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Fish oil, Joints, and Metabolic Health

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Fish oil, Arthritis pain, and Metabolic syndrome
 
It’s nice to have various options for treating arthritis related pain. In this video I discuss a recent study that looked at the effectiveness of fish oil in arthritis patients who also happen to be elderly and obese. Omega 3 from a Fish oil is a nice option in this scenario where you can treat not only arthritis related pain, inflammation, and the metabolic system.

 
Hello everyone. This is Siddharth Tamber from Chicago Arthritis and Regenerative Medicine. Welcome to our weekly live broadcast. It’s September 30th, 2020. I hope everyone is doing well today. I’ve been talking more and more about the connection between metabolic syndrome and osteoarthritis and joint pain as well. A recent article came out that I think is relevant to this and interesting. A recent article in the Journal of Rheumatology Advanced Practitioners took a look at utilizing fish oil supplementation to reduce pain, osteoarthritis pain in older people who were overweight and obese. Super relevant, because realistically that is a significant portion of our population and osteoarthritis in that population of folks is very high prevalence and we need better options for them. Really conservative better options as opposed to anti-inflammatory meds and chronic narcotics.

In this study they specifically took about 150 people and divided them up into a group that got fish oil, a group that got fish oil plus very low dose curcumin, and a group that received nothing. The dosage of curcumin or turmeric that they received was really low and really not enough to really make any kind of sizable difference. But what they found was that when it came to osteoarthritis pain that there was a significant improvement in those folks who were taking fish oil.
Again really helpful and interesting because as we try to find other low risk options for our patients who’ve got chronic pain, we really want to minimize and avoid things that can cause more problems and issues. So number one what I really liked was that they were able to avoid taking antiinflammatory medications. Personally, I recommend over the counter supplements for my patients if they have osteoarthritis pain including glucosamine chondroitin, omega-3, and turmeric. So what I like about this study is the omega-3 component, which they’re receiving from fish oil, makes a significant difference in this cohort of people that we’re recommending this to.

Number two is the importance of emphasizing how inflammation plays a role in the musculoskeletal system and pain, even in osteoarthritis wear and tear arthritis. And we know that omega-3 works as an anti-inflammatory. So the ability to work not only at a joint level but possibly also at a systemic level in wear and tear arthritis patients is very helpful to know as well. We know that omega-3 in rheumatoid arthritis in high enough dosages is enough to help with pain, stiffness, and function. So it’s nice to find that you can get a similar benefit even in osteoarthritis as well.
The other component that is really great is how would this work on the metabolic system. I presented on Monday how there is evidence that if you have metabolic syndrome, which makes you more prone to heart disease and diabetes, that there’s also evidence that metabolic syndrome can actually cause cartilage breakdown. And that there’s a biomarker that you can actually follow for that. We know that omega-3, because it has that anti-inflammatory component, is appropriate for metabolic syndrome as well. Here is another way that we can look at metabolic syndrome and actually treat that. Again in a conservative way to help preserve and protect the joints as well. Another really nice way to think about how we can connect joints, musculoskeletal issues, pain, and with that total body approach to treating somebody. Where it’s not just looking at this as a structural issue but looking at it as a total biologic issue biochemical issue, nutritional issue, metabolic issue, and how can you treat all those things. Great because if you want to help somebody with pain, let’s make sure we’re not only thinking, “Hey, you’ve got a fixed problem here.” Meaning you’ve got bone on bone arthritis. Let’s think about all the variables and factors that we can actually make a difference on. I think taking that kind of positive approach makes a big difference for people as well.

The last point to this is that omega-3 you can get it in a couple of different things but the two main ones that you can find it in over the counter are in fish oil supplements as well as flaxseed oil. The reality is that the majority of studies that look at the effectiveness of omega-3 when it comes to joint health are actually done utilizing fish oil. So if you’re being really strict by the rules, you’d want to use fish oil supplements. The other aspect to that is if you are someone who has a nutritional preference or you want to avoid fish, then flaxseed oil can give you a high dose of omega-3. But again, we don’t actually know if flaxseed oil can give the same kind of results in terms of clinical response and pain relief.

The last thing to note is that in this study they utilize a total dosage of omega-3 2,400 milligrams. In rheumatoid arthritis studies, they utilize up to 3000 milligrams or higher. That’s a really high dosage. You’re not going to be able to get that on your own from just nutritional ingestion, just from fish ingestion, unless you are an Eskimo and you’re actually using Whale blubber as a condiment. You’re just not going to be getting enough omega-3 on your own. So I think as an option, low-risk option to treat your osteoarthritic pain related issues and just general musculoskeletal pain related issues, I would recommend omega-3 aiming for roughly 3000 milligrams per day.

