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Cartilage comfort - Natural Solutions
Cartilage comfort - Natural solutions
Knee Cartilage Damage: Treatment Options
Knee cartilage starts to wear away as we get older. Knee pain and swelling symptoms develop as the cartilage cushioning begins to fail. So what happens when you have no cartilage in your knee, and what can you do about it? In this blog, we discuss treatment options for knee cartilage damage.
Causes of no cartilage in the knee
The most common cause of knee cartilage damage is osteoarthritis. Knee cartilage loss can be due to an injury to the knee, such as a ligament tear, patellar dislocation, or meniscal tear. In addition, loss of knee cartilage can be triggered by lifestyle factors such as weight gain, diabetes, and high cholesterol. Also, inflammatory arthritis conditions such as rheumatoid arthritis can further damage knee cartilage. Knee osteoarthritis is not as simple as ‘wear and tear.’
A recent study suggested that osteoarthritis should be seen as a ‘total’ failure of the joint, including the cartilage, ligaments, and synovial lining. Studies suggest that pain from knee osteoarthritis is directly related to joint inflammation, synovitis, and subchondral bone.
Symptoms of knee cartilage damage
Generally, symptoms of worsening loss of knee cartilage include pain with activity, swelling of the joint, and reduced knee joint function. Simple tasks such as walking, housework, and standing from sitting become more difficult due to pain, swelling, and restriction.
No cartilage in knee treatment
But all is not lost. A variety of treatments are used to treat cartilage loss in the knee. Generally, treatments range from simple weight loss and exercise measures to more invasive treatments such as injections or surgery. Overall, we recommend simple treatments first.
Weight loss
In general, weight gain leads to worsening symptoms and progression of osteoarthritis. Increasing weight places more pressure on the knee joints, leading to more significant knee cartilage damage. It is well known that obese people develop osteoarthritis at an earlier age and have worse pain than healthy people. Secondly, increased fat cells in the body stimulate insulin production, leading to chronic inflammation. This type of inflammation leads to more significant cartilage degradation and worsening cartilage loss in knee.
Losing weight reduces pressure on the joints and body inflammation, improving symptoms. Studies suggest that a 10% weight reduction leads to a 50% reduction in knee pain from cartilage loss—a vast improvement.
Exercise therapy
Strength training and aerobic conditioning exercises improve symptoms of cartilage loss in the knee. Symptom improvement occurs from lowering chronic inflammation in the body, weight loss, and muscle strength gain. In addition, strengthening the muscles around the knee helps offload the knee and reduce pressure on the joint. Studies suggest that a combination of gym, pilates, yoga, and Tai Chi is the most effective for improving pain and function. Also, aquatic exercises such as swimming or aqua aerobics have significantly improved pain and function.
enerally, exercise works best for the following:
- Younger patients, although older patients, still benefit.
- Knee arthritis. There are over 50 high-level studies showing exercise works in knee arthritis.
- An exercise program that follows the American College of Sports Medicine guidelines. So, a combination of aerobic, resistance training, and balance exercises will be used with the progression of strength training. Also, a supervised program with a personal trainer works best.
Are low-intensity workouts as good as high-intensity workouts for knee arthritis?
We think so. A recent study found that 20-30 minutes of exercise three times a week produced the same benefits on pain and function in knee arthritis compared to 90 minutes three times a week. However, those in the low-intensity group were likelier to stick to their exercise programme. These results suggest that an exercise program involving less time and fewer exercises can still offer benefits and may be easier for people to undertake and stick to than one involving more time and effort.
Can I run with knee arthritis?
There are no simple answers. An exercise program improves symptoms and general exercise tolerance, including running. We always tell people that running should be their goal if they enjoy it. However, depending on the pain, some people might need to reduce their running time.
The good news in this study is that running at your own pace does not worsen cartilage loss in the knee on X-ray and may improve your pain.
Also, a recent survey of marathon runners found they were not at an increased risk of knee arthritis compared to the average population.
