Knee Hurt

Category: Knee Arthritis

  • right side knee pain when bending

    right side knee pain when bending

    Knee pain when bending is a common issue that many people face. This discomfort can be mild or severe and can affect daily activities. Understanding the causes and treatments for this type of pain is important to find relief and improve quality of life. In this article, we’ll explore the various reasons behind knee pain when bending and discuss ways to manage and prevent it.

    Common Causes of Right Side Knee Pain When Bending

    right knee pain illustration

    Knee pain when bending is a common problem for many people and can have numerous underlying causes. Osteoarthritis, meniscus tears, bursitis, ligament strain, and tendonitis are some of the most common causes. Bone fractures or infections in the joint may also cause knee pain. Often, knee pain can occur due to overuse or an unexpected increase in physical activity. Additionally, obesity or misalignment of the hips (such as hip aberration) can lead to increased pressure and tension on the knees that can cause pain.

    Sharp Pain in the Knee When Bending

    knee pain illustration

    Torn Ligament or Meniscus

    A torn ligament or meniscus can cause sharp pain when bending the knee. This injury often happens during sports or physical activities. You might also notice swelling and difficulty moving your knee.

    Knee or Patellar Fracture

    A fracture in the knee or patella can lead to severe pain when bending. This type of injury usually results from a direct blow or fall. Symptoms include intense pain, swelling, and an inability to straighten the leg.

    Osteoarthritis

    Osteoarthritis is a common cause of knee pain, especially in older adults. This condition occurs when the cartilage in the knee joint wears down over time. Symptoms include pain, stiffness, and swelling, which can worsen when bending the knee.

    If you experience sharp pain in your knee when bending, it’s important to consult a healthcare professional for a proper diagnosis and treatment plan.

    Pain at the Top of the Kneecap When Bending

    Knee Bursitis

    Knee bursitis happens when the small fluid-filled sacs, called bursae, become inflamed. These sacs help reduce friction and cushion pressure points between your bones and the tendons, muscles, and skin near your joints. When they get irritated, you might feel pain at the top of your kneecap, especially when bending your knee.

    Quadriceps Tendonitis

    Quadriceps tendonitis is an inflammation of the tendon that connects your quadriceps muscles to your kneecap. This condition often results from overuse, especially in activities that involve a lot of jumping or running. Pain at the top of the kneecap is a common symptom, and it can worsen when you bend your knee.

    Osteoarthritis

    Osteoarthritis is a type of arthritis that occurs when the cartilage that cushions the ends of your bones wears down over time. This can lead to pain and stiffness in the knee, particularly at the top of the kneecap. Bending the knee can become especially painful as the condition progresses.

    If you experience persistent pain at the top of your kneecap when bending, it’s important to consult a healthcare professional for a proper diagnosis and treatment plan.

    Diagnosing Knee Pain When Bending

    Medical History and Symptoms

    When diagnosing knee pain, doctors first look at your medical history and symptoms. They ask about when the pain started, what makes it worse, and if you have any other health issues. This helps them understand the possible causes of your pain.

    Physical Examination

    Next, the doctor will do a physical exam. They will check your knee for swelling, tenderness, and range of motion. They might also move your knee in different ways to see what hurts. This can help them find out if you have a specific injury or condition.

    Imaging Tests

    Sometimes, doctors need more information to diagnose your knee pain. They might order imaging tests like X-rays, MRIs, or CT scans. These tests can show details inside your knee, like bones, cartilage, and ligaments. This helps doctors see if there is any damage or other issues causing your pain.

    If you are experiencing knee pain, especially when you bend it to walk, kneel, sit, squat, and more, it is likely that you have a condition or injury that needs treatment. It is incredibly difficult to self-diagnose correctly, so seeing an orthopedic specialist is critical.

    Treatment Options for Knee Pain When Bending

    knee pain illustration

    Medications

    For knee pain, doctors often suggest medications to help manage discomfort and reduce inflammation. Over-the-counter pain relievers like ibuprofen or acetaminophen can be effective. In some cases, a doctor might prescribe stronger medications or injections to provide relief.

    Physical Therapy

    Physical therapy is a common treatment for knee pain. A physical therapist can guide you through exercises that improve strength, flexibility, and mobility in your knee. These exercises are tailored to your specific condition and can help you recover faster.

    Surgical Interventions

    When other treatments don’t work, surgery might be necessary. Procedures can range from minimally invasive arthroscopy to more complex operations like knee replacement. The type of surgery depends on the cause and severity of your knee pain.

    It’s important to consult with a healthcare provider to determine the best treatment plan for your knee pain. They can help you weigh the benefits and risks of each option.

    Preventing Knee Pain When Bending

    Proper Warm-Up and Stretching

    Warming up and stretching before any physical activity is crucial. Always stretch your legs before and after exercising. This helps to prepare your muscles and joints for the activity, reducing the risk of injury. Avoid sudden increases in the intensity of your exercise routine; instead, gradually work your way up.

    Strengthening Exercises

    Practicing regular strengthening exercises that target the muscles supporting your knees can significantly reduce the risk of injury. Focus on exercises that strengthen your quadriceps, hamstrings, and calves. These muscles help stabilize your knee joint.

    Maintaining a Healthy Weight

    Maintaining a healthy weight is essential for reducing the strain on your knees. If you are overweight, losing excess weight can make a big difference. This reduces the pressure on your knee joints, making injuries less likely.

    Consistent exercise and a balanced diet are key to keeping your knees healthy and pain-free.

    When to See a Doctor for Knee Pain

    Persistent Pain

    If your knee pain doesn’t go away after a few days, it’s time to see a doctor. Chronic pain that lasts for weeks or even months needs medical attention to find out what’s wrong and how to fix it.

    Swelling and Instability

    If your knee is swollen or feels like it might give out, you should get it checked. Swelling can mean there’s something serious going on inside your knee, and instability can make it hard to walk or do everyday things.

    Limited Range of Motion

    When you can’t bend or straighten your knee like you used to, it’s a sign you need to see a doctor. Limited movement can be a sign of a bigger problem that needs treatment.

    Don’t ignore knee pain. Seeing a doctor early can help you get the right treatment and avoid more problems later.

    Conclusion

    Knee pain when bending can be a real hassle, affecting your daily activities and overall quality of life. It’s important to remember that there are many possible causes, from minor injuries to more serious conditions like osteoarthritis or torn ligaments. If you’re experiencing this kind of pain, it’s best to consult a doctor for a proper diagnosis and treatment plan. In the meantime, simple measures like rest, ice, and over-the-counter pain relievers can help manage the discomfort. Stay proactive about your knee health, and don’t ignore persistent pain. Taking early action can make a big difference in your recovery and long-term well-being.

    Key Takeaways

    • Knee pain when bending can be caused by different factors like injuries, arthritis, and tendonitis.
    • Sharp knee pain might indicate a serious issue like a torn ligament or fracture.
    • Pain at the top of the kneecap could be due to bursitis or tendonitis.
    • Proper diagnosis often requires a combination of medical history, physical exams, and imaging tests.
    • Treatment options range from medications and physical therapy to surgical interventions.

    Frequently Asked Questions

    Why does my knee hurt when I bend it?

    Knee pain when bending can be caused by various conditions such as Baker’s cyst, hamstring tendonitis, or a knee injury. Sharp pain might indicate a torn ligament or meniscus, a knee fracture, or osteoarthritis.

    What should I do if I have sharp knee pain when bending?

    If you experience sharp knee pain when bending, it’s important to see a doctor. They can diagnose the issue, which could be a torn ligament, meniscus, or a fracture. Avoid putting weight on the knee until you get a diagnosis.

    Can I treat knee pain at home?

    Some mild knee pain can be managed at home with rest, ice, compression, and elevation (RICE). Over-the-counter pain relievers may also help. However, if the pain is severe or persists, you should see a doctor.

    How can I prevent knee pain when bending?

    To prevent knee pain, make sure to warm up and stretch before activities, strengthen your leg muscles, and maintain a healthy weight. Wearing proper footwear and avoiding sudden increases in physical activity can also help.

    When should I see a doctor for knee pain?

    You should see a doctor if your knee pain is persistent, causes swelling or instability, or limits your range of motion. These could be signs of a more serious condition that needs medical attention.

    What are the treatment options for knee pain?

    Treatment options vary depending on the cause and severity of the pain. They can include medications, physical therapy, and in some cases, surgical interventions. Your doctor will recommend the best course of action for your specific situation.

