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May is National Arthritis Awareness Month and, according to a CDC 2022 analysis, arthritis is increasing in U.S. adults. The number of adults diagnosed with arthritis in 2022 hovered around 59 million, or about one in four adults.
Arthritis is a term used to describe more than 100 conditions that affect the joints, tissue around the joints and other connective tissues. Although specific symptoms vary on the type of arthritis, as well as the individual afflicted, symptoms usually include joint pain and stiffness.1
Osteoarthritis (OA), also known as degenerative joint disease, is the most common type of arthritis. It typically develops with age and most frequently occurs in the hands, hips and knees. Inflammation and injury to the joint cause changes in bone-joint structure, deterioration of tendons and ligaments, and a breakdown of cartilage; the breakdown of cartilage causes bones in the joint to rub together, resulting in severe pain. 1,2
Treatments for pain include over-the-counter (OTC) pain relievers such as nonsteroidal anti-inflammatory drugs (NSAIDs). However, findings in a systematic review and meta-analysis of prolonged NSAID use (ranging from one to seven years) indicated NSAIDs accelerate OA progression.3 Patients who are resistant to or who cannot tolerate NSAIDs are often prescribed opioids.
Surgical treatments — specifically primary and revision hip and knee arthroplasty — are also increasing. The American Joint Replacement Registry 2022 Annual Report indicates the cumulative procedural volume for hip and knee arthroplasty grew by 14% in 2021, or 305,645 additional cases.4
The majority of post-surgery arthroplasty patients are also prescribed opioids. A study indicates that 6% to 15% of opioid-naïve post-op patients became chronic opioid users after major or minor surgery, including 4% of those who underwent total hip arthroplasty and 8% of total knee arthroplasty.5
Although the opioid epidemic in the U.S. is no longer making headlines in national news, national overdose deaths from opioids continue. A significant increase in opioid overdose occurred in 2020, with 68,630 reported deaths, and again in 2021, with 80,411 reported deaths. Prescription opioids caused 16,416 reported deaths in 2020 and 16,706 overdose deaths in 2021.6
Compounding topical pain preparations for arthritis patients may help reduce potential opioid addiction and possible exacerbation of OA progression from prolonged use of NSAIDs.
When taken orally, glutathione is known to help support cartilage. However, using PCCA Glutathione (L) Reduced EP (Pharma Grade) (PCCA #30-5100) topically at a concentration of 20% in a permeation-enhancing base, such as Lipoderm® (PCCA #30-3338) or PermE8® Anhydrous Gel (PCCA #30-5038), works faster than oral administration. We recommend patients apply the preparation directly to affected joints three times daily. Follow-up reports indicate stabilization of cartilage degradation and, in some cases, improvement of joint cartilage.
Magnesium also helps support joint cartilage as well as many other important functions. Magnesium Chloride USP Hexahydrate (PCCA #30-5137) can be used topically at a concentration of 10% in a permeation-enhancing base such as Lipoderm or PermE8.
NSAIDs should only be considered for short-term duration — two to four weeks — for acute inflammation of the joints. Ketoprofen USP, Special Micronized (PCCA #50-3849) may be used at a concentration of 10% topically in a permeation-enhancing base such as Lipoderm or PermE8.
Low-dose naltrexone (LDN) continues to receive great results for various autoimmune diseases and may prove helpful for patients with arthritis. We suggest starting doses using PCCA Naltrexone Hydrochloride USP Anhydrous (PCCA #50-4377), prepared in 0.5 mg capsules with LoxOral® (PCCA #30-4774) as the filler, and titrate 0.5 mg every two weeks up to a maximum of 4.5 mg daily. Keep in mind that we need to be careful of anyone taking opiates with LDN — we recommend a full drug therapy review before starting LDN.
Nutritional supplements may also support joint cartilage and serve other important functions.
As previously mentioned, glutathione taken orally is known to help support cartilage. Wellness Works Glutathione & MSM (WW #10333) provides key nutraceuticals to help cartilage synthesis and stability, support a healthy inflammatory response and provide overall structural support to joint tissue. Other Wellness Works products, such as Wellness Works Glucosamine & Chondroitin Plus (WW #10070) and Glucosamine Sulfate 750 mg (WW #10074), help support the synthesis and maintenance of inflammation while supporting joint health.
Wellness Works Joint Health Support (WW #10091) provides key nutraceuticals to help support a healthy inflammatory response and facilitate cartilage synthesis while providing antioxidant support.
Curcumin has long been proven to support a healthy response to inflammation and appears to contribute to antioxidant defense. Wellness Works Curcumin Ultra (WW #10390) is a revolutionary curcumin supplement that features an innovative liquid-soluble delivery system. Our patented ingredient has shown in clinical studies to provide higher bioavailability than any curcumin/turmeric extract products on the market.7 Wellness Works Curcumin Complex (WW #10251) provides a healthy response to inflammation for those seeking to maintain joint health.
1. Centers for Disease Control and Prevention (CDC). (last reviewed 2022) Arthritis. Accessed May 2023 at https://www.cdc.gov/arthritis/
2. Arthritis Foundation. How Arthritis Hurts. Accessed May 2023 at https://www.arthritis.org/health-wellness/healthy-living/managing-pain/understanding-pain/sources-of-arthritis-pain
3. Simic, D., Harmer, A. van der Esch, M. et al. (2019) Do non-steroidal anti-inflammatory drugs cause osteoarthritis progression, a systematic review and meta analysis. Osteoarthritis and Cartilage, 27, S280-S282. Accessed May 2023 at https://doi.org/10.1016/j.joca.2019.02.663
4. American Academy of Orthopaedic Surgeons. (2022) American Joint Replacement Registry: 2022 Annual Report. Accessed May 2023 at https://www.aaos.org/registries/publications/ajrr-annual-report/
5. Roberts, K.C., Moser, S.E., Collins, A.C., et al. (2020) Prescribing and Consumption of Opioids After Primary, Unilateral Total Hip and Knee Arthroplasty in Opioid-Naïve Patients. J of Arthropls. 35(2)1, 960-965. Accessed May 2023 at https://www.arthroplastyjournal.org/article/S0883-5403(19)30767-3/fulltext
6. National Center for Health Statistics. (2023) Drug Overdose Death Rates. Accessed May 2023 at https://nida.nih.gov/research-topics/trends-statistics/overdose-death-rates
7. Stohs,S.J.,Ji.J.,Bucci,L.R.,&Preuss,H.G.(2018) AComparative Pharmacokinetic Assessment ofaNovelHighlyBioavailableCurcuminFormulationwith95%Curcumin: A Randomized, Double-Blind, Crossover Study. JAmCollNutr.37(1),51-59. Accessed May 2023 at https://pubmed.ncbi.nlm.nih.gov/29043927/