Couch to 5km is a good start for sedentary people who want some guidance for a gradual return to running.
Supplements
There is increasing evidence that some supplements may improve knee arthritis pain:
Boswellia serrata is a herb extracted from the Indian frankincense tree. Boswellic acids inhibit the 5-lipoxygenase enzyme, which has anti-inflammatory effects. In some studies, Boswellia serrata reduces pain and stiffness in knee arthritis. We recommend 100-250mg daily for four weeks.
Curcumin is obtained from the Curcuma longa plant. It has anti-inflammatory effects through several pathways, including inhibiting inflammatory substances such as the COX-2 enzyme. Studies suggest it is effective for knee arthritis and should be taken for 12 weeks.
An offloading brace can be effective when cartilage loss in the knee is confined to only one area. These braces push the knee away from the side with no cartilage, reducing pressure and inflammation in that part of the knee. Generally, braces are OK at reducing pain and improving function in the knee. However, some people find them uncomfortable.
A new shoe insert called APOS therapy has recently gained NICE recommendations for treating severe knee arthritis. These particular shoes have unique rounded pods fitted to the undersurface of the shoe. APOS therapy reduces knee pain by changing the forces on the foot and knee and correcting abnormal walking patterns. NICE highlighted that clinical evidence from a high-quality trial improves knee pain and function compared to a sham device. The cost for the footwear and associated treatment from trained professionals is estimated at £875 per person.
NSAIDs for cartilage loss in the knee
Over-the-counter medications such as ibuprofen reduce pain associated with no cartilage. However, the effect is negligible. Generally, diclofenac or etoricoxib works best for arthritis. But, you must be aware of possible side effects such as gastritis, reduced kidney function, and increased blood pressure. Generally, those people with heart disease should avoid NSAIDs. One alternative to tablets is topical NSAID creams or ointments, which are effective in relieving the pain of hand and knee osteoarthritis. In addition, creams have significantly fewer side effects than tablets.
Cortisone injection for cartilage loss in the knee
Cortisone is a powerful anti-inflammatory drug that reduces inflammation and pain.
Studies suggest short-term and mild improvement of knee pain for up to 8 weeks. However, recent studies show that cortisone is no different from a placebo for knee arthritis at six months. Also, there is concern about repeated cortisone injections causing more knee cartilage damage. Overall, we use cortisone injections less for longstanding cartilage loss in the knee and reserve these injections only for a severely swollen knee.
Platlet - rich - plasma also known as PRP, is a concentrated source of platelets. We obtain PRP from your whole blood. Then, the blood is spun in a centrifuge, separating the plasma from the white and red cells. This plasma contains concentrated platelets, which have many growth factors. Overall, we believe PRP works by allowing the growth factors to settle chronic inflammatory cells, leading to lower pain.
Recent studies suggest that PRP or platelet-rich plasma improves knee pain for over 12 months compared to gel injections, cortisone, and other substances.
Currently, 23 randomised trials show that PRP is better for no cartilage knee than other injections such as cortisone and hyaluronic acid. Also, we think that a type of PRP called leucocyte-poor PRP (compared to leucocyte-rich) has a good effect with less risk of a flare.
Often, 2-3 injections are needed over 4-6 weeks.
Combining PRP with hyaluronic acid
Recent evidence suggests combining PRP with hyaluronic acid might be better than PRP alone. This positive effect is seen at 3, 6, and 12 months. Also, we think adding hyaluronic acid reduces the risk of a flare after a PRP injection.
When combining treatment for knee cartilage damage, we recommend one high molecular weight hyaluronic acid and 2 PRP injections.
Nstride PRP
Nstride PRP is a second-generation PRP that concentrates the platelets and white cells.
The theory is that Nstride PRP will last longer than normal PRP. Some studies suggest the pain-relieving effect can last for a few years. But how genuinely effective is Nstride PRP? It seems that the evidence is not so convincing compared to placebo. Also, Nstride contains a higher concentration of leucocytes or white cells. Higher white cells may cause a significant flare after an injection.
