Bonlutin: A comprehensive formula for Arthritis

The first sign is chronic pain, usually followed by a loss in mobility and resulting stiffness. Pain manifests itself as a sharp ache, with a burning sensation experienced in muscles and tendons. Crepitus (‘crackling noises’) may occur when joints are moved or touched, while joints may fill with fluid and nearby muscles and tendons go in to spasm.

Arthritis commonly affects the hands, feet, knees, hips and elbows. Stemming from the ancient Greek arthro-, meaning ‘joint,’ +itis, meaning ‘inflammation,’ there are over 100 different types of arthritis with different underlying pathophysiologies – osteroarthritis, rheumatoid arthritis, gouty arthritis, fibromyalgia and systemic lupus erythematosis account for 90% of all cases [1].  It is the experience of pain and swelling around the joints that forms the primary definition of this degenerative disease, making arthritis in all its collective manifestations Australia’s – and probably the world’s – most common cause of disability and chronic pain [2]. 

Aetiology
Wherever two bones articulate with one another in the body, they are generally prevented from rubbing directly against each other by a thin protective layer of cartilage around their heads. This largely collagen-composed layer helps to ensure that bones glide smoothly across one another when they come into contact, a process which is further lubricated by synovial fluid in the knee joint.

As time goes on and people age, the water content in bone cartilage tends to decrease due to a gradual reduction in proteoglycan (aggrecan) levels, leaving the collagen fibres within the cartilage more open to degradation. As the water and collagen within the cartilage deteriorates, the cartilage itself becomes less resilient, losing its elastic properties and allowing bone to grind against bone. This is one of the primary causes for inflammation in the most common form of arthritis: osteoarthritis.

New adventitious bone outgrowths, known as osteophytes (or ‘spurs’), may accompany this condition, causing further pain and inflammation and impeding normal movement as they grind against bone, muscle and tendons.

Rheumatoid arthritis is a systemic auto-immune disorder affecting mainly the synovial joints. As part of an aberrant immune reaction triggered by an as yet unidentified mediator, pro-inflammatory cytokines are produced and begin to attack the non-cartilaginous joint lining (synovium), bone and cartilage itself, giving rise to severe pain and inflammation. As an immune reaction, this process is systemic, commonly affecting multiple joints and eventually leading to deformities and other severe complications.

 
Figure 1. The signs of rheumatoid arthritis. An elderly woman with the finger and wrist deformities that are characteristic of this debilitating disorder.

Treatment
Because arthritis is a degenerative condition, in most cases it is irreversible, and is in fact likely to only get worse over time. Consequently, the vast majority of modern arthritis treatments focus on the management and relief of the symptoms associated with the condition: joint pain and inflammation. Non-steroidal anti-inflammatory drugs (NSAIDs) and analgesics have therefore become the cornerstones of all arthritis treatment regimes [3].  Yet, unfortunately, these medications fail to provide a sufficient level of relief to many arthritis sufferers.

A considerable amount of interest in complementary and adjuvant therapies for arthritis has emerged in recent years, with glucosamine and chondroitin therapeutics proving particularly popular and effective for many individuals. The relatively recent discovery that fish oils can also help to provide effective relief from the symptoms of arthritis is less well known.

Fish Oils (Omega-3 Marine Triglycerides)
Omega-3 marine triglycerides are considered to be essential fatty acids – they are essential for human health, but cannot be manufactured by the body. It is therefore necessary to obtain these acids from food, with fish (particularly fatty fish such as salmon, tuna, herring and mackerel) providing an excellent source.

There are three key types of omega-3 fatty acids that are used by the human body: alpha-linolenic acid (ALA), docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA). Once ingested, ALA tends to be converted into the 20- and 22-carbon fatty acids DHA and EPA, the two forms of omega-3 most favoured by the human body. Research has shown that these omega-3 fatty acids may be useful in reducing the risk of cardiovascular disease, cancer and inflammation associated with arthritis.