  •  Knee Pain Inside and Below Knee Cap: What You Need to Know

     Knee Pain Inside and Below Knee Cap: What You Need to Know

    Knee pain can be a real bother, especially when it’s inside or below the knee cap. It can make simple activities like walking or climbing stairs a challenge. Understanding what causes this pain and how to treat it can help you get back to doing the things you love.

    Key Takeaways

    • Understanding the knee’s anatomy is crucial to identifying the source of pain.
    • Common causes of knee pain include Patellofemoral Pain Syndrome, Chondromalacia Patella, and Tendonitis.
    • Symptoms like pain, swelling, and clicking sounds should not be ignored.
    • Proper diagnosis often requires a physical exam and imaging tests.
    • Treatment can range from rest and physical therapy to medications and surgery.

    Understanding Knee Anatomy

    The knee is a complex joint made up of several important parts. Understanding its anatomy is crucial for identifying the causes of pain. The knee includes bones, cartilage, ligaments, tendons, and muscles that all work together to allow movement and support the body.

    Bones and Cartilage

    The main bones in the knee are the femur (thigh bone), tibia (shin bone), and patella (kneecap). Cartilage is a smooth tissue that covers the ends of these bones, helping them glide smoothly against each other.

    Ligaments and Tendons

    Ligaments are strong bands of tissue that connect bones to other bones. The knee has four main ligaments:

    • Anterior cruciate ligament (ACL)
    • Posterior cruciate ligament (PCL)
    • Medial collateral ligament (MCL)
    • Lateral collateral ligament (LCL)

    Tendons connect muscles to bones, allowing for movement. The patellar tendon connects the kneecap to the shin bone.

    Muscles Involved

    Several muscles around the knee help with movement and stability. The quadriceps at the front of the thigh help straighten the leg, while the hamstrings at the back help bend it.

    Understanding the anatomy of the knee can help you recognize when something is wrong. If you experience pain, it might be a sign that something is not right.

    If you ever see a “page not found – knee hurt” message, it might be a sign to check your knee health. Always consult a professional if you have concerns about your knee.

    Common Causes of Knee Pain Inside and Below the Knee Cap

    Patellofemoral Pain Syndrome

    Patellofemoral Pain Syndrome, often called runner’s knee, is a common issue. It happens when the cartilage under the kneecap is damaged due to overuse or injury. This condition can cause pain during activities like running, squatting, or climbing stairs.

    Chondromalacia Patella

    Chondromalacia Patella involves the softening and breakdown of the cartilage on the underside of the kneecap. This can lead to pain and swelling, especially when moving the knee. It’s often seen in young athletes and older adults.

    Tendonitis

    Tendonitis is the inflammation of the tendons around the knee. This condition is usually caused by repetitive stress or overuse. Symptoms include pain, swelling, and difficulty moving the knee. Rest and physical therapy are common treatments for this condition.

    Symptoms to Watch For

    Pain and Swelling

    Pain and swelling are common signs of knee problems. You might feel a sharp or dull ache inside or below the knee cap. Swelling can make your knee look bigger and feel stiff.

    Clicking or Popping Sounds

    Hearing clicking or popping sounds when you move your knee can be a sign of trouble. These sounds might happen when you bend or straighten your knee.

    Difficulty Bending the Knee

    If you find it hard to bend or straighten your knee, it could be a sign of an issue. This might make it tough to walk, run, or even sit comfortably.

    Important: If you notice any of these symptoms, it’s a good idea to talk to a doctor. Early treatment can help prevent more serious problems.

    Diagnosis and Medical Evaluation

    Physical Examination

    When you visit a doctor for knee pain, the first step is usually a physical examination. The doctor will check for tenderness, swelling, and range of motion. They may also ask you to walk or perform specific movements to see how your knee responds.

    Imaging Tests

    If the physical exam doesn’t provide enough information, imaging tests like X-rays or MRIs might be needed. These tests can show detailed pictures of the bones and soft tissues in your knee, helping to identify any damage or abnormalities.

    When to See a Specialist

    Sometimes, knee pain requires more specialized care. If your pain is severe, doesn’t improve with basic treatments, or is accompanied by other symptoms like fever or significant swelling, it’s important to see a specialist. They can offer more advanced treatments and help you manage your condition effectively.

    Early diagnosis and treatment can make a big difference in managing knee pain and preventing further damage.

    Treatment Options for Knee Pain

    Rest and Physical Therapy

    Taking a break from activities that cause pain is often the first step. Resting the knee can help reduce inflammation and give it time to heal. Physical therapy is also important. A therapist can guide you through exercises that strengthen the muscles around the knee, improving stability and reducing pain.

    Medications and Injections

    Over-the-counter pain relievers like ibuprofen can help manage pain and swelling. In some cases, doctors may recommend injections. These can include corticosteroids to reduce inflammation or hyaluronic acid to lubricate the joint.

    Surgical Interventions

    When other treatments don’t work, surgery might be needed. Common procedures include arthroscopy to remove damaged tissue or realignment surgery to correct the position of the kneecap. Surgery is usually considered a last resort after trying other treatments.

    It’s important to talk to your doctor about the best treatment plan for your specific condition. They can help you decide which options are right for you.

    Preventing Knee Pain

    knee pain illustration

    Strengthening Exercises

    Regular exercise is crucial for keeping your knees healthy. Focus on exercises that strengthen the muscles around your knee, like squats and lunges. These exercises help support the knee joint and reduce the risk of injury. Aim to include these exercises in your routine at least three times a week.

    Proper Footwear

    Wearing the right shoes can make a big difference in preventing knee pain. Choose shoes that provide good arch support and cushioning. Avoid high heels and shoes with worn-out soles. If you have flat feet or other foot issues, consider using orthotic inserts for extra support.

    Avoiding Overuse

    It’s important to listen to your body and avoid overusing your knees. Take breaks during activities that put a lot of stress on your knees, like running or jumping. Mix up your workouts to include low-impact activities like swimming or cycling. This helps prevent overuse injuries and keeps your knees in good shape.

    Taking care of your knees now can help you avoid pain and problems in the future. Make these simple changes to your routine to keep your knees healthy and strong.

    Living with Chronic Knee Pain

    Pain Management Techniques

    Living with chronic knee pain can be challenging, but there are ways to manage it. Finding the right pain management techniques is crucial. This might include over-the-counter pain relievers, prescribed medications, or even alternative therapies like acupuncture. It’s important to find what works best for you.

    Lifestyle Adjustments

    Making some changes in your daily routine can help ease knee pain. Simple adjustments like using supportive footwear, avoiding high-impact activities, and incorporating low-impact exercises such as swimming or cycling can make a big difference. Consistency in these changes is key to managing pain effectively.

    Support and Resources

    Having a support system is essential when dealing with chronic knee pain. This can include family, friends, or support groups. Additionally, there are many resources available, such as physical therapy, online forums, and educational materials, to help you navigate your condition.

    Living with chronic knee pain requires patience and persistence. Remember, you are not alone, and there are many ways to find relief and support.

    Conclusion

    Knee pain inside and below the knee cap can be a real bother, but understanding the causes and treatments can help. Remember, it’s important to listen to your body and not ignore the pain. Simple steps like resting, icing, and doing the right exercises can make a big difference. If the pain doesn’t go away, it’s a good idea to see a doctor. They can help figure out what’s wrong and get you back on your feet. Taking care of your knees now can keep them healthy for years to come.

    Frequently Asked Questions

    What is Patellofemoral Pain Syndrome?

    Patellofemoral Pain Syndrome is a condition where you feel pain around your knee cap. It’s often caused by overuse or misalignment of the knee.

    How can I tell if I have Chondromalacia Patella?

    If you have Chondromalacia Patella, you might feel pain under your knee cap, especially when going up or down stairs. Your knee might also make a grinding sound.

    What are the common symptoms of knee tendonitis?

    Common symptoms of knee tendonitis include pain and swelling in the knee area. You may also find it hard to move your knee.

    When should I see a doctor for knee pain?

    You should see a doctor if your knee pain is severe, doesn’t go away, or if you can’t move your knee. Also, if your knee looks deformed, it’s time to see a specialist.

    What can I do to prevent knee pain?

    To prevent knee pain, you can do strengthening exercises, wear proper shoes, and avoid overusing your knee. It’s also good to keep a healthy weight.

    Are there treatments available for chronic knee pain?

    Yes, there are treatments for chronic knee pain. These include physical therapy, medications, and sometimes surgery. Pain management techniques can also help.