Arthrex ACP Max
Arthrex ACP Max is a second-generation PRP system that super concentrates platelets, producing a dose of 5-12 billion. It has an innovative dual syringe system enables a double spin and concentrates platelets. Unlike NStride, it has a low white cell count, meaning the potential flare is generally less severe.
Arthrosamid injection for damaged knee cartilage
Arthrosamid is a unique hydrogel of water molecules attached to a polyacrylamide backbone. It is injectable and non-degradable, meaning the body does not break it down.
It works by coating the lining of the synovium of the knee joint, reducing inflammation, and providing lubrication.
Recent studies show improvement in pain scores lasting for up to 4 years. In addition, compared to hyaluronic acid, it works better in younger and slimmer patients.
Comparing injectables, Durolane, PRP or Arthrosamid: Which drug is more effective?
According to studies published on each injectable for knee a
According to studies published on each injectable for knee arthritis, we think the effectiveness for the treatment of knee arthritis in percentage terms is as follows:
Durolane: 70%
PRP: 70%
Arthrosamid 75%. Patients less than 70 years old do better (80-95%)
Surgery for damaged knee cartilage: what are the options?
Surgical options for bone-on-bone cartilage loss in the knee are limited.
Firstly, keyhole surgery for knee cartilage loss is ineffective and could accelerate knee damage. Therefore, the only indication for keyhole surgery is when you have actual mechanical symptoms such as locking or giving way due to a loose body or a meniscal flap.
High tibial knee osteotomy can reduce pressure on the knee joint if there is a malalignment problem. However, the evidence for effectiveness is not strong, and the risks are real. In addition, recovery is prolonged (greater than six months), and there is currently debate about whether osteotomy is better than a knee replacement.
Finally, knee replacement surgery effectively reduces pain and improves function compared to physiotherapy. Still, the sting in the tail is that 16% of people have problems after this surgery – some of these are serious. The bottom line is that surgery should only be done once your pain and activity levels become unacceptable.
Knee cartilage repair without surgery: Is it possible?
Overall, no current non-surgical treatment will repair or regenerate cartilage in the knee. Even surgery for cartilage replacement is problematic. Injections such as PRP, hyaluronic acid, and stem cells have not demonstrated cartilage regeneration in arthritis. Procedures injecting stem cells into knee joints have not shown better results than any other injection, including a placebo.
Other commonly asked questions about knee cartilage
damage:
Will my knee arthritis get worse?
Not necessarily. Your chances of knee replacement are only 30% in your lifetime. Generally, the best way to prevent the progression of knee cartilage damage is to maintain a healthy lifestyle: exercise, lose weight, and stop smoking. If you gain weight, your chances increase from 30% to 35%.
What causes pain with knee arthritis?
Contrary to popular opinion, cartilage damage does not cause pain. Instead, pain comes from swelling of the bone under the damaged cartilage (subchondral bone) or the inflamed synovium.
Does arthroscopic surgery help knee arthritis?
No. Some studies suggest it may worsen cartilage loss in the knee. However, keyhole surgery may also contribute to mechanical symptoms such as locking or giving way due to a loose body or flap.
When to have knee surgery for arthritis?
Every person is different, but we suggest a knee replacement if you need to reduce your step count to 7000 or less daily due to pain. The good news is that most people (85%) get back to their chosen sport five months after a knee replacement. These activities include walking, skiing, and even running.
Which injection is best for knee arthritis?
Overall, we think Arthrosamid injection has a slightly better effect than other injectables, such as PRP or hyaluronic acid. Studies suggest that 73% of patients experience a meaningful reduction in knee pain and improved function compared to 60-70% who have PRP and 65-70% who have hyaluronic acid. However, Arthrosamid is considerably more expensive.
Can you combine Duoxetine with a knee joint injection for knee arthritis?
Duloxetine is an antidepressant that has been shown to work for osteoarthritis. A recent study found that combining Duxoxetine with a knee injection (cortisone and hyaluronic acid) was more effective than the injection alone. At 6 months, those patients who took Duloxetine after a knee injection did better than those who just had an injection.
