Knee and hip osteoarthritis are the twelfth leading cause of global disability (8). OA was the eighth leading cause of the US health expenses in 2016 (8). In countries like Canada, 4 million individuals have OA where 122,000 knee and hip replacements are performed annually (3).

Both the Osteoarthritis Research Society International (OARSI) and American College of Rheumatology (ACR) published new guidelines for non-surgical management of knee and hip OA (2&5). These guidelines include self-management strategies, exercise, and weight loss for overweight individuals. Manual therapy has not been included in the OARSI guideline due to the lack of supporting evidence.

Manual therapy is a collection of therapeutic interventions used by chiropractors and physiotherapists in the management of OA. The current lack of high-quality evidence presents manual therapy from being the core treatment for OA (4). However, the National Institute of Health and Care Excellence (NICE) and the US Bone and Joint Initiative recognize the potential effectiveness of manual therapy (6&7).

A recent review on manual therapy found improvements in pain and physical function in the short and long term for patients with OA (4). A systematic review, specifically for knee OA, reviewed 11 RCTs that concluded that the effects of manual therapy with and without exercise provide short-term benefits on pain levels, functional disability, range of motion and physical performance (1). There were other studies on the effectiveness of manual therapy showing effective symptom improvement for people with OA.

​However, these results can’t be considered conclusive due to the limitations each study had. If you would like to know more about this condition, feel free to contact us here at Sprouting Health Chiropractic. 

Citations

1. Anwer S, Alghadir A, Zafar H, Brismée J-M. Effects of orthopaedic manual therapy in knee osteoarthritis: a systematic review and meta-analysis. Physiotherapy. 2018;104(3):264–276
2. Bannuru RR, Osani M, Vaysbrot E, et al. OARSI guidelines for the non-surgical management of knee, hip, and polyarticular osteoarthritis. Osteoarthritis Cartilage. 2019;27(11):1578–1589
3. Canadian Institute for Health Information. Hip and Knee Replacements in Canada 2017–2018 Canadian Joint Replacement Registry Annual Report. 2019. https://www.cihi.ca/sites/default/files/document/cjrr-annual-report-2019-en-web_0.pdf.
4. French HP, Brennan A, White B, Cusack T. Manual therapy for osteoarthritis of the hip or knee – a systematic review. Man Ther. 2011;16(2):109–117
5. Kolasinski SL, Neogi T, Hochberg MC, et al. 2019 American College of Rheumatology/Arthritis Foundation Guideline for the Management of Osteoarthritis of the Hand, Hip, and Knee. Arthritis Rheumatol. 2020;72(2):220–233
6. National Institute for Health and Care Excellence. Osteoarthritis: care and management – clinical guideline. National Institute for Health and Care Excellence Guidelines; 2014. p. CG177
7. Nelson AE, Allen KD, Golightly YM, Goode AP, Jordan JM. A systematic review of recommendations and guidelines for the management of osteoarthritis: The chronic osteoarthritis management initiative of the U.S. bone and joint initiative. Semin Arthritis Rheum. 2014;43(6):701–712
8. Young JJ, Važić O, Cregg AC. Management of knee and hip osteoarthritis: an opportunity for the Canadian chiropractic profession. J Can Chiropr Assoc. 2021;65(1):6-13.

 
We have all heard about arthritis and it is safe to assume that we all know someone, maybe in the family, that has arthritis. Arthritis is a very common inflammatory joint disease and affects around 3 million people in Australia, representing about 15% of the population.(1) There are different types of arthritis such as rheumatoid arthritis, ankylosing spondylitis, osteoarthritis, etc.
 
Osteoarthritis(OA) is among the most common type of joint diseases. It is the leading cause of pain and disability among the elderly population.(1) The causes of joint disease are usually straight forward; common examples include previous injuries, biomechanical imbalance, obesity, weakened muscles and so on.(2)
 
OA often occurs around weight baring joints such as knee, hip and spine. These joints are synovial joints that consist of cartilage, a joint capsule and synovial fluid to help lubricate the joint and help with smooth movement. When the biomechanical loading of the joint is compromised the inflammation process will kick-in. As a result, we see chronic inflammation occuring, wear and tear of the joint surface accelerates, chances of bone spur(unwanted bone growth) increase and pain in the joint/s is often present.