  • Health benefit of patients with established rheumatoid arthritis and its influencing factors: a multicenter study in China

    Health benefit of patients with established rheumatoid arthritis and its influencing factors: a multicenter study in China

    Cross-sectional data of RA patients in the intermediate and advanced stages from 8 tertiary hospitals in four provincial capitals Nanjing, Hangzhou, Chengdu and Shijiazhuang (two of each) were obtained, using the Chinese version of the EQ-5D-5L to measure and rate HRQOL. The patients were enrolled by trained investigators based on quota sampling from June to July 2020.

    Participants in the study

    Based on available sources and rules of thumb, a total of 200 patients (50 in each city, male/female = 1:2) were planned for recruitment. The inclusion criteria were: (1) Informed and voluntary; (2) 18-70 years (Given the challenges and precision associated with completing questionnaires by older people, previous research protocols26and available sources); (3) Diagnosed with RA according to the diagnostic criteria of the 2010 American College of Rheumatology (ACR)/European League Against Rheumatism (EULAR) classification (score ≥ 6)27The exclusion criteria were: (1) pregnant women, persons with psychiatric disorders, and patients who were unconscious and unable to express their condition; (2) patients suffering from other serious illnesses such as tumors and myocardial infarction.

    Data collection

    A total of 16 trained interviewers divided into 8 groups were responsible for data collection in each of the 8 hospitals. In the corresponding departments of each hospital during the study (no distinction between outpatients and inpatients), the interviewers introduced the aim and content of the study to the patients and their attending physicians and obtained written informed consent. Then, the consenting patients and physicians were asked to fill out the respective questionnaires independently in a quiet room. If patients have questions about the questionnaire, the interviewers should provide explanations, but they should not guide or actively hinder the patients in filling out the questionnaire. The completed questionnaires were reviewed by the interviewers to identify any obvious errors or missing data. After the questionnaires were retrieved, the data were digitalized and reviewed by 2 independent and transparent auditors.

    Questionnaires for patients and physicians

    Two respective questionnaires for the patients and physicians were provisionally designed based on the literature15.28. Then, based on the opinions of experts, we revised the questionnaires and conducted a pilot survey in 2 tertiary hospitals in Nanjing to validate the rationality, readability, and comprehensibility of the questionnaires. (Since the subjective questions in the questionnaire are all derived from validated scales, we did not repeat the validation of the psychological measurement properties of the questionnaire.) The questionnaires were revised and formed the final version based on the results of the pilot survey and the suggestions of experts based on the results of the pilot survey. The rationality, readability, and comprehensibility of the questionnaire were confirmed by the experts and supported by the pilot survey.

    The patient questionnaire consists of two parts. Part one collected patients’ HRQOL measured by the Chinese version of the EQ-5D-5L and other self-reported outcomes, including general health, arthritis pain, and disease activity. General health was evaluated using a four-level scale: good, general, poor, and very poor. Arthritis pain and disease activity were assessed using two visual analog scales (VAS), respectively. The patient’s assessment of arthritis pain VAS (PtAAP-VAS)29 measured the degree of pain they experienced on the day of the examination: 0 means no pain, 100 means the most severe pain. The patient’s global assessment of disease activity VAS (PtGADA-VAS)30,31 assessed current disease activity: 0 means patients feel very well and have no symptoms, 100 means patients feel very bad and have severe symptoms. Part two used questions to assess patients’ demographic characteristics, including gender, age, ethnicity, height, weight, region, marital status, education level, occupation, types of health insurance, and personal annual income.

    The physician questionnaire assessed the patients’ clinical characteristics and clinician-reported outcomes, including disease stage (based on the results of joint X-ray examination, Grade I/early stage: no bone-destructive changes; Grade II/middle stage: osteoporosis with mild cartilage damage; Grade III~IV/advanced stage: osteoporosis with cartilage or bone destruction and joint deformity)32treatment modalities (inpatient/outpatient), erythrocyte sedimentation rate (ESR) (unit: mm/h), high-sensitivity C-reactive protein (CRP) (unit: mg/L), symptoms and functional capacity, swollen joints (SJC) and tender joints (TJC). Of these, symptoms and functional capacity were assessed using the Physician’s global assessment of disease activity VAS (PhGADA-VAS)30,31 (0 and 100 mean that patients are asymptomatic and normal activities are not limited, and have severe symptoms that cannot be tolerated and are unable to perform normal activities). SJC, TJC, CRP and ESR were used to calculate the 28 joint counts (DAS28) scores, including DAS28-CRP score and DAS28-ESR score33Higher DAS28 scores indicate higher disease activity. Disease activity can be divided into four states, including remission (DAS28 scores < 2.6), low activity group (2.6 ≤ DAS28 scores < 3.2), moderate activity group (3.2 ≤ DAS28 scores < 5.1), and high activity group (DAS28 scores ≥ 5.1)33.

    EQ-5D-5L

    Compared with EQ-5D-3L, EQ-5D-5L has improved measurement properties in terms of health status descriptive system and HUV34; and its reliability and validity have been verified in China35The descriptive system assesses the subjects’ health status on the day of the survey on five dimensions (mobility, self-care, usual activities, pain/discomfort, and anxiety/depression), each using five severity levels (no problems, mild problems, moderate problems, severe problems, and unable/extreme problems) and produces a total of 3125 (55) health conditions34. Each health condition can be expressed by a 5-digit number. For example, “12.345” means no difficulty with mobility, mild difficulty with self-care, moderate difficulty with usual activities, severe pain/discomfort, and extremely anxious/depressed. All health conditions defined by the system can be converted into HUVs using a value set. In this study, Chinese version of the EQ-5D-5L and the value set36 for China was adopted. The EQ-5D-5L also includes the EQ visual analogue scale (EQ-VAS) which assesses subjects’ self-reported health status via a straight line (0: the worst health you can imagine; 100: the best health you can imagine)34.

    Data analysis

    Descriptive statistics

    Descriptive statistics such as mean and standard deviation (SD) for continuous variables, frequency and percentage for categorical variables were used to present the characteristics and outcomes of the patients. The distribution of EQ-5D-5L data (i.e., responses to each dimension, HUV, and VAS score) of the patients with different characteristics were presented. The skewness and kurtosis of EQ-5D-5L HUV were also shown. We also compared the mean age (P> 0.1) and sex ratio (P< 0.01) of patients with that of Chinese RA patients15,37,38and the EQ-5D-5L data weighted by the sex ratio of Chinese RA patients37.

    Univariate analysis

    To identify significant factors of the patients’ HUV, Kruskal-Wallis test or univariate regression were performed on the categorical variables or continuous variables, respectively. The variables included patient characteristics and patient/clinician-reported outcomes, of which age, body mass index (BMI), and the person’s annual income were included as categorical variables. Kruskal-Wallis test was also performed on the patients’ responses to EQ-5D-5L.

    Multivariable analysis

    The beta model was used for the multivariable regression analysis due to the characteristics of HUV distribution (i.e., non-normally distributed and censored at (1). The beta model required the value of the dependent variable to be between 0–1. The EQ-5D-5L scores were adjusted via the formula: adjusted score = (original score + 0.391)/1.391 (The range of EQ-5D-5L score was -0.391 to 1 based on the Chinese value set. If the original score was -0.391 or 1, the adjusted score was added or subtracted e−12 to ensure that it fell between 0 and 1.) Since the sex ratio in the sample was different from that of Chinese RA patients, we used the sex weighting in the regression. The dependent variable was the EQ-5D-5L HUV. Referring to the recommendations of clinical experts, literature15,16,17and the results of univariate analysis, some of the characteristics and outcomes were included as explanatory variables in the regression analysis. To reduce multicollinearity among the variables, Spearman rank correlations were used to test the correlations among them (correlation coefficients: very weak = 0–0.19; weak = 0.20–0.39; moderate = 0.40–0.59; strong = 0.60–0.79; and very strong = 0.80–1.00). For a few variables with the coefficient higher than 0.4, the variable that was also more correlated with other variables would be excluded (Supplementary material Appendix 1). The variables entered into the final model are related to the EQ-5D-5L score, but the correlation among these variables is low, including demographic variables age, gender, BMI, and place of residence; and clinical variables PtGADA-VAS, DAS28-ESR, disease stage and treatment modalities (the correlation heatmap is shown in Fig. 1). Finally, we would measure the multicollinearity in the regression model via the variance inflation factor (VIF).

    Figure 1
    Figure 1

    The correlation heatmap of variables.

    All of the above analyses were performed on Microsoft® Excel 2021 and stata15.