Great. Well, thank you for your time. This one is relatively brief today and I hope that was helpful. Send me your questions or thoughts. If you have any, as a reminder, we do this on Mondays and Wednesdays live broadcast discussing issues that are relevant to what we do here at Chicago Arthritis and Regenerate Medicine where we focus on nonsurgical management and treatment of arthritis, tendinitis, injuries, and back pain. And until next time I hope everyone does well, has a good day, and live well. Bye bye.

Questions and Answers re your Musculoskeletal Health

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Questions and Answers re your Musculoskeletal Health:

-How to diagnose a joint infection.
-How to evaluate and treat bursitis.
-Can you inject stem cells into an infected joint?
-When would you retreat a joint or tendon if it’s already been treated with a regenerative medicine treatment.

***For evaluation and treatment at Chicago Arthritis and Regenerative Medicine:
https://chicagoarthritis.com/schedule-a-telemedicine-appointment/


– Hello. This is Siddharth Tambar from Chicago Arthritis and Regenerative medicine. It’s October 5th, 2020, and welcome to our weekly live educational broadcast. So last couple of weeks, I’ve been doing this on my own, but I have a team here today asking me questions, which is the way we’re supposed to be doing it, where I answer questions that they have, or that patients have about what we do here in clinic. As a reminder, we are focused on nonsurgical treatment and management of arthritis, tendinitis injuries, and back pain. So great to be doing this with questions again. Jackie, you have questions go for it.

– [Jackie] Yeah, so the first one would be how to rule out the infection of the joint?

– Okay. So first question was from a patient who was asking, how do you know if you have infection in a joint? So a couple things, number one, if you have an infection, there’s certain classic things you would expect to have. Fevers, for sure, swelling in the joint as well, but the gold standard way to really rule that out would be to take fluid out of the joint and to send that off to the lab, let that incubate and grow for several days and rule out any bacteria, fungus, or any other kind of infectious organisms. So for most people, it should be that simple. There are some cases where someone may have a chronic infection or a chronic reaction if they’ve got hardware in the joint, but for the most part, ruling out infection is generally pretty straightforward in that manner. Next question.

– [Jackie] What can you do for patients that have bursitis?

– Great. So what can we do for patients that have bursitis? So bursitis essentially means over different parts of the body, let’s say the shoulder, the knee, the hip, you have the small little fluid sacks called a bursa, which basically helps to protect the bone and that part of the region from any kind of stress, it’s just another sort of small buffer. And in some patients you can have an irritation of that sack, which then leads to bursitis, pain and swelling. So what’s interesting is that number one, does a person really have bursitis? So something that I frequently see, whether it’s for hip bursitis or shoulder bursitis, is that what gets called clinically bursitis is not actually truly bursitis. When you actually look under ultrasound, which you find is more tendonitis and you don’t actually find fluid in the bursa. So number one is, do you really have that proper diagnosis? And so if somebody truly has tendonitis and it’s not actually bursitis, you’d want to make that diagnosis first. And then the treatment for that would be as we do that, as we do this every single day, which is physical therapy, activity modification, and then if needed using either your own platelets for platelet rich plasma or your own bone marrow derived STEM cells, inject that into the injured tissue, whether that is the tendon, the ligaments that support the support that area as well. And sometimes if there is a chronically irritated bursa, even injecting into that as well. On the other end, if somebody really does have fluid in the bursa, then number one, just draining the fluid out of the bursa, making sure that it’s not infected, making sure that there’s no crystals or other inflammation in it. And then treating not only the bursa with those same cells, but then also treating those other soft tissue components around that as well to help basically protect that area, make it stronger, and then prevent that recurrence of bursitis. What other questions?

– [Jackie] My very last one. Patient wanted to know, how would that procedure work for him, the regenerative procedures, if he does in fact have infection in the joint?

– Okay, great question. So last question that Jackie asked is I guess the question is, can you utilize these kinds of cell based treatments if you have an infection in the joint? And really the simple answer is no. I mean, if you truly have an infection in the joint, you’d want to get that cleared. Firstly with antibiotics, you may need to actually get that surgically cleared as well, drained out more thoroughly. I would not recommend injecting cells or really anything for that matter into an actively inflamed joint. A better option would be to treat the infection first and then treat any sort of residual issues that may be there. For people that have had chronically injured joint after a prior infection, after the infection is cleared and you’re kind of fully away from that, then you can actually inject your own cells, whether it’s bone marrow or platelets into the joint, to actually treat that injured joint to that point. But when it’s actually infected, you definitely want to avoid that.

