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Living with Arthritis in Prince George? Contact Dr. Warawa Today

If you have osteoarthritis (OA), join the crowd. This form of arthritis is probably the most common disease known to mankind. X-rays can detect some signs of the disease in more than half the population by age 50. By age 70, the figure jumps to 85%. Ready to heave a sigh of despair? Save your breath. Although osteoarthritis is a nearly universal disease, it’s not always painful or disabling. If you have osteoarthritis, or any other form of arthritis, and live in Prince George, Dr. Terrance C. Warawa invites you to schedule an appointment to learn more about your options.


Compared to other forms of arthritis, osteoarthritis usually produces relatively mild symptoms. And in many people, the disease is silent. That is, while X-rays may show some signs of osteoarthritis, the changes may not produce pain or discomfort for decades, if ever.

“The connection between the osteoarthritis changes that show up on X-rays and the pain and discomfort you actually feel is tenuous at best. There are thousands of people walking around with a substantial degree of osteoarthritis who feel no discomfort at all,” says New York physician W. Nagler, M.D.

Millions of people do have pain and discomfort from OA. Women are twice as likely as men to develop this disease. Most often, symptoms begin after the age 40, but OA can strike earlier if your joints have been injured.

OA causes a deep, aching pain in one or more joints, especially those that bear weight, such as the hips, knees, and feet. The disease can also settle in the spine. Another place for OA to target is the hands, causing knobby enlargements of the finger joints and pain at the base of the thumb.

In OA, the smooth cushions of cartilage at the ends of the bones become pitted and frayed. In time, the cartilage may completely wear away, leaving the end of the bones unprotected. The bones also begin to grow and thicken in the joint, producing little bony spurs or osteophytes, that can get in the way of normal movements and cause pain. Eventually, the joint begins to work like a rusted hinge rather than a well oiled one.

Doctors used to think of OA as a wear and tear disease. They assumed that, with age, cartilage inevitably wore thin, like the tread on a pair of tires after many miles of use. But modern researchers say it’s unfair to blame age alone for OA. Normal joints do wear some with age, but generally to a much lesser degree than previously injured or over-stressed joints.

So what causes OA? It may be an insult to the joints when we’re young that sets off a gradual process that causes the symptoms to appear years later. Or years of repeated out-of-the-ordinary demands on a joint that may eventually lead to OA. OA is more common in the toes of ballet dancers, for example, because they spend so much time on their toes. Similarly, basketball players tend to develop OA in their knees, while miners and loggers get it in the spine, probably from lifting heavy loads and improper work positions.

“Development of OA can often be traced to abnormal or increased stress on a joint,” writes Dr. Bland in Running and Fit News, the newsletter of the American Running and Fitness Association. That is, when a joint is continually stressed, it can become injured, and possibly OA can develop.” People who are overweight are more likely to develop OA, studies show.

Phases of Osteoarthritis

Osteoarthritis is a degenerative process that worsens with time. If neglected, this potentially crippling condition quietly progresses without obvious symptoms.

It starts with some type of uncorrected trauma to the joint. A slip or a fall. A car accident. Smaller, less obvious repetitive injuries can also start this process. The “first phase” of OA is revealed as a loss of normal joint movement or function. Other joints and tissues often compensate, starting a chain reaction of health problems.

Left uncorrected, the body responds by depositing calcium onto the affected joint surfaces, ligaments and connective tissue. This “second phase” of OA is the result of the body’s attempt to stabilize and “splint” the malfunctioning joint. As with high blood pressure or cancer, pain or other obvious symptoms are often absent until the problem advances. Unaware of the serious damage that is occurring, many allow their problem to worsen.

Joint pain

How to Prevent Osteoarthritis

Chances are you already know you can help prevent heart disease by not smoking, watching your cholesterol, and getting regular exercise. But did you know that many of those same health habits are important for lowering your risk of arthritis, too?

Doctors do not know enough about what causes arthritis to be able to tell people how to prevent all of its various forms. But many believe you can take steps to reduce your risk of osteoarthritis, the most common type of arthritis.

What’s more, it’s never too late to begin “arthritis proofing” your joints. Even if you already have arthritis, you can still benefit from building a strong musculoskeletal system. Many of these tips also can help to reduce the pain and discomfort of OA, if you have it.

A joint-healthy lifestyle includes these habits:

GETTING FIT: Exercise is essential for healthy cartilage, and it strengthens muscles, tendons, and ligaments that keep joints working properly. Exercise keeps the bones strong, too, by preventing calcium loss. In general, the recommendation for a person who is well, who is not having joint pain, would be to remain active, to maintain muscle tone and range of motion.

PAYING ATTENTION TO PAIN: Pain is the body’s way of telling you to ease up before it’s too late. If pain bothers you, cut back a little or change temporarily to a less stressful activity, such as swimming. With exercise, you may feel some muscle soreness, but it should lessen very quickly. Pain that persists is a sign that we’re overdoing things or that there is something wrong mechanically in the joint.

