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Joint Pain and Arthritis by David Musnick MD

Have you been told that you have Osteoarthritis(OA), or DJD of a knee, hip, neck shoulder, thumb or low back? Many Physicians and other providers do not really explain to their patients what this type of arthritis really is and most people get very few options for treatment other than rest or drugs like Aleve, Ibuprofen (NSAID drugs). One problem with that approach is that NSAIDs can have serious side effects in your kidneys or cause ulcers in your stomach and intestine. They also do not address many of the processes involved in OA so that the process continues and joints can get worse . If the OA is symptomatic and progressive you can have loss of joint range of motion, swelling, weakness, loss of strength and problems enjoying activities. It does make sense to have

a goal of keeping your joints as healthy as possible.

What is actually going on in a joint with OA?

There are a number of processes going on in a joint with OA including:

Narrowing of the joint surface

Decreased number of viable chondrocyte(Cartilage) cells and poorer quality of matrix surrounding the chondrocyte cells (the matrix supports the cartilage cells). Cartilage cells are very important because they maintain the cushioning between the bones of the joints and prevent “bone on bone."

Poorer quality synovial(joint) fluid that is less viscous

Enzyme breakdown of cartilage cells by metalloproteinases (destructive enzymes)

Inflammation with interleukins and other molecule

Bone spurring

Did you know that the more severe the OA of a joint the morel likely there is involvement of surrounding muscles and bone. There may even be fluid in the bone, cysts and/or decrease bone density in the joint.

Did you know that OA of one joint can make another joint worse like OA of the right hip leading to OA of the right knee. Did you know that OA of your thumb or finger joints is much more inflammatory than other types of OA. Did you know that there are many treatment options for OA.

The main thing that anyone with joint pain needs is a very comprehensive evaluation(including imaging and exam of the joints(especially for restricted motion or looseness of ligaments. The health care provider should look at the joints above and below the panful joint. They need to be educated about all of the processes that go on in OA of joints. It is also important that the provider

that you see can give you methods to support the cartilage, decrease all of the inflammation molecules, and stop the destructive enzymes. The patient with OA of a joint or joints also should see a provider that offers all of the possible treatments(or is aware of all of the possible treatments and is willing to refer for them.

What treatments are available for OA of a joint or of the neck or low back?

Well it depends on how severe that joint or region is. Here is a reasonably complete list of possible treatments:

Supplements, Hyaluronic acid injections, Platelet Rich Plasma(PRP) injections, Frequency Specific Microcurrent, PEMF, PT, Chiropractic, bracing and topical medicines. Did you know that Frequency Specific Microcurrent and PEMF are non drug treatments that can greatly decrease inflammation

and support regeneration of joints. Did you know that your own platelets in your blood have growth factors that can be concentrated 8-10x and injected into joints to aid regeneration especially of shoulders, thumbs, knees and hips. Set a goal of keeping your joints as healthy as possible, see to regenerate degenerative joints and get a very comprehensive evaluation.

About the Author: David Musnick MD is a Sports Medicine and Functional Medicine Dr at FMI Center for Optimal Health in Eagle. He has developed an Integrative approach to fully address OA of any joint/joints in the body. He offers all treatments other than surgery and has written a textbook chapter on OA in the book Metabolic Orthopedics, published in May 2018. Learn more here.


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