Final word from sportdoctorlondon about knee cartilage damage
Loss of cartilage in the knee is expected as we age. Weight loss and exercise are the best medicines to reduce pain and improve activity. Only use injections sparingly to help with lifestyle factors, with a preference for knee gel and PRP. Avoid expensive treatments like stem cells that promise regeneration. Finally, consider a knee replacement if all other treatments fail and your ability to exercise drops.
Reference: Sport Doctor London.
Top 5 health benefits of quinoa
Top 5 health benefits of quinoa
What is quinoa?
Quinoa, pronounced ‘keen-wa’, is a gluten-free alternative to starchy grains. Although it often occupies a similar role to grains in dishes, quinoa is actually a seed from the same family as beets, chard and spinach. It is high in protein and an important plant source of all nine essential amino acids. Grown in South America (Peru, Chile and Bolivia) for thousands of years, quinoa formed the staple diet of the Incas and their descendants. In recent years, foodies have heralded it as a superior alternative to bulgur wheat, couscous and rice.
Nutritional benefits of quinoa
A 100g serving of cooked quinoa provides:
- 120 Kcal/503KJ
- 4.4g protein
- 1.9g fat
- 19.4g carbohydrate
- 2.8g fibre
- 17mg calcium
- 64mg magnesium
For those following a vegan or plant-based diet, quinoa makes a valuable dietary inclusion. Like buckwheat, quinoa has an excellent amino acid profile, containing all nine essential amino acids.
1. May lower the risk of chronic disease
Quinoa is high in anti-inflammatory phytonutrients, which make it potentially beneficial for human health in the prevention and treatment of disease. Quinoa contains small amounts of the heart healthy omega-3 fatty acids and, in comparison to common cereals, has a higher content of monounsaturated fat.
2. May help you lose weight
High in fibre and with more protein of rice or barley, quinoa may be beneficial for those looking to manage their weight. One explanation for this is the filling nature of protein and fibre which helps us manage our appetite. Quinoa also has a low glycaemic index (GI) so its slower energy release makes it less likely to trigger cravings and stimulate hunger.
3. May help balance blood sugar
Although more research is needed, a small number of studies suggest quinoa may improve triglyceride
4. Suitable for those with coeliac disease and gluten intolerance
Naturally gluten free and nutritionally dense, quinoa makes an ideal option for those unable to eat gluten grains, such as those with coeliac disease. Being high in fibre, quinoa is a better choice for gut and digestive health than refined gluten alternatives like rice or potato flour.
5. May improve gut health
Studies suggest quinoa may improve gut health by enhancing the diversity of beneficial gut bacteria and reducing the inflammatory symptoms of conditions like colitis. Acting as a prebiotic, quinoa supplies the fuel for beneficial gut bacteria, allowing them to thrive.
levels and improve blood sugar management.
Is quinoa safe for everyone?
Quinoa is among the least allergenic of ‘grains’ with allergic reactions to it being rare. However, natural compounds coating the seeds called saponins may be the cause of some adverse reactions. It is possible to remove these compounds by thoroughly rinsing or pre-soaking quinoa before use.
o Williams – Registered nutritionist: Published: January 10, 2023 at 2:31 PM:
Quickly Drain You Lymph System Using Theses Simple Techniques to Boost Immunity and Remove Toxins
Quickly Drain You Lymph System Using Theses Simple Techniques to Boost Immunity and Remove Toxins
The lymph system is a complex drainage system. The lymphatic drainage consists of lymph nodes, vessels, spleen, and thymus. The lymphatic system plays an important role in fighting infections and absorbing excess fluids, fats, and toxic waste material from your entire body.
A lack of exercise, iodine deficiency, illness, or digestive imbalances can clog the lymphatic system and cause health issues and diseases. Luckily there are many natural ways to cleanse your lymphatic system and improve skin issues, arthritis, cellulite, headaches, colds, sinus infections, fatigue, cholesterol, digestive disorders, and overall health.