– [Jackie] Thank you.

– Devi or Susan, questions?

– [Susan] Nope, none for me.

– Wow, I must be doing a great job answering questions at works then.

– [Jackie] I do have a question. I know I said last one.

– Yes, please.

– [Devi] So we oftentimes have patients who are repeat customers to either treat the same joint a few years later, or the complimentary joint. So, you know, first we did right hip and then coming back to the left. So is it normal for patients to have a few years go by and have the same area treated again and why?

– Okay, great question. So the question is, is it normal to retreat an area after it’s been treated once? Partly it depends on what the problem is, right? So if somebody has, let’s say a recent onset injury, the expectation is if you can treat that early on, you can actually prevent that from progressing in the future. They probably would not need repeat treatments. On the other end, if somebody has, let’s say a chronically arthritic knee or lower back, it’s likely that they will need repeat treatments sometime in the future. The evidence shows that not only do people get long lasting results, but that if they do need a second treatment, they’ll actually get a improvement to a higher level after that second treatment as well. So a couple examples of that. Number one is my own mother-in-law, I’ve treated one or the other knee, basically every six months. So treating, let’s say, her left knee once per year, her right knee once per year. It’s been about a year since we last treated either one of her knees. And she’s someone that has had really significant damage in the knees in the past. Because we’ve repeat treated her over time, she’s actually done well without any treatment for either one of those needs for the last year. So she’s had sort of a persistent longer lasting result because she’s had repeat exposure to cells. Another example would be a patient who I saw in the past that had what I would consider a very challenging hip case. And he actually got treated every six months, three times with his own bone marrow STEM cells. And he’s done phenomenally well, like much better than I would have expected. And so even in cases that would be considered chronic or poor candidates repeating treatment can make a big difference longterm as well. So absolutely for chronic issues, you should expect somewhere down the line, repeat treatment. Note that the best way to maintain effectiveness longterm is to maintain ideal body weight, strength around that joint as well, and alignment, neuromuscular health, metabolic health, all the basics that we talk about nowadays. So yes.

– [Devi] Is that expectation set during the evaluation with you?

– It’s discussed, for sure. Yeah, absolutely. I mean the data and the evidence and the numbers that we generally kind of quote about effectiveness of treatment are based on a one time treatment. What I tell patients is expect somewhere down the line, if you have a chronic issue, you’ll likely need a repeat treatment again at some point. What else? Devi, Jackie.

– [Jackie] I think those were my main ones for this topic.

– Susan, are you inspired with any questions?

– [Susan] No, none. Okay, great. Well, thank you very, very much everyone. This is a relatively short one, but sometimes that’s all the questions that there are. And as a reminder, we do this live two times per week, Monday and Wednesday. As another reminder, I’m doing a webinar this Wednesday 5:00 PM central standard time on regenerative medicine treatments for knee pain. So if you have knee arthritis and are interested in STEM cell treatment, we’ll talk about that. If you’re someone that’s had a recent onset knee injury, we’ll talk about how platelet rich plasma or your own bone marrow cells can help out. If you have an ACL injury, MCL injury, a tendon related injury or tendonitis. Or if you’re just interested in regenerative medicine, learning more about treatment in general and how you can discern and figure out which physician or clinic to see based on best practices, I’ll be discussing that as well. So until next time, have a good day and live well. Bye bye.

– [Woman] Thanks, Dr. T.

– You’re welcome.


Content- Weekly Education
Live Weekly educational meeting for the team at Chicago Arthritis and Regenerative Medicine where we discuss the basics of what we do for arthritis, tendinitis, injuries, and back pain.
Watch live on FB/IG/Youtube every Monday.
https://www.Instagram.com/ChicagoArthritis
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Sign up for our email newsletter:
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See our blog:
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Listen to the Regenerative Medicine Report podcast:
https://chicagoarthritis.com/regenerative-medicine-report/


 

MEDICAL ADVICE DISCLAIMER: All content in this message/video/audio broadcast and description including: infor­ma­tion, opinions, con­tent, ref­er­ences and links is for infor­ma­tional pur­poses only. The Author does not pro­vide any med­ical advice on the Site. Access­ing, viewing, read­ing or oth­er­wise using this content does NOT cre­ate a physician-patient rela­tion­ship between you and it’s author. Pro­vid­ing per­sonal or med­ical infor­ma­tion to the Principal author does not cre­ate a physician-patient rela­tion­ship between you and the Principal author or authors. Noth­ing con­tained in this video or it’s description is intended to estab­lish a physician-patient rela­tion­ship, to replace the ser­vices of a trained physi­cian or health care pro­fes­sional, or oth­er­wise to be a sub­sti­tute for pro­fes­sional med­ical advice, diag­no­sis, or treatment. You should con­sult a licensed physi­cian or appropriately-credentialed health care worker in your com­munity in all mat­ters relat­ing to your health.

