Osteoarthritis (OA) is the most common form of arthritis worldwide, affecting 7% of the global population. It is often referred to as degenerative joint disease or ‘wear and tear’ arthritis.
OA is a leading cause of disability in older adults and negatively impacts quality of life. OA related joint pain can cause functional limitations such as loss of independence, fatigue, low mood and poor sleep.
OA is a common reason for consultation in general practice, with 1/3 of adults aged 45 years and over having sought treatment for symptoms.
Classical treatments for OA, often focus on symptom relief only and not the root cause. Long term use of many of these medications can cause serious side effects.
What happens in a joint with osteoarthritis?
Cartilage is a firm, slippery tissue than cushions the ends of bones and enables smooth joint movement. OA begins when this protective cartilage breaks down and wears away, eventually causing friction and damage to the whole joint structure.
Whilst OA can affect any joint, it most commonly affects joints in the hands, knees, hips and spine. Changes to the joint usually occur gradually and can get worse over time.
The severity of OA symptoms can vary from person to person and between affected joints.
Stiffness of the joints may be more noticeable upon awakening or after long periods of inactivity
Extra bits of bone can form around the affected joint. Often, they may feel like hard lumps under the skin
Inflammation and an increase in synovial fluid within the joint may cause swelling
Joints may not move as freely or as far as normal
Joints may hurt during of after movement or at the end of the day
Movement of the joint may cause a crackling or grating sensation
Joints may feel tender when light pressure is applied
High bone density has been found to be associated with OA at the knee and hip.
Being overweight or obese puts more stress on joints, particularly weight bearing joints like the hips and knees.
Obesity may also have metabolic effects and cause low grade inflammation, a factor now thought to contribute to the
development of OA.
Injury, overuse of a joint causing repetitive stress, or joint surgery may lead to OA at that site later in life.
Genetics are a key risk factor for OA of the hands and play a smaller role in OA of the hips and knees
Certain occupations that involve physically demanding work and repetitive movements can cause excessive stress on a joint and increase the risk of OA
Onset of OA is more common in people in their 40s and increases with age
OA is more common in women than in men for most joints. It often starts after the menopause
Minimum loss of cartilage, doubtful narrowing of joint space
Cartilage beginning to break down, Joint-space narrowing, occurrence of bone spurs
Moderate joint-space reduction, multiple bone spurs, possible deformity of bone ends
Joint-space greatly reduced, large bone spurs, definite deformity of bone ends
In addition to mechanical and other risk factors, accumulating evidence suggests that the presence of chronic low-grade inflammation has a role in the development of osteoarthritis. This low-grade inflammation appears to be related to the composition of the gut microbiota¹¹.
An imbalance of the gut microbiota, known as dysbiosis, can lead to increased permeability of the intestinal wall. This facilitates the movements of pro-inflammatory molecules such as endotoxins into the blood. These endotoxins can activate the immune system and cause systemic low-grade inflammation, which may ultimately lead to breakdown of the joint structure5 6 7.
The link between dysbiosis and osteoarthritis offers new therapeutic opportunities to help patients manage the condition. By modulating the composition of the gut bacteria it may be possible to reduce the progression of osteoarthritis5.
† Dysbiosis: Adverse alterations in the diversity, structure or function of gut microbiota that is associated with disease
320 male and females with mild-moderate osteoarthritis
1 capsule/day (Bifidobacterium longum CBi0703 + Vitamin C)
(Visual Analogue Scale (VAS))