Top 10 Natural Ways To Boost A Sluggish Lymphatic System
1. Alternative Therapies
- Lymph drainage massage: this type of massage stimulates lymph circulation and drains fat, fluids, toxins and other waste products away from your cells.
- Acupuncture: stimulates lymph flow.
- Sauna: saunas or steam baths are an excellent way to sweat out toxins and waste material through the skin and cleanse your system.
2. Exercise
Regular exercise that involves jumping is the best way to keep your lymph system flowing smoothly. Although jumping up and down is the best way to stimulate lymph flow, any type of exercise will do the trick. While your muscles are moving, they massage your lymphatic system which improves lymph flow.
3. Foods To Cleanse Your Lymph System
A healthy diet produces less toxins and waste products, which reduces the chance of a clogged lymphatic system. Try to opt for organic products as much as possible to avoid pesticides and other chemicals.
Foods That Promote Lymph Flow
- Fruits, especially cranberries that help the lymphatic system, bowels and kidneys to get rid of various kinds of harmful toxins, are loaded with antioxidants and many other nutrients. You can find more information about the healing powers of berries in the e-book The Healing Berry Guide which is a must if you want to become healthier from the inside out and get healthy and easy berry recipes that are sure to boost your health.
- Veggies, especially leafy greens (due to their chlorophyll content) – also refer to the article how to cleanse your body using chlorophyll.
- Flaxseed Oil
- Spirulina – Find more information in the article how to boost your health by eating seaweeds and algae.
- Walnuts
- Almonds
-
- Brazil nuts
- Flax or chia seeds – Read here more about the amazing health benefits of nuts and seeds.
- Avocados
These food sources provide important vitamins, minerals, antioxidants, fatty acids, and other beneficial phytonutrients to keep your lymph flowing and cleanse your body. Add more raw fruits, vegetables, and fresh juices to your diet as they provide powerful enzymes and acids to cleanse your lymphatic system.
Foods To Avoid
- Artificial sweeteners
- Sugar – you can find here 13 effective ways to quit sugar.
- Meat
- Preservatives
- Refined grains
- Processed foods
- Foods high in salt
- Candy and baked goods
All those foods are known to produce toxic waste and may clog your system.
4. Drink Plenty Of Water
Your body needs water to stay hydrated to keep your lymph fluid flowing properly. A good rule of thumb is to drink 6 to 8 glasses of filtered or purified water a day and ditch sodas, sport drinks, and commercially available sugar-laden fruit juices.
5. Deep Breathing
Deep breathing exercises stimulate lymph flow to avoid toxin build-up and bring more fresh oxygen to your cells.
6. Dry Brushing
The skin is our largest organ and is responsible for detoxifying our body just like the liver, kidneys and colon. Dry brushing is an ancient technique which is part of the Indian Ayurveda and holds numerous health benefits. Not only this, but it’s easy and simple to do, takes only few minutes a day and is very cheap.
Health benefits of dry brushing
Dry brushing exfoliates the skin and removes dead cells, thus contributing to younger, smooth and fresh looking skin. This way the skin is able to better absorb nutrients into the body.
Dry brushing also improves blood circulation and helps the lymphatic system release toxins, thus improving its role in fighting infections and improves the immune system. You can read more about the importance of a proper blood circulation and how to improve it in this article.
It also helps in cells renewal, improves muscle tone, tightens the skin and reduce cellulite by releasing fatty deposits under the skin’s surface. For more natural ways to reduce cellulite click here.
Another added bonus is stress relief. Dry brushing has meditative benefits, especially if done in a quiet place. It may reduce muscle tension and calm your mind, just like a light body massage.
As you can see, dry brushing detoxifies the body from the outside in and works on multiple levels. You can learn more about the concept of detox and how to use detox to energize and cleanse your body in the e-book The Detox Guide.
How to do dry brushing?
