Musculoskeletal Conditions

Question 1

\_\_\_\_\_\_\_\_\_\_\_\_\_ Disease
Includes more than 100 different manifestations of
inflammation and loss of function involving the joints,
tendons, ligaments, bones, muscles (and sometimes the
internal organs)
Osteoarthritis (OA):
• Affects 21 million Americans
Gout:
• Affects 5.1 million Americans
Rheumatoid Arthritis (RA):
• Affects 3 million Americans
Fibromyalgia:
• Affects 3.7 million Americans

Answer 1

Rheumatic

Question 2

Inflammation

• Inflammatory process normally occurs to
_____&_______ damaged tissue; once the
cause resolves, the inflammation subsides
• Inflammation from stress on the joints (OA) or an
autoimmune response (RA) – in most forms of
arthritis - the inflammatory response continues
OUT OF CONTROL causing MORE damage than repair
Inflammation is the predominant cause of pain
The most debilitating form of arthritis involve
inflammation

1—Omega-6 fatty acids
– In general, lead to the production of more inflammatory chemicals Omega-3
– Result in less inflammatory chemicals
2—Inflammatory and anti-inflammatory chemicals or
“__________” are therefore created from nutrients in the food we eat
3–ArA Cascade = (PRO-inflammatory)
–* NOTE: _______ enzyme inhibitors reduce inflammation by blocking the final step in this pathway
RECALL: While they block production of inflammatory prostaglandins, they also block the production of the anti-inflammatory series 3 Prostaglandins in the Omega-3 Pathways
4—EPA Cascade = (ANTI-inflammatory)
5–NSAIDs: (aspirin, naproxen, ibuprofen: Advil, Motrin ) block the COX-1 and COX-2 enzyme
—COX-1 is involved in:
 Cytoprotection of gastric cells
 Normal vascular endothelial function
 Platelet aggregation
—–Inhibition of _____ results in problems including:
 Gastric ulceration & gastrointestinal bleeding
 Cardiovascular problems

Answer 2

protect and repair

prostaglandins

COX-2
***COX-2 is responsible for pain and inflammation

COX-1

Question 3

Anti-Inflammatory Diet—-May take a few days, weeks or longer for a patient to see a difference in symptoms
through dietary changes or supplementation

1—REDUCE INTAKE OF
–Arachidonic acid
–Saturated fats and omega 6 fatty acids
—Added, simple sugars
—Trans fats/partially hydrogenated fats
2—Pharmaceuticals used to treat _______ may disrupt
gastrointestinal barrier integrity inducing inflammation
and a state of hyper-permeability
3—PREbiotics and PRObiotics may help restore GI barrier functionality and down regulate pro-inflammatory mediators
4—Bioflavonoids—In vitro experimental systems also showed that flavonoids possess anti-inflammatory, antiallergic, antiviral, and anticarcinogenic properties
—___________, in particular, inhibits both
COX and LOX activities, thus diminishing the formation of these inflammatory metabolites
— Strongly inhibited arthritic inflammation in rats

Answer 3

PAIN

Quercetin

Question 4

KEY POINTS

1—Osteoarthritis—Achieve and maintain a desirable body weight—OA is accelerated by ____–Low vitamin D may contribute to progression of OA
2–Glucosamine Sulfate–Found in body as precursor to glycosaminoglycans—Used by condrocytes to manufacture proteoglycans incorporated into ARTICULAR cartilage—Body’s manufacturing declines with age—Supplemental glucosamine may compensate to help
REBUILD worn articular surfaces–Works slowly by reconstituting cartilage—NOTE: While NSAIDs alleviate pain faster, they may accelerate the degeneration of articular cartilage
3–S-Adenoyl-L-Methionine (SAMe)—Found to have efficacy equivalent to that of NSAIDs in reducing ____ and functional limitations with OA and with fewer side effects
4–Gout–Increased intake of fluids of at least 3 L per day will help with the excretion of uric acids and minimize the risk of renal calculi formation– a LOW-purine diet that provides a moderate intake of meats, seafood, and alcohol is usually advised…______ contains large purine load and regular ingestion may contribute to
hyperuricemia and gout

Answer 4

obesity

PAIN

BEER

Question 5

5—Fibromyalgia–Characterized by muscle pain, fatigue, and tender points in the neck, spine, shoulders, and hips
• Increase fruits and vegetables may have a beneficial effect in the treatment of fibromyalgia
—-“______” Cocktail = Consists of magnesium, calcium, B vitamins, and vitamin C— Popular approach for treating Fibromyalgia and Chronic Fatigue syndrome

Answer 5

Myers

Question 6

6–Chronic Lower Back Pain–83% of the study patients had an abnormally low level of vitamin D before treatment
—Phase 1: Acute = Managing Pain & Inflammation
Duration: 12-72 Hour
—Phase 2: Sub-Acute = Repairing Tissue
Duration: 4-6 Weeks
—Phase 3: Chronic = Ongoing Care for Acute and Chronic Injuries
Duration: Long Term

Answer 6

KNOW