    Ethical approval and consent to participate

    This study was conducted in accordance with the principles of the Declaration of Helsinki and approved by the Clinical Trial Ethics Committee. Clinical Trial Ethics Committee of Huashan Hospital Affiliated to Fudan University (Reference number 2019–252). Written informed consent to participate was signed by all participants.

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  • The health technology device that helps people fight insomnia, reduce stress and manage anxiety with Stefanie Broes + BoneCoach™ Osteoporosis and Osteopenia – BoneCoach™

    The health technology device that helps people fight insomnia, reduce stress and manage anxiety with Stefanie Broes + BoneCoach™ Osteoporosis and Osteopenia – BoneCoach™

    What if the key to better health was right under your nose?

    We’re going to explore the hidden power of something you do 22,000 times a day, without even thinking about it…

    To breathe.

    Come with me as I sit with you Stefanie Broesan expert in pharmaceutical sciences, who’s here to reveal how a simple change in the way you breathe could be the game-changer you didn’t know you needed – for your sleep, your stress levels and even your bones.

    We introduce you to Moonbird, a revolutionary device making waves in the world of wellness, and explain why everyone from insomniacs to patients with osteoporosis pay attention to this old practice with a modern twist.

    Episode Timeline

    0:00 – Episode Beginning

    2:27 – Meet Stefanie Broes, CEO and co-founder of Moonbird

    3:45 – Explanation of the science behind breathing techniques and their impact on overall health and well-being

    05:50 – How breathing techniques help reduce stress and anxiety, and why it’s important for people with osteoporosis

    8:22 – Details about the Moonbird device: what it is, how to use it, and how it helps with stress and insomnia

    10:52 – How Moonbird is different from other health technology products on the market

    12:10 – How breathing exercises can improve sleep quality, especially in older adults, and their benefits for bone health

    14:34 – The importance of sleep for bone health, including the risks associated with sleep deprivation and its impact on bone formation and remodeling

    15:58 – Real success stories from Moonbird users

    18:12 – Simple breathing exercises that listeners can begin to improve their health and well-being

    19:32 – Future plans for Moonbird and the future of breathwork in the health tech industry

    21:19 – Recommendation of the book “Breath” by James Nestor for more insight into the importance of breathing

    21:48 – Special offer and where to find more information about Moonbird products

    22:55 – Stefanie’s final tips for listeners

    Sources mentioned

    **Show notes @ https://bonecoach.com/stefanie-broes-moonbird-life-health-tech

    Below you will find Stefanie’s sources!

    >> $10 OFF with code BONECOACH

    >> https://www.moonbird.life/

    >> https://www.instagram.com/moonbird.life

    What can you do to support your bone health and this podcast?

    1. Click the “Subscribe” button on your respective podcast player (e.g. Apple, Google, Spotify, Stitcher, iHeart Radio, and TuneIn). Never miss an episode that can help improve your bone health.

    2. Leave a review. The more positive ratings and reviews and the more subscribers we have, the more people can find us and get the answers to the questions they need. Thank you! 🙂

    3. Tell a friend about The Bone Coach Podcast or share via text, email, or social. Know of a Facebook group where people could benefit from this info? Feel free to click one of the share buttons below.

    About Stefanie Broes:

    Stefanie is the CEO and co-founder of Moonbird, a health tech startup operating in the wellness sector. Moonbird is the world’s first wearable breath pacer and is all about making breathwork accessible so people can live healthier, happier lives.

    The product is used to reduce stress, manage anxiety and combat insomnia. Stefanie has a medical background, a PhD in pharmaceutical sciences and a master’s degree in IP and data protection law. When she discovered how effective breathing exercises are in tackling her own insomnia, she delved deeper into the subject and eventually started the company to help more people discover the positive effects of slow breathing.

    Medical disclaimer

    The information shared above is for informational purposes only and is not intended to provide medical or nutritional advice; it does not diagnose, treat, or cure any disease, condition; it should not be used as a replacement or substitute for medical advice from physicians and trained medical professionals. If you are under the care of a healthcare professional or are currently taking prescription medications, you should discuss any changes to your diet and lifestyle or possible use of dietary supplements with your doctor. You should not discontinue any prescribed medications without first consulting your doctor.



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  • Effects of IL-6, JAK, TNF inhibitors and CTLA4-Ig on knee complaints in patients with rheumatoid arthritis

    Factors that contribute to the relief of knee complaints

    From January 2010 to August 2023, a total of 2,321 patients started b/tsDMARD treatment (Fig. 1). Of these, 573 had knee pain and/or swelling at the time of starting b/tsDMARDs (considered baseline). Six months later, 438 individuals returned for follow-up and swelling and/or tender joints were recorded. We excluded patients who had undergone total knee arthroplasty on the symptomatic side (N = 18) and those who had undergone TKA during the follow-up period (N= 7). As a result, 413 patients were included in the study (Supplementary Table S1). We then focused on patients who continued b/tsDMARDs for at least 3 months. Consequently, 295 cases were analyzed. The mean age at baseline was 60.9 years, ACPA positivity was 78.3%, RF positivity was 76.6%, females were 85.1%, and the mean RA duration was nine years (Table 1).

    Figure 1
    Figure 1
    Table 1 Demographics and disease characteristics of patients with knee joint symptoms at baseline of b/tsDMARD treatment who continued the medication for 3 months and had knee joint symptoms at 6 months.

    The symptom relief at 6 months in patients who continued b/tsDMARDs for 3 months was 78.2% for IL-6 inhibitors, 68.6% for JAK inhibitors, 65.9% for TNF inhibitors, and 57.6% for CTLA4-Ig (P< 0.01, Figure 2). The rates of knee joint symptom relief at 3 months were 66.3% for IL-6 inhibitors, 51.2% for JAK inhibitors, 61.4% for TNF inhibitors, and 55.6% for CTLA4-Ig, without statistical significance (P= 0.32, Supplementary Figure S1a). Significant differences were observed in the proportion of improvement in knee joint symptoms between 3 and 6 months for all b/tsDMARDs. Notably, further improvement in knee joint symptoms from 3 to 6 months was noted for both IL-6 and JAK inhibitors (Supplementary Figure S1b).

    Figure 2
    Figure 2

    Percentages of relief of knee joint symptoms after 6 months of treatment, categorized by mode of action of each drug, in patients with knee joint symptoms at initiation of treatment with biologic/targeted synthetic disease-modifying anti-rheumatic drugs (b/tsDMARDs) who continued therapy for 3 months. IL-6, interleukin 6; JAK, Janus kinase; CTLA4-Ig, cytotoxic T-lymphocyte-associated antigen-4-Ig; TNF, tumor necrosis factor. ** P< 0.01 according to the Cochran-Armitage trend test.

    Three months after initiation, the continuation rate was 76.5% for IL-6 inhibitors, 74.5% for JAK inhibitors, 63.1% for TNF inhibitors, and 85.5% for CTLA4-Ig (P< 0.01; Figure 3a).

    figure 3
    figure 3

    Continuation rates and disease activity for each drug.a) The percentage of patients with knee joint symptoms at baseline of b/tsDMARD treatment who continued therapy for 3 months. **; P< 0.01, by Chi-square test (B) Basic disease activity (C) Disease activity after 3 months of treatment.D) The difference in disease activity from baseline after 3 months of treatment.and) Disease activity after 6 months of treatment.F) The difference in disease activity from baseline after 6 months of treatment. *; P< 0.05, **; P< 0.01, ***; P< 0.001 by the Steel-Dwass test. DAS28-ESR, disease activity score 28-joint count with erythrocyte sedimentation rate; CDAI, clinical disease activity index; SDAI, simplified disease activity index

    In patients who continued b/tsDMARDs after 3 months, disease activity (DAS28-ESR, disease activity score 28-joint count with erythrocyte sedimentation rate [DAS28-ESR]clinical disease activity index [CDAI]and simplified disease activity index [SDAI]) improved at 3 and 6 months compared to baseline (Fig. 3b–f). Although differences were observed in the values ​​of DAS28-ESR, CDAI and SDAI at 3 and 6 months, as well as differences from baseline, between these drugs, IL-6 inhibitors were not inferior to the other drugs in any of these indicators.

    When examining treatments associated with relief of knee joint symptoms in patients who continued b/tsDMARD therapy beyond 3 months, the use of IL-6 inhibitors emerged as a significant contributing factor, surpassing TNF inhibitors in resolution of knee joint symptoms (Fig. 4, odds ratio [OR] 2.1, 95% confidence interval [CI] 1.1–4.3, P= 0.03) or CTLA4-Ig (OR 3.0, 95% CI 1.4–6.5, P= 0.005). The OR for relief of knee joint symptoms with b/tsDMARDs as first-line treatment was 1.72 (95% CI 0.99–2.99, P= 0.05). Methotrexate (MTX) or glucocorticoid use did not appear to be a significant risk factor.

