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Relevant Key Messages
Obesity and elevated body max index are high risk factor for Osteoarthritis. Obesity is associated with incidence and progression of osteoarthritis of both weight-bearing and non-weight-bearing joints (Arthritis Australia, 2017).
Osteoarthritis cu
ently has no known cure and the available treatments (both surgical and non-surgical) are associated with high risk of mo
idity and mortality due to adverse effects of the interventions (OARSI, XXXXXXXXXXIt is also noted that going through a joint replacement does not amount to remission or reversal of disability, but rather it lessens the disease severity though there may be improvement in pain and physical function, most people continue to suffer physical impairment post joint replacement (OARSI, 2016).
The use of nutraceuticals and their like-diets such as Pomegranates, green tea, devil’s claw, Ginger, Indian frankincense (Boswellia se
ata), Turmeric, and Ananas comosus (Akhtar & Haqqi, XXXXXXXXXXalthough they require high level evidence RCGP, (2018)), combined with exercise has the potential to counteract any damage which may be happening in the joints(Fraser, 2009),. The synovial fluid which lu
icates and nourishes the joints is squeezed into the cartilage when the joint is being exercised (Fraser, 2009).
Discussion
Researchers have identified three stages of prevention/management of OA;
Primary prevention: This stage according to Roos and Arden, XXXXXXXXXXinvolves those measures that could help in preventing the occu
ence of the condition, such as;
Weight control; Obesity is a high-risk factor for OA, thus maintaining a healthy weight would reduce the occu
ence of OA and other forms of arthritis.
Injury prevention: Injury of the muscles, bone and joints is a major risk factor for OA and can occur from repetitive movement that associates certain type of work, and also from some strenuous sports activities, falls and others. Preventing these injuries would prevent the occu
ence of OA (Roos & Arden, 2016).
Secondary prevention: According to Neogi and Zhang, XXXXXXXXXXthis stage, closer attention is paid on early diagnosis of OA by monitoring closely the suspected signs and symptoms. This will help in the early detection and timely intervention to reduce the progression of the disease. Although there are no particular effective biomarkers to track the disease progression, however, health professionals should endeavour to offer all people with clinically symptomatic osteoarthritis advice on;
How to access appropriate information;
The importance of activity and exercise;
Interventions to achieve weight loss if over-weight;
The importance of dietary supplements in balancing their diets (Neogi & Zhang, 2011).
Tertiary prevention: At this stage according to Norma, and Mary, (2010), prevention is based on the reduction of the consequences of the disease which is aimed to reduce, delay complications onset, and disability. This is mainly to reduce pain and disability, and improve functioning and quality of life. The strategies at this stage include;
Self-management
Home-help program
Cognitive behavioural interventions
Medical surgical treatment as last resort
Rehabilitation with exercise and physical activities, education on maintaining healthy lifestyle (Norma, & Mary, 2010).
A pyramid representing the stages of managing OA (GLAD Australia 2017).
Absence of cure for OA presents a burden on global health. Proper management and maintaining a healthy lifestyle can help in a great way to reduce the occu
ence of OA. Exercise and Nutraceuticals are of great benefit in reducing the progression of OA (OARSI, 2016)
PREVENTION AND MANAGEMENT OF OSTEOARTHRITIS;
The effectiveness of exercise and dietary supplements (Nutraceuticals)
Sussana Chilaka, XXXXXXXXXX
Recommendations
Medicinal fruits and he
s commonly used as dietary supplements for treatment of OA (Akhtar & Haqqi, 2012)
Regular exercise is important for relieving pain and improving function in people with osteoarthritis (RACGP, 2018).
Weight management is strongly recommended for the prevention and management of osteoarthritis especially for people with OA who are overweight or obese (Vincent et al., 2012).
Nutraceuticals such as avocado/soybean unsaponifiable (ASU), Indian frankincense (Boswellia Se
ata extract), pine back extract and others, are seen to be of great benefit (Akhtar & Haqqi, 2012, Castrogiovanni et al., 2019, Christiansen et al., 2015), but requires high-level evidence for a strong recommendation (RACGP, 2018)
Background
Osteoarthritis is a chronic and progressive condition which affects the joints, especially of hips, knees, ankles, and hands and spine (AIHW, XXXXXXXXXXIt involves the gradual loss of cartilage. Cartilage is a ru
er-like elastic tissue which pads and protects the end of bones at the joints and in some other parts of the body. Loss of cartilage causes joint friction which resultantly causes pain, swelling and reduced physical function of the affected individual (AIHW, XXXXXXXXXXThe major risk factors for osteoarthritis include but not limited to Obesity, Previous injury of the joint, repetitive movement, excessive weight bearing, family history of osteoarthritis, age (Arthritis Australia, 2017), gender (being females is a high-risk factor than being male) and others (OARSI, 2016).
Comparison of healthy joint and joint with osteoarthritis (AIHW, 2015 cited in AIHW, 2019) A picture representation of the nutraceuticals and their cycle in osteoarthritis (Castrogiovanni et al.,2019).
