Long thought to be caused by wear and tear, osteoarthritis is one of the most common joint problems affecting millions of people worldwide. Recently, a team from the University of Surrey has discovered a crucial link between metabolism and osteoarthritis.

This new understanding opens up a pathway to potentially preventing osteoarthritis via the simple practice of exercise and maintaining a good diet.

The prevalence of osteoarthritis

Osteoarthritis is a very common degenerative joint disease which results from the loss of cushioning between the joint spaces. While many risk factors are known (weight, genetics, injury), the exact cause of osteoarthritis is still unknown.

In the United States alone, 10% of men and 13% of women suffer from osteoarthritis – making it the most common joint disorder. Meanwhile, over in the Southern Hemisphere, 9% of Australians are affected by osteoarthritis.

Due to the lack of a definite causative agent, the treatment and prevention of osteoarthritis has always proved to be a challenge with no absolute solution in sight as of this moment.

The role of metabolism in the pathogenesis of osteoarthritis

First published in early April, a team of researchers from the UK successfully identified a working link between metabolism and osteoarthritis. The team discovered that an altered metabolism state is able to incite a change in articular cartilage, subchondral bone and synovium – all of which are crucial components of any joint.

A lowered state of activity promotes a change in metabolism that causes immune and inflammatory cells to become active. This results in the promotion of inflammation and protein degradation within the joints.

One key metabolic component in this cycle is lactic acid, a by-product of excess glucose metabolism. The presence of lactic acid in joints forms a highly acidic environment within the joints, which further promotes inflammation.

Adding further weight to this discovery is the increased levels of lactic acid found in the joints of patients with osteoarthritis. This two-way observation helps to confirm the positive correlation between lactic acid and joint damage.

Where a lack of metabolic activity can bring about joint damage – the opposite would hold true as well – with physical activity acting as a protective factor against developing osteoarthritis. While the link between metabolism and osteoarthritis was clearly elucidated by this review, the researchers concluded that more research was needed in the immune and metabolic pathway of osteoarthritis.

The research team believes that this pathway holds the key not just to the mechanism of osteoarthritis, a possible avenue to develop a cure.

Clinical implications

For the general population, this study serves to highlight the importance of a good diet and exercise as the main course for the prevention of osteoarthritis. This situation is especially true for individuals who are at a high risk of developing osteoarthritis; such as those with a positive family history or a previous joint injury.

Meanwhile, there is good news also for those presently living with osteoarthritis. A good diet and exercise can help improve their condition while slowing down the progression of the disease.

The normalisation of the body’s metabolism was found to help slow down the progression of osteoarthritis and even promote joint recovery in the long term. As such, the general advocacy of a good diet and joint strengthening exercises for patients with osteoarthritis should be further reinforced into patient education of their condition.

Conclusion derived from the study

While the knowledge that a good diet and exercise can help to alleviate symptoms of osteoarthritis is no breakthrough discovery – it serves to highlight the importance and benefits it brings. Now, with concrete evidence, clinicians have more reason to promote a healthy diet and regular exercise for all osteoarthritis patients and those who are at a high risk of it.

This review proves that there is more to osteoarthritis than a simple case of wear and tear, with a more complex metabolic and immune pathway in play. This pathway holds the key to understanding and treating osteoarthritis. But for now, maintaining a stable metabolism is the best measure to keep osteoarthritis at bay. MIMS

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