    Figure 4
    figure 4

    Multivariable logistic regression analysis of relief of knee joint symptoms after 6 months of treatment. MTX, methotrexate.

    Factors contributing to the inhibition of the destruction of the knee joint

    Next, we focused on 141 patients who continued b/tsDMARD therapy for 3 months and underwent knee joint radiography at baseline and 2 years later. At baseline, there were no significant differences in disease activity as measured by DAS28-ESR, SDAI, and CDAI (Supplementary Table S2). At 3 months, DAS28-ESR was higher in patients using JAK inhibitors and CTLA4-Ig, 4.0 and 4.1, respectively, compared with 3.0 in patients using IL-6 inhibitors. MTX use was lower in CTLA4-Ig users; however, this difference was not statistically significant. In addition, the rate of use of JAK inhibitors as first-line b/tsDMARDs was lower.

    At baseline, there were no significant differences in Larsen grade between the different drugs (Fig. 5a). Over two years, excluding progression from grade 0 to grade I, worsening of Larsen grade was observed in 5.2% of patients treated with IL-6 inhibitors, 6.3% with JAK inhibitors, 19.4% with TNF inhibitors and 28% with CTLA4-Ig (Fig. 5b, P< 0.01).

    Figure 5
    figure 5

    Radiographic examination of the knee.a) X-ray of the knee at the start of treatment and after two years, assessed based on the Larsen grade.B) Percentage of patients with progression in Larsen grade on radiographs from baseline to two years, excluding progression from grade 0 to I. **; P< 0.01 according to the Cochran-Armitage trend test.C) Factors contributing to progression of Larsen grade on radiographs from baseline to two years, using multivariable logistic regression analysis.

    In line with this, when considering the use of MTX, glucocorticoids, the use of b/tsDMARDs as first-line treatment and the mode of action as covariates, the use of IL-6 inhibitors emerged as a protective factor against knee joint deterioration compared with CTLA4-Ig (OR 0.14, 95% CI 0.02–0.78, P= 0.02, Figure 5c).

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  • Duke-NUS launches LIVE Ventures to boost commercialisation of academic research

    Duke-NUS launches LIVE Ventures to boost commercialisation of academic research

    shutterstock 390538711 6b3c40fdd32742caa54307db3553cab1

    Duke-NUS Medical School today launched LIVE Ventures, a S$20 million incubation programme designed to catalyse the commercialisation of innovative academic research. Aimed at translating scientific breakthroughs into clinical applications, LIVE Ventures will provide Duke-NUS scientists conducting high-impact research with essential commercialisation expertise and resources, and partner with both public and private sector entities to co-fund these projects. The initiative will start with a pilot project focused on developing novel treatments for chronic inflammatory diseases.

    Bridging the knowledge gap in translating academic research into industrial products

    The knowledge gap in commercialization and entrepreneurship is one of the biggest challenges for academic innovators in bringing research concepts to the market. To overcome this barrier in the early stages of the complex market discovery journey, LIVE Ventures will guide our scientists in conducting product-market fit evaluations by involving a diverse range of experts from industry, investors, pharmaceutical companies and market data professionals to explore the real market needs for each project. An Investment Advisory Committee has been established to tap into the expertise and experience of these experts to provide critical industry perspectives for project evaluation.

    To increase the likelihood of successful commercialization, LIVE Venture will leverage external expertise by pairing experienced entrepreneurs, called Entrepreneurs-in-Residence, with awarded projects to provide dedicated entrepreneurial mentorship and operational support. Hands-on guidance from experienced entrepreneurs and domain experts is crucial for the transition from academic research projects to viable commercial ventures.

    Essential funding for the commercialization of academic research projects

    Traditionally, innovation funding opportunities have focused on either basic science research or end-spectrum commercialization, with limited resources dedicated to helping academic projects take that first crucial step toward commercialization. LIVE Ventures, with its first tranche of funding of S$10 million, will help bridge this gap by supporting up to 20 Duke-NUS research projects over the next five years. LIVE Ventures will not only guide these projects through the formation of spin-offs, but will also strategically invest in these companies, supporting their business growth.

    Recognizing the critical role of early-stage funding in the successful development of academic research projects, LIVE Ventures will leverage Duke-NUS’s extensive network of industry partners to secure industry co-funders. By forging strategic alliances with organizations such as the School’s academic medicine partner SingHealth and other public and private funders such as 65LAB, LIVE Ventures brings together expertise and resources across research, clinical and venture creation to enable promising technologies to cross the “valley of death” of innovation.

    As an incubator, LIVE Ventures aims to translate scientific discoveries into viable commercial opportunities with the potential to create start-ups by providing industry expertise, mentorship and financial support. In addition to supporting our scientists in translating research into novel clinical solutions, LIVE Ventures will foster a culture of entrepreneurship within the academic community, ultimately benefiting patients worldwide.”


    Dr. Rainny Xie, Head of LIVE Ventures at Duke-NUS

    First project awarded by LIVE Ventures

    The first project that LIVE Ventures, in collaboration with 65LAB, will invest in is a unique platform developed by Associate Professor Lena Ho from the Cardiovascular and Metabolic Diseases Program to identify novel and high-value targets for anti-inflammatory therapies.

    Over the next two years, Associate Professor Ho and her team expect to identify at least three candidates with therapeutic potential for reducing overactive inflammation in common diseases such as rheumatoid arthritis, inflammatory bowel disease and atopic dermatitis.

    Duke-NUS’ strong track record of innovation

    Innovation is a hallmark of Duke-NUS, with nearly half of its principal investigators involved in collaboratively developing their discoveries into new products to improve patient care. The school is globally renowned for its exceptional ability to translate research into commercial output.

    As a translational research center, Duke-NUS scientists have achieved many scientific breakthroughs that have attracted the attention of investors and industry for further development. Duke-NUS’ track record in commercialization includes cPassTMthe world’s first “rapid smart test kit”, invented by Duke-NUS and co-developed with A*STAR’s Diagnostics Development Hub and biotech company GenScript Biotech. Launched in early 2020 and commercially available globally two years later, the tool helped countries in the fight against COVID-19.

    Duke-NUS’s close collaboration with SingHealth, also Singapore’s largest healthcare institution, gives the school’s scientists direct access to SingHealth’s clinical resources, enabling them to validate their research findings and translate preclinical discoveries into clinical trials.

    Associate Professor Christopher Laing, Vice Dean for Innovation and Entrepreneurship at Duke-NUS, said:

    “What makes LIVE Ventures unique among academic life science programs in Singapore is its focus on integrating market perspectives and industry guidance early in the development process.”

    “This is in line with our mission at the Office of Innovation & Entrepreneurship: by working with our academic partners, investors, entrepreneurs and corporates, we are building an innovation ecosystem to provide our scholars with access to critical funding, resources and expertise, thereby fostering entrepreneurship and driving innovation at Duke-NUS.”

    In furtherance of Duke-NUS’ commitment to accelerating innovation from the lab to the bedside to positively impact patient care, LIVE Ventures will look to invest in projects with a development time of one to two years after proof-of-concept stage, assessing the commercial prospects of the projects by evaluating the level of innovation, validity and scalability, market potential and investment interest.

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  • Manage your sugar cravings with strategies from scientific studies

    Manage your sugar cravings with strategies from scientific studies

    Overconsumption of sugar is bad for your bones and your health. So why does your body crave it?

    In this article, you’ll learn about the science behind sugar cravings and the many ways they develop and persist. We’ll also examine a major systematic review of studies on the relationship between sugary drink consumption and bone loss.

    You will also learn strategies to break the vicious cycle of sugar cravings and develop healthy habits without sacrificing your appetite.

    Sugar Sugar Sugar

    Sugar cravings are common among people who follow a standard Western diet. Even if you eat healthier and more balanced, it is easy to fall into a sugar habit.

    Whether it’s everyday sugary desserts, sweet snacks or sugary drinks, the food industry makes sure that sugary foods are easily available and hard to resist.

    One of the major negative effects of consuming foods high in added sugars is on blood sugar levels. When you eat refined sugar, your save our bones program blood sugar levels rise rapidly. However, this spike in blood sugar levels does not last long and creates a series of peaks and valleys that put a strain on your body’s regulatory system.

