the “wear and tear disease” that wears away cartilage that cushions the knee joint.

Osteoarthritis can affect any joint but most often affects the hands, hips, knees and spine. It gets worse over time and there is no cure for osteoarthritis or rheumatoid arthritis.

As the condition becomes disabling, knee replacement surgery may be recommended.

Knee pain causes

The knee is a hinge joint with one of the widest ranges of motion of any joint. The knees are the body's primary weight-bearing joints. For this reason, they are among the joints most commonly affected by osteoarthritis.

No one knows what causes knee arthritis. However, some of the causes are believed to include:

  1. Previous injuries—an old trauma to a knee joint increases the risk of osteoarthritis forming there.
  2. Heredity—some people inherit a defective gene responsible for cartilage production which can increase their susceptibility to osteoarthritis.
  3. Weight—overweight and obese people have a higher incidence of developing osteoarthritis of the knee due to increased loads their weight places on the knee joints.
  4. Repetitive overuse—running and jumping, participation is certain sports or occupations leads to repeated joint stress over a long period of time.

Usually, knee arthritis comes on slowly. In fact, only one-third of people whose x-rays show evidence of osteoarthritis report pain or other symptoms. Often pain symptoms of arthritis are not noticed as much until age 45 and older.

Knee arthritis pain symptoms

Generally, the pain associated with knee arthritis develops gradually, although sudden onset is also possible. More pain may become an issue as the disease progresses. If arthritis symptoms are not treated, osteoarthritis of the knee can lead to disability.

The warning signs of knee arthritis include:

  1. Steady or intermittent pain in a knee joint, especially upon movement.
  2. Stiffness of the knee after getting up in the morning, or after driving or sitting for a long time.
  3. Difficulty getting in and out of the bathtub, and in and out of chairs.
  4. Pain and difficulty when going up and down stairs
  5. Swelling, or tenderness, making it difficult to bend or straighten the knee.
  6. Knee locking, buckling, or catching. A crunching feeling, or the sound of bone rubbing on bone.
  7. Weakened thigh muscles
  8. Weather changes increasing the degree of pain from arthritis of the knee
  9. Pain? Not always.
  10. Hot, red, or tender? Probably not osteoarthritis. Check with your doctor about other causes, such as rheumatoid arthritis.

Diagnosis of arthritis of the knee

Only a qualified medical doctor can diagnose knee arthritis. It will be necessary for your doctor to perform a physical examination that focuses on your walk, the range of motion in your knee joints, as well as determining joint tenderness or swelling.

X-rays of the affected knee(s) will be taken to reveal the extent of lost joint space between the knee joints.

Other imaging tests may be ordered, such as magnetic resonance imaging (MRI) and blood tests to diagnose rheumatoid arthritis. One of peculiarities of rheumatoid arthritis is that often the same joint is affected on both sides of the body (both knees, both hands, both ankles, etc.).

Only about one in four diagnoses of osteoarthritis of the knee will require immediate surgical procedure. Effectiveness of different treatments for knee arthritis varies from person to person.

When is knee joint replacement necessary?

Osteoarthritis is the most common cause of knee arthritis requiring knee replacement and may be recommended in the following situations:

  1. Failure to respond to conservative therapy (NSAID or alternative natural medication) for six months or more.
  2. Significantly decreased knee function caused by osteoarthritis or other knee arthritis
  3. Unable to work because of knee pain
  4. Inability to sleep through the night because of knee pain
  5. Inability to walk more than 3 blocks because of knee pain.
  6. A loose knee prosthesis from previous knee surgery
  7. A fractured knee

Non surgical knee arthritis treatments

Your doctor may present a wide range of non-surgical treatment options whether your diagnosis is knee osteoarthritis or rheumatoid arthritis. His/her objective is to obtain patient satisfaction by trying to reduce pain, increase function, and reduce overall symptoms. Non surgical knee arthritis treatments fall into seven basic groups:

