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Prevalence Of Bone & Joint Disorder

  • Arthritis is the common term used to describe over a hundred medical conditions that impact the  musculoskeletal system, in particular, the joints. The  most common form of this degenerative joint disease is known as osteoarthritis.
  • Osteoarthritis which is the most prevalent form of arthritis and the leading cause of disability in India affects over 15 million Indians each year. About 20 years ago, osteoarthritis was known as a disease of the elderly affecting those above the age of 65 years. However, orthopedic surgeons are increasingly diagnosing osteoarthritis in younger people of age group of 35-55 years.

  • Worldwide osteo-arthritis is the most common articular disease of people 65 years and older. It represents a major cause of disability in the United States and affects more than 20 million Americans and may double over the next 10 years.

  • In the UK alone, it is thought that 10 million people, or 1 in 5 of the adult population are suffering from arthritis. In most cases, it's not one joint but several that are affected by this disease. Arthritis is most commonly associated with hip and knee joints, as well as wrists and fingers. It can affect people of all ages, although the elderly tend to be more susceptible.

  • WHO estimates that 40% of people over the age of 70 years suffer from OA knee and about 80% of the people at some time in their life have had low back. Osteoporotic hip fracture, injuries and diseases of the musculoskeletal system account for more than 20% of patient visits to primary care physicians. The global prevalence of disease ranges from 14% to as high as 42%.

  • Rheumatoid arthritis, the other crippling form of arthritis, affects mainly small joints. This is a chronic systemic autoimmune disorder affecting approximately 1% of the population and leading eventually to joint deformation, dysfunction and disability in most diseased individuals.

  • These patients need effective treatments which are safe and effective as the duration of therapy is much longer and may be for lifelong in many cases.

 CURRENT TREATMENTS, THEIR SHORTCOMINGS AND NEW APPROACHES:

  • Drug treatments of arthritic joints are aimed primarily at alleviating symptoms, but do little to correct the underlying cause. These include taking NSAIDs. However, there are serious adverse effects associated with their long-term use.

  • Nonselective CoX inhibiting NSAIDs also inhibit prostaglandin synthesis at gastric mucosa and may

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result into severe forms of gastric injuries and ulcers over a period of time. Certain NSAIDs like Nimesulide are under question due to their adverse impact on liver functions whereas many coxibs are already withdrawn from the market due to adverse effects on cardiovascular and renal functions.

  • Interesting fact is that, NSAIDs restrict sulfate availability, so cartilage cannot be repaired1.This is a shocking fact for many people who are trying to heal their injury with these drugs, yet are actually doing more harm than good by depleting their sulfate levels.

  • Conversely, certain natural supplements can reduce pain and also improve the structural aspects of the joint and therefore slow or perhaps prevent and reverse disease progression. The two most widely studied and clinically used synergistic substances are glucosamine and MSM.

  • The role of certain sulfur containing amino acids is also important. Joint structures, mainly cartilage, require large quantities of sulfur to form its basic structure. Racemethionine and taurine are naturally occurring sulfur containing amino acids and are the major sources of sulfur. Further these amino acids also involve in antioxidant protection directly as well as by forming other important substances like S-Adenosyl Methionine (SAMe) and glutathione. The currentresearch is backing the additional benefits of their supplementation during osteoarthritis, rheumatoid arthritis and other forms of bone and joint disorders18,19,20 .

  • Cartilage is a solid connective tissue that is to a certain extent pliable, making it resilient. These characteristics of cartilage are due to the nature of its matrix. The ground substance of cartilage is rich in proteoglycans consisting of a core protein with numerous (about 100) glycosaminoglycans (GAGs) attached in bottle-brush fashion around it. GAGs are made of repeating units of disaccharides, one of which is always a glycosamine (hence the name) such as glucosamine or galactosamine. In cartilage, the GAGs attached to the core proteins are chondroitin sulfate and keratan sulfate.

  • The proteoglycans themselves are attached, by special linker proteins to long, rigid molecules of hyaluronic acid (HA). HA itself is a GAG, but is composed of several thousand disaccharide units, rather than several hundred or less, as are other GAGs. About eighty proteoglycans are attached to one molecule of HA.

  • The sulfate groups of the GAGs attract water. Between 60 and 80 percent of the net weight of (hyaline) cartilage is water and this large component of water accounts for the resilient nature of cartilage. Water is attracted to the negative charges in the abundant sulfate and carboxyl groups on the GAGs. This bhydration permits diffusion of water-soluble molecules in the ground substance.

  • Inside the joints, cartilage is undergoing a constant process of breakdown and repair. The body requires the building blocks of cartilage to be present and available. Glucosamine and MSM are the natural substances found in and around the cells of cartilage that help in this process. Many sulfur containing amino acids such as racemethionine and taurine are important sulfur donors that maintain the resilient structure of cartilage.

  • Increased wear and tear or insufficient supply of the above mentioned basic ingredients may result in to weakening of protective effect of cartilage causing arthritis and other joint related disorders. The bones rub against each other unprotected causing stiffness, pain, inflammation and swelling. Consequently, the affected joints have restricted mobility and this can be very debilitating for patients.