BEING KIND TO YOUR JOINTS: If you have an old injury in a joint, ease up on the pounding exercises such as jumping rope or jogging. Do the same if you have a joint alignment problem.

PROPER FOOTWEAR: It is hard to get the roof straight if the basement is crooked. Proper footwear is essential for proper foot mechanics, which is essential for proper knee, hip and back mechanics. It would be advisable to perform a FREE FOOTMAXX COMPUTERIZED GAIT ANALYSIS. The analysis would help determine if there are any problems with your feet, and guides you on how to correct them.

KEEPING YOUR WEIGHT DOWN: Recent studies show that people who are overweight are more likely to develop OA. Also, people who are overweight are more apt to be sedentary and forgo the activity needed for healthy joints.

CHIROPRACTIC CARE: Chiropractic care is essential for proper joint alignment and function. When the joints are “out” increased stresses are placed on that joint thus increasing the wear and tear on that joint leading to OA.

GLUCOSAMINE: Glucosamine sulfate and chondroitin sulfate can help with the changes of OA.

Is There an Arthritis Cure?

Have you visited your veterinarian lately? He or she may have a suggestion for the treatment of your arthritis! Glucosamine, the new therapy for OA, has been used by vets for more than a decade treating arthritic horses and dogs. The main advantage of Glucosamine is that it does more than just treat the arthritic symptoms, it addresses the underlying cause with minimal side effects.

What Is Glucosamine? 

As the name implies, glucosamine is a combination of a sugar and an amino group and it is normally manufactured by the body. Glucosamine is metabolized to glycoamine molecules which are linked together to form glycoaminoglycan (GAG). These long chains of GAG are found in many of the body’s tissues, including tendons, ligaments, cartilage, synovial fluid and in the mucous membranes of the respiratory and gastro-intestinal tracts.

Cartilage, the shock absorbing cushion of the joints, consists of a protein “backbone” with GAG’s attached. Many of these giant molecules together form the sponge-like, protective covering for bones. As we age, our bodies produce less glucosamine, and with less of the building blocks available to make GAG, our joints are less able to regenerate damaged cartilage.

Glucosamine is tasteless, water-soluble and stable. It is small enough molecule to be readily absorbed from our intestines and can found in the bloodstream for several hours after ingestion. The most common form is glucosamine sulfate, but it can be found a N-acetyl-glucosamine, Both are synthetic and there is no advantage of one over the other. (though rumors persist, incorrectly, that the sulfate form presents a problem for those with sulfa allergies). Although well absorbed, glucosamine undergoes fairly extensive “first-pass” metabolism in the liver, where it is ultimately broken down to urea, carbon dioxide and water. It rapidly diffuses into all body tissues.

Can Glucosamine Cure Osteoathritis?

More conventional therapies for OA have treated the disease as “irreversible” or “incurable.” The goal has been to manage the symptoms and decrease discomfort.

The most widely used class of drugs is the NSAIDs (Non-steroidal Anti-inflammatory Drugs such as ASA, Ibuprofen, Naproxen, Diclofenac etc.). When compared, patients reported a more immediate response with NSAIDs but tended to build up a tolerance to the medication in as little as 8 weeks of treatment. Glucosamine, on the other hand, is slower to produce a response (in many advanced cases of OA, glucosamine may take up to 3-6 months to reduce symptoms), but symptoms continually improve so that by 4-6 weeks, it actually exhibits greater effectiveness than the NSAIDs. Moreover, its effects can persist even after discontinuation. One study demonstrated 6-12 weeks of extended response after only 2 months of therapy.

There are 2 theories as to glucosamine’s mechanism of action:

1. Providing the necessary building blocks to maintain and rebuild healthy joint cartilage.
2. Acting as an anti-inflammatory agent.

The bulk of the available literature seems to support the first theory. One study utilized finely detailed electron microscopy to analyze the cartilage of a patient taking glucosamine and found that the tissue actually appeared to be regenerating! Numerous other studies have shown promising results and, in fact, the World Health Organization (WHO) has called for a long-term study into glucosamine’s effectiveness and side-effects.

How Is Glucosamine Taken?

The dose of Glucosamine Sulfate is 3500mg doses per day. There are virtually no side effects and no known contraindications or interactions. It has been suggested that an anti-inflammatory medication be combined with the glucosamine for the first 4-6 weeks, then tapered off as the full effects of glucosamine are established. One could safely combine any of the herbal medications with glucosamine.

Some investigations into the function of joints have determined that while glucosamine promotes production of cartilage, another compound, CHONDROITIN SULFATE, appears to block the enzyme that breaks down cartilage. This synergistic effect of decreasing destruction while increasing production has the potential for even better results.

Give us a call if you have any questions.


questions answered

Dr. Warawa can assess your health, answer questions and determine the right treatment option for you.

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