  1. Lifestyle modifications—Losing weight for many people can reduce stress on weight-bearing joints, such as the knee. Simply losing weight can reduce pain and increase function, such as walking. Swimming or cycling exercises are preferred over running or jumping.
  2. Exercise—Your doctor or a physical therapist may help develop an individualized exercise program that meets your needs and lifestyle. Exercises can help increase range of motion and flexibility and help strengthen leg muscles and reduce pain.
  3. Supportive devices—Walking aids, such as a cane, can reduce pain and disability, as can wedged shoe soles or inserts, knee braces and sleeves.
  4. Other methods—These can include applications of heat or ice, liniments or elastic bandages.
  5. Drug treatment—Most doctors will prescribe a non-steroidal anti-inflammatory drug (NSAID) as medication to reduce pain and reduce inflammation. These can include aspirin, acetaminophen, ibuprofen contained in over-the-counter preparations. All drugs have potential side effects, including gastrointestinal bleeding and ulcers. Nonetheless, these pain relievers are usually the first choice of therapy for osteoarthritis of the knee. Prescription drugs, such as Celebrex, may also be prescribed. Corticosteroids are powerful anti-inflammatory agents that can be injected into the joint. A viscosupplementation injection into the affected joint with hyaluronic acid can be helpful for people whose arthritis has not responded to other treatments.
  6. Natural treatment--You may be able to obtain the same degree of pain relief for knee arthritis without the side effects of drugs when you choose high quality herbal or plant-based treatments.
  7. Alternative therapies—Alternative knee arthritis therapies include the use of acupuncture and magnetic pulse therapy. Many such forms of therapy are unproven by clinical trials, but some patients prefer to try anything other than continuous drug treatment.

Surgical knee arthritis treatment

If knee osteoarthritis does not respond to the above non-surgical treatments, you may need to have surgery. There are several surgical options, including the following:

  1. Arthroscopic surgery—This is usually the first surgical procedure recommended. Arthroscopic surgery uses fiber optic technology to enable the surgeon to see inside the joint. This surgery requires small incisions only, and allows the surgeon to clear the joint of debris or to repair torn cartilage.
  2. Osteotomy surgery—This is an operation in which the bone is cut to change its alignment or shorten or lengthen it. For the knee it involves cutting the shinbone (tibia) or the thighbone (femur) to improve the alignment of the knee joint.
  3. Arthroplasty surgery—This is a total or partial knee replacement. In this surgery the severely damaged knee joint cartilage is replaced with metal and plastic.
  4. Cartilage grafting surgery—This surgery of the articular cartilage is usually for younger patients as an alternative to knee replacement. It removes undermined or diseased cartilage with the aim of trying to stop inflammation.

New study shows hospitalizations for knee surgeries are soaring

Another recent report by an agency of the U.S. Department of Health and Human Services showed that hospitalizations due to osteoarthritis rose to 735,000 in 2006 (the latest year statistics are available) from 322,000 in 1993, mostly due to an increase in knee replacement operations.

From 2000 to 2006, knee replacement surgery rates rose 65 percent, while hip replacement surgery rates rose 21 percent, according to the Agency for Healthcare Research and Quality.

September, 2008 study: Arthroscopy may not help knee arthritis

Arthroscopic knee surgery for people suffering from knee arthritis doesn’t reduce joint symptoms or improve its function compared with optimal non-surgical treatment, according to a new study published Sept. 8, 2008 in The New England Journal of Medicine.

"This study provides definitive evidence that arthroscopic surgery provides no additional therapeutic value when added to physical therapy and medication for patients with moderate osteoarthritis of the knee," says study researcher Brian Feagan, MD, clinical trials director at the Robarts Research Institute at the University of Western Ontario and a professor of medicine, and epidemiology and biostatistics at the university's Schulich School of Medicine & Dentistry.

However, Bob Litchfield, MD, an orthopaedic surgeon and one of the study's researchers, explained that the study focused on arthritis-related knee problems, emphasizing that arthroscopic knee surgery is still beneficial in many other conditions that affect the knee, such as meniscal and ligament problems. "As surgeons, we need to know when things are working and when they're not," says Litchfield of the Fowler Kennedy Sport Medicine Clinic and the University of Western Ontario.

A 2002 study demonstrating similar results to this study was broadly dismissed by the medical community, and arthroscopic surgery of the knee remains a common treatment for joint pain and stiffness. But in this latest study the researchers conclude "based on the available evidence, we believe that the resources currently allocated towards arthroscopic surgery for osteoarthritis would be better directed elsewhere."

Natural supplements for pain treatment have minimal side effects

Natural treatment of symptomatic knee arthritis has the same objectives that doctors have—controlling the pain, maintaining patients’ functional independence and improving their quality of life. This focus also attempts to prevent structural deterioration with the hope of delaying the need for total knee replacement.

