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
-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 ot 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, Microcurrent, PEMF, PT, Chiropractic, bracing and topical
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 lives in Star). 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

For more information about this author, go to


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