3 tips to prevent OA!
 

1. Exercise and movement - research has shown less sedentary activities can result in a better health outcome!(2) Not only reducing your chance of getting OA, but also staying away from obesity, type 2 diabetes and so on!
2. Eat healthy - More green leafs and fruits, less refined sugar, soft drinks and processed food! This will help reduce chronic inflammation in your system!
3. Check your shoe - check the heel of your shoes! If one side is wearing out quicker than the other, you are likely putting more weight onto one side! Sneaky!

 
Chiropractors are trained to take care of your musculoskeletal system, your muscles and joints. It is important to act early because once the joint wears out, it is impossible to get them back! If you or your loved ones are curious about how we can help manage joint pain or arthritis, speak to one of our chiropractors today.


 

References

1.         March LM, Bagga H. Epidemiology of osteoarthritis in Australia. The Medical Journal of Australia. 2004;180(5):S6.
2.         Lee J, Chang RW, Ehrlich‐Jones L, Kwoh CK, Nevitt M, Semanik PA, et al. Sedentary behavior and physical function: objective evidence from the Osteoarthritis Initiative. Arthritis care & research. 2015;67(3):366-73.

Vitamin D deficiency and insufficiency occurs in 27-91% of all pregnant women depending on the country they live in.[1]  Vitamin D has many important functions in the human body and can have a huge effect on pregnant mums, developing foetus’ and newborns if mothers are deficient during pregnancy.
 
Studies have now found links between vitamin D deficiency and poor immune system function. Low maternal vitamin D predisposes the fetus/newborn to low vitamin D stores which can lead to rickets, wheezing, upper respiratory tract infections and mental health issues.  Maternal vitamin D deficiency in pregnancy has also been associated with the increased development of allergies and eczema in children. [2],[3]
 
Low vitamin D levels during pregnancy can also increase the risk of pregnancy complications and is associated with pre-eclampsia, gestational diabetes, pre-term births, and small for gestational age babies.[4]
While some foods like salmon, sardines, tuna, cod-liver oil, egg yolk and shiitake mushrooms provide some Vitamin D, diet alone only provides 100 to 200 IU of vitamin D per day.  However exposure to sunlight produces 10,000 to 20,000 IU when 30% of the body surface area is exposed to sunlight 15-30 minutes a day.[5]  
It is really important to ensure you are meeting your daily vitamin D needs especially if you planning to conceive or are currently pregnant. Having your vitamin D levels assessed for deficiency and supplementing when necessary, can help improve pregnancy and child health outcomes. 

If you have any questions or concerns about your Vitamin D needs and intake, please give us a call and we can help you get the support you need during your pregnancy and beyond.
 

References
[1] Hossein-nezhad A., Holick M.F. Vitamin D for health: A global perspective. Mayo Clin. Proc. 2013;88:720–755.

[2] Jones A.P., Palmer D., Zhang G., Prescott S.L. Cord blood 25-hydroxyvitamin D3 andallergic disease during infancy. Pediatrics. 2012;130:e1128–e1135. doi: 10.1542/peds.2012-1172.

[3] Baïz N., Dargent-Molina P., Wark J.D., Souberbielle J.C., Annesi-Maesano I., EDEN Mother-Child Cohort Study Group Cord serum 25-hydroxyvitamin D and risk of early childhood transient wheezing and atopic dermatitis. J. Allergy Clin. Immunol. 2014;133:147–153.

[4] Wei S.Q., Qi H.P., Luo Z.C., Fraser W.D. Maternal vitamin D status and adverse pregnancy outcomes: A systematic review and meta-analysis. J. Matern. Fetal. Neonatal Med. 2013;26:889–899. doi: 10.3109/14767058.2013.765849.
 

[5] Bouvard B., Annweiler C., Sallé A., Beauchet O., Chappard D., Audran M., Legrand E. Extraskeletal effects of vitamin D: Facts, uncertainties, and controversies. Joint Bone Spine. 2011;78:10–16. doi: 10.1016/j.jbspin.2010.10.011.