Common Ailments in Germany - What to Do About Osteoarthritis?

Osteoarthritis is a widespread condition. The Robert Koch Institute estimates that around 18% of adults in Germany suffer from complaints due to the joint disease. Women are affected more often at nearly 22% than men (almost 14%). In the age group over 65, even over 48% of women suffer from osteoarthritis, while it is about 31% for men.

Much more important than incidence or prevalence for those affected is: osteoarthritis is painful. Osteoarthritis can even be accompanied by almost unbearable pain. Michelangelo had to experience this in the 16th century, and currently even stars like former Spice Girl Victoria Beckham complain about osteoarthritis pain.

But what helps with osteoarthritis and how can osteoarthritis be prevented? Is there perhaps even a miracle cure for osteoarthritis?

As early as the 16th century, Michelangelo complained about osteoarthritis symptoms

What is osteoarthritis?

Osteoarthritis is an exceptional wear of the joint cartilage:

Primary osteoarthritis

Osteoarthritis can appear as a primary disease. According to current knowledge, excessive joint wear due to primary osteoarthritis is essentially genetically determined. However, individual factors such as lack of exercise, poor nutrition, and stresses from overweight or similar can promote its occurrence.

Secondary osteoarthritis

Secondary osteoarthritis, on the other hand, is the result of other occurrences. This can be a primary disease like arthritis (joint inflammation). But also individual or multiple triggering events related to misuse or overuse of the joints can lead to secondary osteoarthritis. This problem is often found in craft or industrial work environments.

What types of osteoarthritis are there?

Different forms of osteoarthritis are distinguished based on their location in the body:

• Hip osteoarthritis (coxarthrosis): It can occur with malformations of the joint socket, cartilage injuries, or blockages in the joint.
• Knee osteoarthritis (gonarthrosis): It is distinguished whether it occurs in the entire knee or only in one joint compartment.
• Herniated disc (disk prolapse): It arises from new bone formation due to degeneration of the intervertebral discs.
• Finger osteoarthritis (Heberden's osteoarthritis): It leads to a decrease in strength, grip endurance, and dexterity of the hands.
• Osteoarthritis of the thumb saddle joint (rhizarthrosis): It has similar symptoms to finger osteoarthritis.
• Osteoarthritis in the ankle joint: It is often the result of sports injuries and therefore mostly affects younger people.
• Spinal osteoarthritis (spondylarthrosis or facet joint osteoarthritis): This involves wear of the so-called facet joints, associated with cartilage loss, which causes painful rubbing of the joints.
• Midfoot osteoarthritis and Lisfranc joint osteoarthritis: Osteoarthritis of the midfoot or metatarsal bones often affects women.
• Osteoarthritis of the big toe joint (hallux rigidus): This type of osteoarthritis can be a late consequence of a splayfoot.
• Shoulder osteoarthritis (omarthrosis): It is a rare form of osteoarthritis, mainly affecting people of very advanced age.
• Elbow osteoarthritis (cubital osteoarthritis): This type of osteoarthritis is also rare and usually results from improperly treated fractures near the elbow.

What is activated osteoarthritis and how long does it last?

Activated osteoarthritis is a secondary inflammatory development based on arthritic micro-injuries due to overuse or incorrect loading. Usually, activated osteoarthritis is an acute condition.

How long does activated osteoarthritis last? 
You should expect symptoms to occur over a period of up to 2 months or longer. 

Warning: The inflammatory phases of activated osteoarthritis are usually acute but accelerate irreversible degenerative processes in the cartilage tissue. They therefore cause osteoarthritis to progress faster.

Distinguishing osteoarthritis and arthritis

Osteoarthritis and arthritis are often confused. However, arthritis is not joint wear but joint inflammation, which can be bacterial or rheumatic in origin or occur as a result of psoriasis (psoriatic arthritis) or a disturbed uric acid metabolism (gouty arthritis). Also note that the distinction can be complicated in the literature because the Anglo-American term osteoarthritis (OA) is regularly used for osteoarthritis.