Unfortunately, prolonged use of traditional non-steroidal anti-inflammatory drugs has side effect risk, especially gastrointestinal, that's not experienced with natural supplements. In addition, the body assimilates nutrients at the cellular level from natural plant-based formulations, which is not possible with drugs. Glucosamine, for example, offers the possibility of repairing or regenerating joint tissue and cartilage.

At the end of 2007, industry sources reported that the growth of the top performing products in the estimated $24 billion U.S. dietary supplement market is rising at double digit rates thanks to increased consumer focus on alternative health answers to the seemingly endless side effects caused by traditional drug treatment for pain relief of many diseases.

Study shows supplements most effective for moderate to severe pain

If your knee arthritis pain is moderate to severe and you’re worried about health risks from long-term use of pharmaceutical painkillers, you may want to try the natural

dietary supplement, glucosamine hydrochloride, according to a 2006 government funded study. Pain relief will be similar to the use of the drug, Celebrex, or its generic equal (acetaminophen and hydrocodone in combination), but without their harmful side effects.

The Glucosamine/chondrotin Arthritis Intervention (GAIT) study, published in the New England Journal of Medicine (NEJM) in February, 2006, suggested that glucosmine hydrochloride (HCL) and chondroitin sulfate provide significant pain relief for people with moderate to severe pain from knee osteoarthritis. The study was sponsored by the National Institutes of Health (NIH).

The study compared the effectiveness of glucosamine hydrochloride (HCL), chondroitin sulfate, a combination of glucosamine and chondroitin sulfate, the drug celecoxib (Celebrex), or a placebo in people with knee osteoarthritis.

Glucosamine or chondroitin alone or in combination didn't reduce pain more than placebo in the overall mild pain group, but 79.2% of a small subgroup of people with moderate to severe pain did get significant pain relief from glucosamine hydrochloride and chondroitin combined, and 65.7% from glucosamine hydrochloride alone. The GAIT study confirmed that natural dietary supplements glucosamine hydrochloride and chondroitin significantly relieved knee arthritis pain for nearly 80% of patients with moderate to severe pain, exceeding results of the popular drug, Celebrex.

For other knee arthritis patients in the moderate to severe pain group, 69.4% taking celecoxib (Celebrex) experienced pain relief. For patients taking chondroitin alone, 61.4% experienced pain relief.

Roland Moskowitz, MD, professor of medicine at Case Western Reserve University in Cleveland, said having the study participants take their supplement dosage once a day instead of spreading it over three times a day, would have given a higher peak effect, increasing the odds of significant relief. The take-home message for knee arthritis: Dr. Moskowitz concluded of the study, “We have to say something is going on. A three-month trial is reasonable for people who have a lot of pain. If it’s working, by all means continue using them, as these supplements are extremely safe.”

GAIT study results lauded by nutritional association

“The NEJM’s (GAIT study) findings that two popular supplements actually work better than a popular prescription medication for knee arthritis underscore what millions of consumers already know. That is, natural products and dietary supplements, when used properly, hold great potential for improving health and well-being,” said Dr. Daniel Fabricant, Vice President of Science and Quality Assurance for the National Nutritional Foods Association (NNFA).

He added that demonstrated “efficacy and safety beyond that of the pharmaceutical intervention” is good news consumers should take note of. “This study is further proof that dietary supplements can play an integral role in consumer’s daily lifestyle and overall health,” said Fabricant.

“Arthritis is one of the most prevalent chronic health problems in today’s society, and with the use of certain dietary supplements, consumers can empower themselves to lead healthier and more productive lives, while potentially reducing health care costs to the U.S. health care system and reliance on prescription medications,” Fabricant concluded.

There's a wide variance in quality of dietary supplements

Following deregulation of the dietary supplement industry in 1994, hundreds of new small-sized companies flooded the industry with wonder products promising every known cure to the diseases of mankind, including knee arthritis.

These newcomers conducted no clinical studies or research or pre-market testing or even ingredient purity tests on their products whatsoever. Why should they bother? Such science is expensive and affects the bottom line and efficacy is not required by the Food and Drug Administration (FDA)for dietary supplements.

Attempting an answer, FDA introduced the current Good Manufacturing Practices (cGMP) rules for manufacturers in 2007.  The cGMP is well-intentioned, but rogue players continue to embarrass the industry.  The new rules have been lampooned as "too lax", "too loose", and virtually leaving manufacturers on the "honor system" for compliance.  The FDA is underfunded and undermanned for monitoring purposes.  The cGMP's did not mandate standardized testing for manufacturers.  As a result, some supplement makers are not testing at all.  Under the cGMP the FDA does not approve or even see a new product before or after it's marketed.