You should choose the right type of brush. Choose a brush with firm bristles but not too hard. The bristles should be natural, typically vegetable-derived. It’s best to choose a long handle that can easily reach to areas such as the back.
The best time to do dry brushing is in the shower before washing yourself when your skin is dry. The brush itself should also be dry. Because dry brushing energizes the body, many people prefer to do it in the morning before they shower, but you can do it any time of the day (but not too close to bedtime, as it may have a stimulating effect on you). Dry brushing can be done on a daily basis and even twice a day. Just remember to avoid brushing broken or inflamed skin.
As the lymphatic system flows towards the heart, you should always brush towards your heart using long gentle strokes (avoid back and forth movement).
- Apply a firm pressure but not too painful to avoid irritating the skin: your skin should be pink after a session and not red.
- Start from the feet, and then work up your legs, thighs, stomach, back and arms.
- It’s best to avoid your face as usually the facial skin is too sensitive.
- Dry brush yourself for about 3-5 minutes and then shower to wash away the dead skin cells and impurities.
You can even do one of these 5 detox baths to further cleanse your skin. Dry brushing is also one of the 70 habits featured in the e-book 70 Powerful Habits For A Great Health which will guide you how to take positive steps to improve your wellness and overall health.
7. Avoid Chemical-laden Beauty Products
Most commercially available lotions, toothpastes, creams, sunscreens, deodorants, etc. are full of questionable chemicals that end up in your lymphatic system. Choose for natural, organic beauty products or try to make your own chemical-free versions.
8. Herbal Teas
Herbs can be used as a powerful medicine and I’ve already written about herbs and on how to use Herbal Medicine effectively to heal away disease & illnesses in my e-book the Herbal Remedies Guide. Some herbs may help you to boost lymph flow and eliminate toxins. Those include echinacea, goldenseal, red clover, pokeroot, astragalus, or wild indigo root among others. Make sure to contact an herbalist for advice if you are on medication and avoid those herbal teas when pregnant or lactating. You can find here how to make lymph cleansing herbal infusion.
9. Alternate Hot/Cold Shower
Alternating hot and cold shower for several minutes has a beneficial effect on your blood and lymph flow. The heat causes vessels to dilate and the cold makes them contract. Avoid this therapy when pregnant or struggling with a heart or blood pressure condition.
10. Wear Loose Clothing
Tight clothing slows down lymph flow and can cause blockages. So make sure to wear lose clothing or clothing that fits properly.
If you keep those tips and tricks in mind, your lymphatic system will be working more efficiently to improve your overall health. You’ll have more energy, less aches, and less toxin build-ups.
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Reference: 2025 Healthy and Natural World: Healthy And Natural World
45-year-old woman damages liver from drinking herbal brew - dangerous 'side effects' Story by Solen Le Net •
45-year-old woman damages liver from drinking herbal brew - dangerous 'side effects'
Herbal supplements are widely used as a natural alternative to prescribed medicines. Their heavily purported health claims make them alluring to global consumers searching for a quick fix to boost their health. Due to the categorisation of the remedies as supplements, however, they're exempt from regulation on other medicines sold in pharmaceutical settings.
Earlier this year, doctors published the case report of an unnamed 45-year-old woman with liver injury in the Cureus Journal of Medical Science.
The patient, who was receiving treatment for hypothyroidism at the time of her presentation, reported severe epigastric pain and nausea.
She denied any alcohol or drug use, recent travel and history of blood transfusions prior to her symptoms.
One note-worthy admission was that she had started drinking a herbal tea three days before experiencing symptoms, in a bid to boost her immunity.
"Further examination revealed that the patient had recently begun using a herbal tea and that symptoms had completely resolved after discontinuation," noted the authors.
According to the report, the tea contained 23 ingredients, including reishi mushroom, aloe, vera, and Siberian ginseng.
All three ingredients have been linked to cases of liver injury in past research.
Twelve case reports have been published since 2005 indicating a risk of liver injury in connection to aloe vera.
Research dating back to 2004, has identified several cases of liver injury in patients taking reishi mushroom formulations.
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