Stages and symptoms of osteoarthritis

The insidious thing about osteoarthritis is that it practically starts without symptoms. Only in the second stage do mild, temporary pain during exertion and slight stiffness of the joints, especially in the morning, appear. Only in the third or advanced stage do joint pain and stiffness become stronger and begin to become chronic. Resting pain and joint creaking may also occur. In the fourth stage, constant, severe pain is felt. The joints are then only very limited in mobility.

How can osteoarthritis be prevented?

One of the most effective measures against joint wear is, of course, effective osteoarthritis prevention. It essentially consists of two components that should also accompany therapy: exercise and nutrition.

Exercise should take place regularly and frequently. However, special strain on the joints should be avoided. Recommended activities include swimming and cycling, as well as certain hiking activities, including Nordic walking. A specially designed gymnastics program can also be added.

Nutrition is, as always, about moderate balance. Any excess weight should be reduced and body fat mass lowered. Fresh fruit and especially vegetables should be the main sources of food. In particular, allium vegetables like onions, garlic, leeks, chives, and similar can be a true miracle weapon against osteoarthritis. 

This may be due to typical ingredients such as diallyl sulfide and methylsulfonylmethane (MSM). You should largely avoid red meat and refrain from tobacco and preferably also alcohol. At the very least, alcohol consumption should be limited to a minimum.

Which doctor is responsible for osteoarthritis?

Fortunately, osteoarthritis is well treatable. However, it is important that you see a doctor as early as possible. This should be a specialist in physical and rehabilitative medicine or an orthopedist.

What can be done against osteoarthritis?

Osteoarthritis therapy begins with a conservative treatment that includes the nutrition and exercise program as described above. This is supplemented by physical applications such as heat and cold therapy as well as physiotherapeutic exercises. 

In addition, pain-relieving medication treatment can be carried out, for example, with active ingredients like diclofenac, naproxen, or ibuprofen. When developing the treatment plan, the doctor also determines what the best ointment for osteoarthritis is in the individual case.

What else helps against osteoarthritis? Are home remedies also recommended?

Meanwhile, conventional medicine has recognized that naturopathic methods can also support conservative treatment. Numerous studies repeatedly show that mostly side-effect-free home remedies from folk medicine such as arnica, willow bark, or devil's claw can have a pain-relieving effect in osteoarthritis. 

This can enable the doctor to include them in the therapy to reduce the use of synthetic painkillers. This can lower the risk of side effects. Furthermore, natural remedies can positively influence how long activated osteoarthritis lasts.

In addition, attention is increasingly focused on bitter substances. They can already play a special role in dietary adjustments. Folk medicine values them for their stimulating effects on intestinal activity and fat metabolism.

What does Hildegard von Bingen say about osteoarthritis

In Hildegard von Bingen, chapter 69 of her Physica contains a recipe possibly applicable to osteoarthritis based on apium or celery. However, it must be considered that until the early modern period, arthritic and probably also osteoarthritic diseases were only referred to as podagra or gout. 

Saint Hildegard recommends "against severe gout pain" a powder made from celery, rue (Ruta graveolens or wine/garden rue), nutmeg, cloves, and saxifrage (Saxifraga granulata) to be taken several times "both on an empty stomach and after meals."

Surgical procedures against osteoarthritis

If osteoarthritis is too advanced, doctor and patient can also agree on surgery. For some types of osteoarthritis, there is the option of minimally invasive procedures through cartilage cell transplantation. 

If osteoarthritis has developed in the spine, a pain block may also be considered. Otherwise, there is the option of a partial prosthesis or a total endoprosthesis in the form of artificial joints.

Conclusion - Lifestyle matters in osteoarthritis

With osteoarthritis, it is important to act early and preferably preventively. The most promising treatment method for this is a lifestyle adjustment. 

But even if symptoms are already present, nutrition and exercise programs can be a kind of miracle weapon against osteoarthritis and delay or completely avoid surgery for many years. 

Those who use certain natural remedies in consultation with their doctor may be able to reduce the need for synthetic medications.

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