"This has been a `buyer beware' market," Dr. Mark B. McClellan, the FDA commissioner, admitted in an announcement about the 2007 regulations.. "Millions of Americans use dietary supplements every day, and we need to make sure they're getting the products they pay for."

“We’ve known about this problem for a long time,” said Dr. Wallace Sampson, editor of The Scientific Review of Alternative Medicine and a clinical professor of medicine at the Stanford University School of Medicine. “Dosing in these products can vary from 0 percent to 300 percent.”

In a 7-year period from 2010-2016 more than 60% of supplement makers were found in non-compliance of the safety regulations.  The supplement industry continues to be the target of widespread criticism for selling products for knee arthritis and other conditions with contaminated and undeclared ingredients, or with sub-potency. The media has characterized the industry as being largely unregulated as the guidelines lack teeth and are weakly enforced.  

Unlike pharmaceutical drugs, the cGMPs do not require dietary supplement manufacturers to do pre-market testing of their products. Therefore, proof of efficacy is not required. To be able to market a supplement, it's not an FDA stipulation that it works at all!  One company voluntarily clinically tests its products for efficacy and goes 'beyond organic' through ingredient purity tests.

However, the FDA has the power to enforce removal of tainted supplements when health issues have been raised by affected consumers. Some critics of the industry think this is too late and doesn't adequately protect the consumer.

How to find the best dietary supplement company

To help me find the best dietary supplement products, I first prepared a list of 30 questions to

measure standards of excellence in different supplement manufacturers.

The answers led me to a leader in the natural nutrition industry, founded in 1956. The science behind each of their products is second to none. They’ve invested more than $250 million in clinical testing, research and development and have over 135 published studies, 100 of which in peer-reviewed scientific journals—more than any other nutritional company!

This company voluntarily operates as if it is regulated the same as a pharmaceutical company—that’s a testament to their integrity.

Their beyond organic' philosophy really separates them from their competitors and helps earn their reputation as the gold standard in the dietary supplement industry.

Featured natural supplements provide knee pain relief and help build cartilage

They manufacture three natural pain relief products consisting of two oral dietary supplements and one topical pain relief cream. We haven’t found anything of better quality anywhere for our neck, shoulder and knee arthritis. The products help to relieve chronic or temporary pain from knee osteoarthritis, other types of arthritis or related pain-causing conditions.

We recommend these products together, or individually. The following bold paragraph-heading links for the supplements listed will take you without obligation to the manufacturer's product pages for prices and additional information on each:

Glucosamine & Boswellia Joint Relief

Clinical studies indicate that glucosamine hydrochloride is most effective when knee arthritis symptoms are moderate to severe. Glucosamine has the ability to rebuild cartilage for joint health and comfortable movement. Formulated with the addition of clinically proven boswellia.

Boswellia and Safflower Oil Pain Relief

When the boswellia herb and oil from the safflower are blended, it creates a potent, natural arthritis pain relief supplement without gastrointestinal side effects. In studies, these two ingredients together are more effective when combined, that they are separately. Boswellia extract is a very potent 5 Lox inhibitor. The safflower extract contains a potent ingredient that is a very selective Cox 2 inhibitor. Therefore, this product is effective against both the 5 Lox and Cox 2 pain pathways--both of the major pathways--which is the only product on the market of its kind. Its formulation and synergy is so unique that it's patented.

Menthol Pain Relief Rub

This is not your ordinary pain cream. It is a topical menthol analgesic that provides temporary relief (up to four hours) for minor pain associated with backache, arthritis, bruises and sprains. It offers fast absorption and deep penetration to soothe aching joints and muscles on contact. In addition to menthol, it contains a proprietary blend of natural ingredients that targets the source of discomfort and provides quick relief by improving blood circulation in the affected area. My husband uses it to provide pain relief for his shoulder arthritis before playing tennis. It really tackles pain because it has a liposome delivery system that penetrates as deep as four inches.

Recommended natural knee arthritis supplements

For pain relief of knee arthritis or rheumatoid arthritis of the knee, I highly recommend the three products listed above, known as the pain trio. (Please scroll this linked page for Our Arthritis Stories).

Disclaimer: Health statements have not been evaluated by the Food and Drug Administration. These products are not intended to diagnose, treat, cure, or prevent any disease.

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