    When sugar levels spike, the body is temporarily flushed with easy energy, but it burns the sugar quickly, causing a crash. To quickly solve the crash problem, you may experience a craving for more sugar. You see how a vicious circle is created.

    This cycle can be created and maintained by several common issues and behaviors.

  • Eating pattern – Fiber, protein, and healthy fats all help regulate blood sugar levels by providing a slow, steady source of energy. A diet lacking these nutrients causes uneven blood sugar levels, which exacerbates the spikes and dips that fuel sugar cravings. Adjusting your diet to include healthy sources of these nutrients can help even out your energy levels and reduce cravings. These nutrients also boost bone health, both directly and indirectly. For example, protein supports muscle growth, which directly stimulates new bone formation.
  • To use – Sometimes cravings can come as regularly as a clock at a certain time of day. This can be the result of behavioral patterns, such as reaching for a sweet treat when you get home from work or choosing a sugary drink for lunch every day. Eating sweets at the same time every day can create a pattern that your brain and body expect, reinforcing the behavior and making it difficult to stop. You can break old habits and form new ones, but it takes effort.
  • Mineral deficiency – Iron deficiency can cause fatigue. Your body may try to compensate by craving a sugar-based energy boost. Calcium, zinc, and magnesium imbalances can also cause sugar cravings. These minerals are essential for metabolic processes and regulation in all body systems. That includes bone remodeling, which is why daily, targeted supplementation is part of the Osteoporosis Reversal Program.
  • Dehydration – Your body needs water to function. Without adequate hydration, you may feel tired or hungry, and your body can’t use important minerals properly. Try to drink water throughout the day to help reduce sugar cravings and stay hydrated. It’s also good for your bones. Dehydration causes an increase in the bone-damaging stress hormone cortisol.1

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    Sugar causes blood sugar spikes, which can lead to a vicious cycle of energy highs and lows that fuel sugar cravings. Poor diet, sugar consumption habits, mineral deficiencies, and dehydration can all cause fatigue and sugar cravings.

    New research links loneliness to sugar cravings

    A recently published study of 93 healthy premenopausal women found that social isolation is linked to altered processing of food signals by the brain.

    Researchers showed participants images of sweet foods, savory foods, and pixelated non-food control images during MRI scans of their brains. Participants with higher levels of perceived social isolation were more likely to have a larger brain response to images of sweet foods.

    “These findings indicate that increased loneliness may be associated with brain patterns indicating difficulties in motivation, control, and processing of internal states in response to food and increased changes in eating behavior, obesity, and psychological symptoms.”2

    In this study, social isolation and loneliness were linked to a brain response that made it harder to resist sweets and the energy boost that sugar brings. Based on this finding, improving your social health may help reduce sugar cravings.

    If you are experiencing social isolation and loneliness, create opportunities to form relationships and participate in social activities. Find local community centers, recreation facilities, or libraries that offer group programming. Sign up for a class at a local art studio, gym, or continuing education program. Enlist the help of family and friends to increase your social connectivity.

    Better social well-being is also associated with better bone health. This can be partly attributed to better mental health and the positive habits and behaviors that good mental health enables.

    Short content

    A study of 93 women linked social isolation to the brain’s response to images of sweet foods, suggesting that loneliness is linked to sugar cravings and a reduced ability to resist them. Improving your social life can help you make better food choices and build other bone-healthy habits.

    Sugary drinks and bone loss

    A systematic review published in Nutrition Journal analyzed 26 studies with a total of 124,691 participants. The included studies compared participants’ sugary beverage (SSB) consumption with their bone mineral density (BMD).

    The study found that there is a significant inverse association between SSB intake and bone mineral density (BMD) in adults.3

    The studies included in the review used different methods to assess SSB intake and measure BMD, which strengthened the conclusions drawn from the analysis.

    This study highlights the importance of resisting and preventing sugar cravings for Savers. Consider the strength of the study’s conclusion about sugar intake and bone health.

    “The results of the qualitative review supported the finding that SSB intake was associated with bone health. There has been a global effort to reduce excessive SSB consumption through approaches such as nutrition education, campaigns and policy implementation. We confirmed that these efforts not only prevent obesity, diabetes and cardiovascular disease, but also have a beneficial effect on the bone health of the population.”3

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    A systematic review published in Nutrition Journal found a significant inverse association between sugary beverage intake and bone mineral density (BMD) in adults. This study illustrates the importance of resisting and preventing sugar cravings for bone health.

    Strategies to Overcome Sugar Cravings

    Knowledge is your first tool for overcoming sugar cravings, and you’ve learned a lot in this article so far. Being able to notice a craving and understand where it might be coming from is a powerful foundation for choosing different behaviors in response to a craving.

    Try these additional strategies to change your choices. Over time, you may find that your cravings for sweets diminish.

  • Adjust your diet to include healthy proteins and fiber to ensure you have a steady supply of energy.
  • Notice what unhealthy habits you have built up and break them. Try replacing them with a less sugary snack, cut out the sweet food altogether, or try introducing a non-food based habit to replace the sugary snack.
  • Drink water throughout the day to stay hydrated. Try to drink half of your body weight in ounces per day. For example, if you weigh 160 pounds, drink 80 ounces of water throughout the day.
  • Take daily supplements to properly fuel your body’s systems. The Osteoporosis Reversal Program offers a full set of Foundation Supplement recommendations.
  • Prioritize quality sleep. Sugar cravings can be a result of a lack of energy, so consistent, quality sleep can help prevent daytime fatigue.

    • Short content

    Knowing why sugar cravings may occur is a helpful step toward beating them. Try the strategies listed above to curb cravings and build bone-healthier habits.

    What this means for you

    You don’t have to let your sweet tooth rule you. Take action to interrupt your sugar cravings and build healthier habits. Eating less sugar can protect your bones and overall health, and reduce your risk of fractures.

    That doesn’t mean your diet has to be bland and unsatisfying. Check out the bone-healthy desserts (and other dishes!) included in the Save Institute’s Bone Appétit cookbook and meal planner. You’ll love Chocolate Banana Pudding, Country Peach Cake, Apple Crisp Delight (to name a few), because the recipes in Bone Appetit offer sweet and indulgent dessert and snack options that you can incorporate into your 80/20 pH-balanced diet without compromising your bones.

    Making the healthiest choice is only useful if it is sustainable. By making healthy choices that you enjoy, you can build good habits that will last a lifetime.

    References

    1 https://journals.physiology.org/doi/full/10.1152/japplphysiol.01010.2007

    2 https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2817148

    3 https://nutritionj.biomedcentral.com/articles/10.1186/s12937-021-00698-1



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  • How Oral Bacteria Affect Your Overall Health

    How Oral Bacteria Affect Your Overall Health

    A recent review in the magazine Nature Reviews Microbiology investigated the interactions between the oral and gut microbiomes and their joint effect on human health.

    Authors Jack A. Gilbert of the University of California San Diego and Erica M. Hartmann of Northwestern University found that while oral microorganisms can invade the gastrointestinal tract and contribute to gut dysbiosis, the mechanisms and broader implications of these interactions require further investigation.

    ImageForNews 786026 17217965109158885Review Article: The Inner Microbiome and Human Health. Image Credit: Lightspring / Shutterstock

    The importance of the gut microbiome

    The human body is home to a wide variety of microorganisms that play an essential role in health by supporting the immune system and defending against pathogens. However, they can also contribute to chronic diseases.

    Dysbiosis, or disruptions in these microbial communities, has been linked to metabolic and autoimmune diseases and gastrointestinal problems. The gut and oral cavity are two important areas with dense microbial populations.

    The oral microbiome is influenced by diet and environment and has been linked to oral diseases such as gingivitis and periodontitis. It affects the health of the entire body by influencing the microbial populations in the digestive and respiratory tracts.

    The gut microbiome, shaped by genetics, diet and lifestyle, is crucial for immune responses and infection prevention. Understanding the interactions between the gut and oral microbiomes is essential to understanding their impact on diseases such as colorectal cancer (CRC) and inflammatory bowel disease (IBD).

    The oral cavity is a gateway

    The gastrointestinal tract begins at the mouth and extends to the anus, including organs such as the liver, pancreas, and gallbladder. The oral cavity, highly vascularized and home to diverse microbial communities, serves as the primary entry point for microbes into the body.

    It hosts more than 770 bacterial species in various microenvironments, such as the buccal mucosa, tongue and dental plaque. Important genera include Streptococcus, VeillonellaAnd Meant to beThe gut microbiome, mainly anaerobic and consisting of species such as Bacteroides And Ruminococcishares some taxons with the oral cavity, but specific physical and chemical barriers generally prevent oral microbes from colonizing the intestines.