Inflammation, Joints, & Heart Disease

inflammation, joints, heart disease
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Inflammation, Joints, Heart disease.

Controlling inflammation is important. Acute inflammation after an injury can be helpful. It’s how regenerative medicine works and the basis for how you restart a normal healing process. But if that inflammation acutely is out of control, or if you have chronic inflammation, those can be real problems. In Rheumatoid arthritis chronic inflammation is the source of not only joint damage and pain, but also for the higher incidence of cardiovascular problems.  Controlling that chronic inflammation in Rheumatoid arthritis is key for joint health. We now have evidence that you can make a difference from a cardiovascular disease standpoint as well.

Chicago Arthritis and Regenerative Medicine Weekly Live broadcast.
Check us out live on Instagram, Facebook, or Youtube every Wednesday at 12:15pm cst.
Discussing relevant issues regarding state of the care for arthritis, tendinitis, injuries, and back pain.
https://www.Instagram.com/ChicagoArthritis
https://www.Facebook.com/ChicagoArthritis
https://www.Youtube.com/c/chicagoarthritis

***For more educational content:
Sign up for our email newsletter: 
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See our blog:
https://chicagoarthritis.com/blog/

Listen to the Regenerative Medicine Report podcast: 
https://chicagoarthritis.com/regenerative-medicine-report/


***For evaluation and treatment at Chicago Arthritis and Regenerative Medicine:
Determine if you are a Regenerative Medicine treatment candidate: 
https://chicagoarthritis.com/regenexx-candidate-form/

Contact us for more information or to schedule an appointment: 
https://chicagoarthritis.com/contact-us/


MEDICAL ADVICE DISCLAIMER: All content in this message/video/audio broadcast and description including: infor­ma­tion, opinions, con­tent, ref­er­ences and links is for infor­ma­tional pur­poses only. The Author does not pro­vide any med­ical advice on the Site. Access­ing, viewing, read­ing or oth­er­wise using this content does NOT cre­ate a physician-patient rela­tion­ship between you and it’s author. Pro­vid­ing per­sonal or med­ical infor­ma­tion to the Principal author does not cre­ate a physician-patient rela­tion­ship between you and the Principal author or authors. Noth­ing con­tained in this video or it’s description is intended to estab­lish a physician-patient rela­tion­ship, to replace the ser­vices of a trained physi­cian or health care pro­fes­sional, or oth­er­wise to be a sub­sti­tute for pro­fes­sional med­ical advice, diag­no­sis, or treatment. You should con­sult a licensed physi­cian or appropriately-credentialed health care worker in your com­munity in all mat­ters relat­ing to your health.

About this video
In this video Siddharth Tambar MD from Chicago Arthritis and Regenerative Medicine discusses inflammation, joints, and heart disease.

Metabolic Syndrome, Knee Osteoarthritis, Cartilage Degeneration

metabolic syndrome, knee arthritis, cartilage breakdown
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Interesting new study showing that metabolic syndrome increases the rate of cartilage breakdown in knee arthritis.
Indian J Orthop. 2020 Jul 24;54(Suppl 1):20-24.

This particular study is really interesting because we need to start thinking about osteoarthritis progressively more and more as a biochemical process, as a biologic process, and not just as a structural process. Eventually there is structural damage but what drives that are biochemical and biologic processes at the level of the joint and throughout the body. You can actually work on these variables with nutrition, supplements, exercise, and if needed Regenerative Medicine procedures.


I frequently talk about how metabolic syndrome is a problem for joints. So metabolic syndrome is a cluster of conditions that when they occur together, increase your risk of heart disease, stroke and type two diabetes. So these cluster conditions include elevated blood pressure high blood sugar, excess body fat around the waist, and abnormal cholesterol or triglyceride or fatty content in the blood. Significant because if you have metabolic syndrome, I frequently talk about how that makes you more prone to inflammation, which then makes you more prone to joint and tendon related problems.

So how does that really translate in a practical manner? And do we have evidence that that can really affect arthritis? It turns out, yes we do. A recent study published in the Indian Journal of Orthopaedics took a look at people that have knee osteoarthritis, and took a look at this specific question about how on a biochemical level does metabolic syndrome affect knee osteoarthritis. They essentially analyzed two different biochemical markers that you see in cartilage health. One is a biochemical marker of cartilage degeneration and another is a biochemical marker of cartilage regeneration. They found that between these two groups one with metabolic syndrome, one without metabolic syndrome, both with knee osteoarthritis, that there was no difference in the level of cartilage regeneration biomarker. However, the degeneration biomarker was higher in the metabolic syndrome patients. That is interesting and significant.

