Strategies for Supporting Joint Health
In a normal joint, local stem cells constantly replace damaged cartilage by differentiating into more cartilage cells. However, prolonged inflammation leads to a progressive shift in the type of cells present at the site of inflammation, and is characterized by simultaneous destruction and healing of the tissue from the inflammatory process. In other words, the normal repair process is compromised by the inflammation. Building blocks of repair may be present or supplied, but repair is compromised, inefficient, and often ineffective under these circumstances.
Supporting healthy inflammatory balance is important to joint health, particularly after exercise or occasional overexertion. A 2016 systematic review and meta-analysis of randomized clinical trials published in the Journal of Medicinal Food clearly demonstrated that curcumin can support joint health.* Curcumin’s ability to modulate numerous signaling molecules such as pro-inflammatory cytokines, apoptotic proteins, NF–κB, cyclooxygenase-2, 5-LOX, STAT3, C-reactive protein, prostaglandin E2, among other actions, is the reason behind its healthy inflammatory support benefits.
Research also demonstrates that boswellia is especially beneficial in supporting joint health.* Researchers have found that boswellic acids influence leukotriene and prostaglandin synthesis. The active compounds in both of these plants work via multiple mechanisms, rather than targeting a single enzyme or receptor. Working on multiple pathways together is probably the reason these two herbs in particular have been studied so extensively. Their ability to support joint health and healthy inflammatory balance systemically is very significant.*
But supporting healthy inflammatory balance is only one piece of the joint support puzzle.
The research associated with the use of glucosamine and chondroitin sulfate to support joint health is extensive with most of the studies showing positive results.* Glucosamine and chondroitin supply glycosaminoglycans and proteoglycans which are major components of joint cartilage. It appears as though the combination of the two—glucosamine and chondroitin—may provide the most benefit to patients who are looking for additional joint support.*
Cartilage, being avascular, requires hyaluronic acid along with exercise to move nutrients in and waste out. This is the reason behind the seemingly paradoxical fact that exercise often reduces joint pain and stiffness. Hyaluronic acid (HA) is a glycosaminoglycan found in extracellular matrix throughout the body and its role in the synovial fluid of the joint space is to hydrate and provide lubrication. As endogenous HA production declines with age, so does our ability to maintain adequate joint lubrication. We now know that chondroitin is a proteoglycan which not only contributes to forming cartilage matrix, but also to joint lubrication and hydration by attracting and binding hyaluronic acid.
The great news is that all these supplements can be incorporated into an integrative practitioner’s toolbox to support the maintenance of healthy joints.*