    However, under conditions such as low stomach acidity or antibiotic use, oral bacteria can migrate to the gut, potentially contributing to disease. Understanding this microbial transfer from the mouth to the gut is crucial to investigating its role in health and disease.

    The mouth-gut connection

    The oral cavity, which is susceptible to conditions such as tooth decay, oral cancer, and periodontal disease (gingivitis and periodontitis), plays an important role in overall health. Periodontal disease involves the destruction of tissues around the teeth due to an inflammatory response to plaque and microbes.

    Gingivitis, a reversible inflammation of the gums, can develop into periodontitis if left untreated, causing deeper tissue damage and bone loss. Research suggests a strong link between oral health and gut disease.

    Periodontal pathogens, such as P. gingivalis And F. nucleatumcan migrate from the mouth to the intestines, contributing to conditions such as IBD. These bacteria promote inflammation and disrupt the microbial balance of the intestines.

    Studies have found higher levels of oral bacteria in the guts of individuals with IBD, suggesting a role for the mouth-gut axis in these diseases. Additionally, the oral microbiome has been linked to CRC. Oral bacteria such as F. nucleatum may influence tumor growth and treatment resistance in colon cancer.

    This connection underscores the importance of oral health in preventing and treating systemic diseases. Understanding these connections may lead to better prevention and treatment strategies for bowel diseases and cancers.

    Oral health and general health

    Poor oral health, especially periodontitis, can have a major impact on the entire body. Oral bacteria can travel through the gastrointestinal tract and bloodstream and contribute to various diseases.

    Periodontitis causes low-grade systemic inflammation, which can disrupt the body’s health and promote diseases such as IBD and cardiovascular disease. It increases the levels of pro-inflammatory cytokines in the blood, indicating an ongoing inflammatory response.

    Oral health affects the body through the bone marrow, among other things. The inflammation caused by periodontitis stimulates the production of immune cells, which leads to increased inflammatory responses elsewhere.

    Another mechanism involves periodontal bacteria that directly affect distant organs by releasing toxins that promote inflammation and diseases such as rheumatoid arthritis and atherosclerosis. In addition, oral health directly affects the gut. Bacteria from the mouth can colonize the gut and worsen conditions such as IBD.

    Treatment of periodontal disease can reduce systemic inflammation and improve symptoms of chronic disease, demonstrating the bidirectional relationship between oral health and systemic disease. Addressing oral health is therefore crucial for overall health and management of systemic disease.

    Conclusions

    Changes in oral bacteria can affect gut health, leading to systemic inflammation and various diseases. The relationship between the oral cavity and the gut is bidirectional, but the exact mechanisms remain unclear.

    More research is needed to understand how oral bacteria influence chronic diseases and to develop better models to study these interactions. Future studies should resolve the oral-gut-microbiome axis at the strain level to confirm the role of oral bacteria in chronic diseases and investigate the role of translocated strains in gut-microbiome-related diseases via in vivo and in vitro models.

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  • Two studies reveal the source of chronic disease and an effective natural treatment

    Two studies reveal the source of chronic disease and an effective natural treatment

    Many of the most pressing societal health crises are caused by chronic diseases such as diabetes, depression, cardiovascular disease and osteoporosis, among others.

    In this article we examine the extensive and important evidence gathered in two major studies into the impact of physical activity on health and chronic conditions.

    Their findings paint a strikingly clear picture of the power of regular physical activity and the serious consequences of a sedentary lifestyle.

    Hundreds of studies, two major meta-analyses, one conclusion

    Two studies gathered a wealth of previous research on the impact of physical activity. They approached the topic from different angles. One examined the health effects of sedentary behavior—a life with little to no physical activity. The other analyzed the evidence that exercise is a treatment for a broad spectrum of chronic diseases.

    The conclusions of both studies present a compelling and clear argument for the necessity of physical activity, not only for the health of the individual, but also for the future of humanity. Consider these conclusive statements from the studies on sedentary behavior and physical activity as a treatment, respectively:

    “The vast evidence herein clearly establishes that physical inactivity affects nearly every cell, organ, and system in the body, leading to sedentary dysfunction and accelerated death. The vast multifactorial nature of dysfunction caused by sedentary behavior means that just as food and reproduction remain requirements for sustained human existence, physical activity is also a requirement for maximizing health and longevity. The only valid scientific therapeutic approach to fully address sedentary dysfunction is primary prevention with physical activity itself.”1

    “In the medical world, it is common practice to prescribe the evidence-based treatment that is known to be most effective and has the least side effects or risks. The evidence suggests that in selected cases exercise therapy is as effective as medical treatment and in special situations more effective or enhances its effect. The accumulated knowledge is now so extensive that it must be implemented.”2

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    Two reviews of studies on the effects of sedentary behavior and physical activity concluded that physical activity is essential for good health and can serve as a treatment for many chronic conditions associated with sedentary behavior.

    Chronic diseases, sedentary life and physical activity

    Below we discuss some specific diseases and conditions that these studies suggest can be caused by a sedentary lifestyle and treated with exercise.

    Tension

  • Fifteen percent of adults will experience an anxiety disorder at some point in their lives.
  • Anxiety disorders are associated with reduced quality of life and an increased risk of chronic health problems (including osteoporosis) and death.
  • An Australian study found that participants who reported no activity at all were 2.1 times more likely to develop anxiety disorders than participants who exercised vigorously for more than 3 hours per week.

    • A 2010 meta-analysis looked at 40 studies and concluded that physical exercise reduced anxiety symptoms in people with chronic illnesses2

    Tension

  • Stress is a common occurrence in everyday life.
  • Repeated or traumatic stress can be a precipitating factor for diseases of the central nervous system and organs.
  • People who experience consistently high levels of stress often cope with it through unhealthy mechanisms such as poor quality diet, avoidance of exercise, tobacco use or alcohol consumption. These behaviors have serious health consequences, including an increased risk of osteoporosis.
  • Research has shown that aerobic exercise in particular helps to relieve stress2

    • Dementia

  • About 3% of people between the ages of 65 and 74 have dementia, and a sobering 47% of people over the age of 85 have some form of dementia.
  • A study of twins shows that poor physical condition is a risk factor for early-onset dementia.1
  • A 2010 meta-analysis looking at the results of 24 studies concluded that physical activity prevents vascular dementia2
  • Research has shown that moderate and high levels of physical activity are associated with a significantly lower risk of Alzheimer’s disease and all forms of dementia.2
  • One study found that for every 10 blocks that female participants over 65 walked each day, there was a 13% decrease in cognitive decline.2
  • As cognitive function declines, so does the ability to live a bone-healthy lifestyle. We need a fully functioning brain to make the choices and take the actions that take care of our bones and our overall health.

    • Hypertension

  • Hypertension (high blood pressure) is a major risk factor for cardiovascular diseases such as stroke, acute myocardial infarction, heart failure and sudden death.
  • Several studies have shown that exercise has a positive effect on blood pressure in participants with and without hypertension.2
  • One 2013 meta-analysis included 23 aerobic training studies in previously sedentary older adults. The studies, which included a total of 1,226 older subjects, found robust statistically significant positive effects on blood pressure in older exercisers compared with control groups.2

    • Chronic obstructive pulmonary disease (COPD)

  • Chronic obstructive pulmonary disease (COPD) is a chronic disease characterized by an irreversible decline in lung function.
  • COPD often creates a vicious circle where the decline in physical capacity, shortness of breath, anxiety and social isolation lead to a reduction in physical activity, which worsens the condition. Rehabilitation can break this circle by introducing physical training, psychological support and building a community among people with COPD.”
  • Eleven randomized controlled trials with 331 participants and two previous systematic reviews found similar improvements in quality of life, walking distance and exercise capacity in response to exercise interventions. The researchers recommend including resistance training in COPD rehabilitation, along with endurance training.
  • Any loss of range of motion limits your ability to build bone. Weight-bearing exercises stimulate the formation of new bone, keeping the bone remodeling process active and healthy.

    • Sarcopenia

  • Sarcopenia is a condition in which there is a loss of muscle, which in turn causes a loss of strength
  • Inactivity is linked to decreased muscle loss. Without use, muscles atrophy.
  • In one study, sedentary people reached muscle weakness 24 years earlier than weightlifters, demonstrating the loss of functional life years that can result from sedentary behavior.2
  • Sarcopenia is a major contributing factor to osteoporosis. Muscle loss leads to bone loss, as according to Wolff’s law, muscle stimulates bone formation.

