Jul 27

Hope For Knee And Hip Osteoarthritis: Distraction and Patient Education and Exercise

Osteoarthritis in the knee and hip are known and growing concerns as our society ages…around the world. Currently in 2021, Canada is reviewing the “Good Life with osteoarthritis in Demark” (GLAD) program for knee and hip osteoarthritis. The program incorporates manual therapy, exercise, and patient education. (1) In one GLAD study, patients attended 2-3 patient education classes and 12 supervised exercise sessions in 8 weeks. Their pain intensity improved 26-33%, walking speed 8-12%, chair standability 18-30%, and joint-related quality of life 12-26%. (2) (Another study used MRI to measure the thickness of knee joint cartilage after knee joint distraction to find that it thickened with treatment resulting in significant short- and long-term cartilage regeneration up to 10 years after treatment. (3) This was in young people, but there is hope!) Back in 2017, a Canadian chiropractor published a paper describing his application of flexion-distraction-based distraction to the osteoarthritic knee, and the success he’s seen in his patients. Overall (acute and chronic patients combined), patients reported a mean visual analog pain scale score drop from 7.7 to 1.8 in 3 weeks and 5.3 treatments. Acute knee OA patients’ scores dropped from 8.1 to 1.1 in 4.8 treatment in 2.4 weeks. Chronic patients’ scores dropped from 7.5 to 2.2 in 3.3 weeks and 5.4 treatments. (4) Chiropractors like yours are ahead of the curve with their modified Cox® Technic principles-of-flexion-distraction-based approach to knee osteoarthritis! New protocols for use in hip OA are also in development. Talk with us about how distraction treatment may help your knee and hip osteoarthritis!

HOPE FOR DEGENERATED DISCS: Chondroitin Sulfate

Back pain treatment approaches from surgery to manual therapy to exercise to nutrition abound, while back pain continues. Injecting hyaluronic acid hydrogel is showing some promise as it is shown to suppress the loss of disc height, promote tissue hydration for disc repair, and reduce inflammation and innervation to prevent more disc degeneration. (5) The nutritional approach continues to hold hope for back pain sufferers as the disc matrix components are known, two central ones being chondroitin sulfate proteoglycan and hyaluronan. Making chondroitin sulfate available to the disc in addition to controlling the hydrostatic pressure of the disc is beneficial. (6) Cox® Technic is shown to drop intradiscal pressure, so combining it with chondroitin sulfate may be, too. Are you taking yours? Consider adding a disc supplement containing chondroitin sulfate to your routine after we talk.
Listen to this PODCAST with Dr. James Cox on The Back Doctors Podcast with Dr. Michael Johnson as he discusses the role of chondroitin sulfate in the health, degeneration and potential regeneration of the intervertebral disc and in the Cox® Technic System of Spinal Pain Management.

We look forward to seeing you at your next visit! Contact us today!

Reference for HEALTHY NEWS – July 2021

  1. Young JJ, Važić O, Cregg AC. Management of knee and hip osteoarthritis: an opportunity for the Canadian chiropractic profession. J Can Chiropr Assoc. 2021 Apr;65(1):6-13. PMID: 34035537; PMCID: PMC8128331.
  2. Roos EM, Grønne DT, Skou ST, Zywiel MG, McGlasson R, Barton CJ, Kemp JL, Crossley KM, Davis AM. Immediate outcomes following the GLA:D® program in Denmark, Canada and Australia. A longitudinal analysis including 28,370 patients with symptomatic knee or hip osteoarthritis. Osteoarthritis Cartilage. 2021 Apr;29(4):502-506. doi: 10.1016/j.joca.2020.12.024. Epub 2021 Feb 6. PMID: 33561542.
  3. Jansen MP, Mastbergen SC, MacKay JW, Turmezei TD, Lafeber F. Knee joint distraction results in MRI cartilage thickness increase up to ten years after treatment. Rheumatology (Oxford). 2021 May 22:keab456. doi: 10.1093/rheumatology/keab456. Epub ahead of print. PMID: 34022055.
  4. Albano L. Innovative application of Cox Flexion Distraction Decompression to the knee: a retrospective case series. J Can Chiropr Assoc. 2017 Aug;61(2):153-161. PMID: 28928498; PMCID: PMC5596966.
  5. Inoue M, Isa ILM, Orita S, Suzuki-Narita M, Inage K, Shiga Y, Norimoto M, Umimura T, Sakai T, Eguchi Y, Watanabe A, Aoki Y, Pandit A, Ohtori S. An Injectable Hyaluronic Acid Hydrogel Promotes Intervertebral Disc Repair in a Rabbit Model. Spine (Phila Pa 1976). 2021 Aug 1;46(15):E810-E816. doi: 10.1097/BRS.0000000000003921. PMID: 34228691.
  6. Takeoka Y, Paladugu P, Kang JD, Mizuno S. Augmented Chondroitin Sulfate Proteoglycan Has Therapeutic Potential for Intervertebral Disc Degeneration by Stimulating Anabolic Turnover in Bovine Nucleus Pulposus Cells under Changes in Hydrostatic Pressure. Int J Mol Sci. 2021 Jun 2;22(11):6015. doi: 10.3390/ijms22116015. PMID: 34199496; PMCID: PMC8199579.