This shows on a biochemical level how metabolic syndrome may be impacting cartilage health and joint health. Also, frequently we think when it comes to treating your joints/tendons, your arthritis/tendonitis, we think of it as very much just a structural issue. We think of it as how do you improve the strength of the muscles. We also think of bones as very static tissue. That’s not really accurate. These are dynamic processes, and they can get better and worse over time. And rather than think of arthritis and tendonitis in a static manner, and as a linear two dimensional physical process only, we should be thinking of it as an inflammatory process, as a biochemical process as well, and realize that there’s other ways to treat these kinds of issues.

This particular study is really interesting because we need to start thinking about osteoarthritis progressively more and more as a biochemical process, as a biologic process, and not just as a structural process. Eventually there is structural damage but what drives that are biochemical and biologic processes at the level of the joint and throughout the body. You can actually work on these variables with nutrition, supplements, exercise, and if needed Regenerative Medicine procedures.

So really interesting study. And to me, it gives another angle about how we need to think about osteoarthritis and joint issues. And it also helps to explain why metabolic syndrome is a problem for people that have osteoarthritis, in particular of the knee, but really osteoarthritis in general. That kind of insight lets us help people in more ways. It allows us to think about how can we be preventative when it comes to knee osteoarthritis. Well, it’s by working on some of those metabolic syndrome and biochemical issues.

***For evaluation and treatment at Chicago Arthritis and Regenerative Medicine:
Determine if you are a Regenerative Medicine treatment candidate:
https://chicagoarthritis.com/regenexx-candidate-form/


MEDICAL ADVICE DISCLAIMER: All content in this message/video/audio broadcast and description including: infor­ma­tion, opinions, con­tent, ref­er­ences and links is for infor­ma­tional pur­poses only. The Author does not pro­vide any med­ical advice on the Site. Access­ing, viewing, read­ing or oth­er­wise using this content does NOT cre­ate a physician-patient rela­tion­ship between you and it’s author. Pro­vid­ing per­sonal or med­ical infor­ma­tion to the Principal author does not cre­ate a physician-patient rela­tion­ship between you and the Principal author or authors. Noth­ing con­tained in this video or it’s description is intended to estab­lish a physician-patient rela­tion­ship, to replace the ser­vices of a trained physi­cian or health care pro­fes­sional, or oth­er­wise to be a sub­sti­tute for pro­fes­sional med­ical advice, diag­no­sis, or treatment. You should con­sult a licensed physi­cian or appropriately-credentialed health care worker in your com­munity in all mat­ters relat­ing to your health.

Testimonial- PRP treatment for Knees and Lower back- 20200811

Testimonial- PRP treatment for Knees and Lower back

***For more educational content:
Sign up for our email newsletter:
https://chicagoarthritis.com/newsletter/

See our blog:
https://chicagoarthritis.com/blog/

Listen to the Regenerative Medicine Report podcast:
https://chicagoarthritis.com/regenerative-medicine-report/


***For evaluation and treatment at Chicago Arthritis and Regenerative Medicine:
Determine if you are a Regenerative Medicine treatment candidate:
https://chicagoarthritis.com/regenexx-candidate-form/

Contact us for more information or to schedule an appointment:
https://chicagoarthritis.com/contact-us/


MEDICAL ADVICE DISCLAIMER: All content in this message/video/audio broadcast and description including: infor­ma­tion, opinions, con­tent, ref­er­ences and links is for infor­ma­tional pur­poses only. The Author does not pro­vide any med­ical advice on the Site. Access­ing, viewing, read­ing or oth­er­wise using this content does NOT cre­ate a physician-patient rela­tion­ship between you and it’s author. Pro­vid­ing per­sonal or med­ical infor­ma­tion to the Principal author does not cre­ate a physician-patient rela­tion­ship between you and the Principal author or authors. Noth­ing con­tained in this video or it’s description is intended to estab­lish a physician-patient rela­tion­ship, to replace the ser­vices of a trained physi­cian or health care pro­fes­sional, or oth­er­wise to be a sub­sti­tute for pro­fes­sional med­ical advice, diag­no­sis, or treatment. You should con­sult a licensed physi­cian or appropriately-credentialed health care worker in your com­munity in all mat­ters relat­ing to your health.