Osteoarthritis: Modern Western Discoveries, Ancient Chinese Insights, Part I

Osteoarthritis is one of the most common human diseases. Arthritic changes first begin in middle age, and those who live into their 80’s all experience, to some degree, the joint pain, swelling, and limited range of motion of arthritis. The severity varies widely, ranging from occasional moderate discomfort to intense pain and crippling joint immobility that prevents the performance of even the most basic tasks.

After more than a century of scientific scrutiny and study, Western medicine has raised more questions about osteoarthritis than it has definitively answered. Medical imaging and cadaver studies have demonstrated that arthritic joints involve narrowing of joint spaces and the development of bony growths and cysts. According to the prevailing theory in rheumatology, this degenerative process results from mechanical wear and tear compounded by low level, chronic inflammation.

Clinical reality, however, does not corroborate this view. Runners, for example, whose lower limbs are subjected to violent, repetitive impact have no greater incidence of arthritis in the knees than the general population. On the other hand, simple overuse does not explain the prevalence of arthritis in post-menopausal women or obese individuals with the latter group prone to arthritis in all joints, not just the weight-bearing ones. Clearly, there is more to the story.

Despite increasing numbers of patients affected by arthritis, options for treatment in Western medicine remain limited. Symptomatic relief is primary, with familiar over-the-counter drugs playing a key role. COX-2 selective inhibitors have been used to temper chronic aches and pain, while addictive opioids are tapped for the most stubborn cases. Unfortunately, the unrelenting progression of the disease necessitates a lifetime of pain management, raising many concerns about long-term adverse effects.

Unable to curb the inevitability of painful articular deterioration and deformation, many doctors eventually recommend surgery for larger joints. Stakes are high, with rogue blood clots being common enough to necessitate blood thinners as a standard prophylactic protocol after surgery. Although joint replacements are, in modern medical terms, archaic—the first hip replacements were performed in 1948—newer implant materials and surgical methods have improved the outcomes. Nevertheless, some reports still suggest that as many as 40% of arthritis patients who relent to surgical correction continue to experience chronic pain.