By prevalence, Osteoarthritis is a major public health issue due to its associated chronic pain and reduced physical function (Marlene et al., XXXXXXXXXXIt is the third most rapid rising condition with lived disability and the most common form of arthritis in Australia affecting about 2.2 million (9.3%) of the population (ABS, XXXXXXXXXXAckerman, XXXXXXXXXXcited in Arthritis Foundation, (2018), put forward that more than half of the population of Australians with osteoarthritis ranges between 25 and 64 years old. According to Mu
ay, (2012), cited in Arthritis Foundation, (2018), osteoarthritis (OA) ranks fifth among all forms of disability in the globe. It is thought to be the most prevalent of all musculoskeletal diseases as it is affecting about 10 percent of the world population aged 60 and above (Pereira, 2011, cited in Arthritis Foundation, XXXXXXXXXXIt is also estimated that such disease as osteoarthritis will impact about 130 million individuals globally by the year 2050 (Maiese, 2016, cited in Arthritis foundation, 2018).
Pie chart showing the impact of arthritis by types in percentages in Australia (AIHW, 2019)
According to Arthritis Australia, (2017), there is cu
ently no known cure for osteoarthritis, this means that the disease remains a chronic condition. Chronic conditions/illnesses cannot be cured, which means that osteoarthritis as one can only be managed. Many treatments available aims at relieving its major symptoms which are pain, and reduced function. These treatments include Pharmacologic interventions such as paracetamol, non-steroidal anti-inflammatory drugs (NSAIDs) and selective cyclooxygenase 2 (COX-2) inhibitors (Chan et al., 2010 & Hsiao et al., 2009, cited in Akhtar & Haqqi, 2012), and non-pharmacologic interventions such as exercises (Arthritis Australia, 2017), and the use of nutraceuticals (Akhtar & Haqqi, XXXXXXXXXXResearch have shown that the use of pharmacologic interventions for osteoarthritis poses a high risk to the affected patients such as; Myocardial infarction, stroke or CVA, causing cardiovascular death, increased risk of peptic ulcer bleed, Arterial fi
illation, chronic kidney diseases, and increase in all course mortality associated with the use of NSAIDs and COX-2 inhibitors (Wehling, 2014).
According to recent research, the level of adverse events that is associated with the use of pharmacological agents in the relieving of osteoarthritis highlights the need for developing safer alternatives and prevention strategies (Akhtar & Haqqi, XXXXXXXXXXCastrogiovanni et al., (2016), in their study put forward that such prevention and alternative therapies could come from Nutraceuticals. Nutraceuticals are dietary compounds which play a role in the balancing of anabolic and catabolic signals in joints (Castrogiovanni et al., XXXXXXXXXXThey are devoid of adverse effects (Akhtar & Haqqi, XXXXXXXXXXFollowing will therefore be discussion and recommendations on the prevention and management of OA through exercise and use of dietary supplements.
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Reference List
Arthritis Australia, XXXXXXXXXXOsteoarthritis. [Online], Available at;
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Akhtar, N., & Haqqi, T. M XXXXXXXXXXCu
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Castrogiovanni, P., Trovato, F. M., Loreto, C., Nsir, H., Szychlinska, M. A., & Musumeci, G XXXXXXXXXXNutraceutical supplements in the management and prevention of osteoarthritis. International journal of molecular sciences, 17(12), 2042.
Christiansen, B. A., Bhatti, S., Goudarzi, R., & Emami, S XXXXXXXXXXManagement of osteoarthritis with avocado/soybean unsaponifiables. Cartilage, 6(1), 30-44.
Fraser, I., XXXXXXXXXXExercise and good diet can beat your arthritis. Stanford Arthritis Foundation. Avery, New York.
GLAD Australia, XXXXXXXXXXTreatment for Osteoarthritis. [Online], available at;
gladaustralia.com.au/treatment-for-osteoarthritis
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Neogi, T., & Zhang, Y XXXXXXXXXXOsteoarthritis prevention. Cu
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Norma, P., & Mary W., XXXXXXXXXXPrimary and secondary prevention of osteoarthritis. Public health Wales, NHS trust, 1(2), 11
Osteoarthritis Research Society International, XXXXXXXXXXOsteoarthritis: A serious disease. [Online] Available at; https:
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Royal Australian College of General Practitioners, XXXXXXXXXXGuideline for the management of knee and hip osteoarthritis. (edn. 2.). [Online], Available at;
www.racgp.org.au/download/Documents/Guidelines/Musculoskeletal/guideline-for-the-management-of-knee-and-hip-oa-2nd-edition.pdf> [Accessed 27/10/19].
Roos, E. M., & Arden, N. K XXXXXXXXXXStrategies for the prevention of knee osteoarthritis. Nature Reviews Rheumatology, 12(2), 92.
Vincent, H. K., Heywood, K., Connelly, J., & Hurley, R. W XXXXXXXXXXObesity and weight loss in the treatment and prevention of osteoarthritis. PM&R, 4(5), S59-S67
Wehling, M XXXXXXXXXXNon-steroidal anti-inflammatory drug use in chronic pain conditions with special emphasis on the elderly and patients with relevant como
idities: management and mitigation of risks and adverse effects. European journal of clinical pharmacology, 70(10), XXXXXXXXXX.
Yingyu, F., XXXXXXXXXXThe National Osteoarthritis strategy. [Online], Available at;
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Zhang, W., Nuki, G., Moskowitz, R. W., A
amson, S., Altman, R. D., Arden, N. K., ... & Dougados, M XXXXXXXXXXOARSI recommendations for the management of hip and knee osteoarthritis: part III: Changes in evidence following systematic cumulative update of research published through January 2009. Osteoarthritis and cartilage, 18(4), XXXXXXXXXX.
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FLINDERS UNIVERSITY Title
Title
Introduction
References
Background and Significance
Key Messages
Recommendations
Implications for Practice
Conclusion
Autho
Title
Introduction