    • Cancer

  • The evidence collected shows that a physically active lifestyle protects against the development of colon cancer, breast cancer, uterine cancer and prostate cancer.2
  • Research has shown that participants who were physically active after being diagnosed with breast or colon cancer had a statistically higher chance of survival compared to participants who were physically inactive.2

    • Short content

    Chronic conditions such as anxiety, stress, dementia, hypertension, chronic obstructive pulmonary disease (COPD) and sarcopenia are all associated with a sedentary lifestyle and can be treated with physical activity.

    Osteoporosis, sedentary life and physical activity

    These studies also spoke to the direct link between physical activity and bone formation. As Wolff’s law describes, bone tissue changes in relation to how muscles are used. When you regularly perform weight-bearing exercises, that use stimulates the formation of new bone to support those activities.

    A study of pre- and postmenopausal women found that sedentary participants lost bone from the lumbar spine and femoral neck at a rate of about 1% per year. The study authors concluded that sedentary behavior is a contributing factor to aging-related bone loss.1

    In addition to healthier and stronger bones, physical training also increases muscle strength, which improves balance and reduces the risk of falls and possible bone fractures.

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    Sedentary lifestyle leads to bone loss. Physical activity stimulates bone formation. Exercise also increases muscle strength, which reduces the risk of falls by improving balance and strength.

    Sedentary life becomes more dangerous with age

    A study published in the journal Frontiers in Nutrition followed 118 healthy older participants as they underwent five, seven, 10, and 14 days of bed rest.

    The authors of the study noted that young adults and older adults responded differently to the sedentary behavior of bed rest. Older adults lost muscle mass faster than younger adults. The study shows how older adults are more susceptible to the harmful effects of sedentary behavior than younger people.3

    Just as exercise stimulates physiological processes that increase strength and well-being, sedentarism initiates physical changes that make us weaker and more susceptible to chronic conditions, including osteoporosis. This fact makes exercise even more important as we age.

    Short content

    A study published in the journal Frontiers in Nutrition found that healthy older adults who undergo periods of bed rest lose muscle mass faster than younger adults. This highlights the fact that exercise becomes even more important as we age, as the effects of sedentary behavior kick in more quickly.

    What this means for you

    Being sedentary is a clear and direct threat to your bones, your well-being, and your life. The answer is physical activity—and there are countless ways to get and stay active.

    The Save Institute created SaveTrainer to help you access and navigate the many options available to keep you active. Our digital video workout platform is designed to help you discover new ways to exercise easily and safely. You can use it to create a variety of fun home workouts, from yoga sessions to aerobic routines to resistance training. SaveTrainer has what you need to build your bones and extend your life.

    Every day is a new opportunity to get active and reap the extensive health benefits of bone-strengthening exercise.

    References

    1 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4241367/

    2 https://onlinelibrary.wiley.com/doi/full/10.1111/sms.12581

    3 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8371327/



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  • Treatment Options for Arthritis Knees: A Comprehensive Guide

    Treatment Options for Arthritis Knees: A Comprehensive Guide

    Arthritis of the knee is a common condition that affects millions of people worldwide. It can cause pain, swelling, stiffness, and reduced mobility, making it difficult to perform daily activities. There are different types of arthritis, including osteoarthritis and rheumatoid arthritis, and each has its own set of symptoms and treatment options.

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    When it comes to treating arthritis of the knee, there are several options available, depending on the severity of the condition and the individual’s needs. Treatment options range from non-invasive methods such as physical therapy and medication to more invasive procedures such as knee replacement surgery. It is essential to work with a healthcare provider to determine the best treatment plan for your specific case.

    In this article, we will explore the different treatment options available for arthritis of the knee. We will discuss the symptoms of arthritis, the various types of arthritis that can affect the knee, and the benefits and risks associated with each treatment option. By the end of this article, you will have a better understanding of the treatment options available for arthritis of the knee and be better equipped to make an informed decision about your care.

    Understanding Arthritis in Knees

    Arthritis is a common condition that affects millions of people worldwide. Specifically, arthritis in knees is a condition that occurs when the cartilage, which is a smooth substance that covers the ends of bones, is lost. This can lead to bone spurs and damage to the soft tissues in the joint.

    Causes and Risk Factors

    Arthritis in knees can be caused by a variety of factors, including age, injury, obesity, stress, and an overactive immune system. As we age, the cartilage in our joints naturally wears down, which can lead to arthritis. Additionally, injuries to the knee joint, such as a torn meniscus or ligament, can increase the risk of developing knee arthritis. Obesity can also put extra stress on the knee joint, which can lead to inflammation and damage to the cartilage. Finally, an overactive immune system can cause inflammation in the joint, which can lead to cartilage loss over time.

    Diagnosis of Knee Arthritis

    Diagnosing knee arthritis typically involves a physical exam, X-rays, and possibly an MRI or blood tests. During the physical exam, a healthcare professional will check the knee joint for swelling, stiffness, and tenderness. They may also check how well you can move your knee joint. X-rays can help show the extent of cartilage loss and any bone spurs that may have formed. An MRI can also be used to visualize the soft tissues in the joint, such as the cartilage and ligaments. Blood tests can help rule out other conditions that may be causing joint pain, such as rheumatoid arthritis.

    If you are experiencing joint pain, stiffness, or swelling in your knee, it is important to see a healthcare professional for a proper diagnosis. Early diagnosis and treatment can help slow the progression of knee arthritis and improve your quality of life.

    Treatment Options for Arthritis Knees

    If you are suffering from arthritis in your knees, there are several treatment options available to help manage your symptoms. In this section, we will discuss the most common treatment options for arthritis knees.

    Medications and Pain Relief

    There are several types of medications that can be used to help manage the pain and inflammation associated with arthritis knees. Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen and naproxen can help reduce inflammation and relieve pain. Acetaminophen can also be used to relieve pain, but it does not reduce inflammation.

    Corticosteroids can be injected directly into the knee joint to help reduce inflammation and relieve pain. Hyaluronic acid injections can also be used to help lubricate the joint and reduce pain.

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    Therapies and Exercises

    Physical therapy and exercise can help improve flexibility and mobility in the knee joint. Strengthening the muscles around the knee can also help provide more support and stability to the joint. Swimming, yoga, and water aerobics are low-impact exercises that can be especially helpful for people with arthritis knees.

    Surgical Treatments

    If other treatments are not effective, surgery may be an option. Knee replacement surgery involves replacing the damaged joint with an artificial one. Osteotomy involves cutting and reshaping the bones around the knee joint to relieve pressure. Arthroscopy involves using a small camera to view and repair damage inside the joint.

    Lifestyle and Home Remedies

    In addition to medical treatments, there are several lifestyle changes and home remedies that can help manage arthritis knee symptoms. Losing weight can help reduce pressure on the knee joint. Rest, ice, and heat can also help reduce pain and inflammation. Braces and assistive devices can provide additional support to the knee joint.

    Alternative Treatments

    Some people may find relief from alternative treatments like acupuncture, glucosamine, chondroitin, or capsaicin. However, the effectiveness of these treatments is not well established and they may have side effects.

    In conclusion, there are several treatment options available for arthritis knees. We recommend consulting with a healthcare professional to determine the best course of treatment for your individual needs.

    Frequently Asked Questions

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    What exercises are recommended to alleviate knee arthritis symptoms?

    Exercise is an essential part of managing knee arthritis. Low-impact exercises such as walking, cycling, and swimming can help reduce pain and stiffness. Strengthening exercises can also help support the knee joint and improve mobility. We recommend consulting with a physical therapist to develop an exercise plan that is tailored to your specific needs.

    What non-surgical remedies are available for bone-on-bone knee pain?

    While bone-on-bone knee pain is a severe form of knee arthritis, several non-surgical remedies can help alleviate symptoms. These include weight loss, physical therapy, and the use of assistive devices such as braces or shoe inserts. In some cases, corticosteroid injections can also help reduce inflammation and pain.

    How can one manage daily life with osteoarthritis of the knee?

    Managing daily life with osteoarthritis of the knee involves making lifestyle changes to reduce pain and improve mobility. This includes maintaining a healthy weight, engaging in regular exercise, and avoiding activities that aggravate knee pain. Assistive devices such as canes or walkers can also help reduce stress on the knee joint.

    Is it common for arthritis knee pain to extend to other areas of the leg?

    Arthritis knee pain can sometimes radiate to other areas of the leg, such as the hips or ankles. This is because the knee joint is connected to other joints and muscles in the leg. However, if you experience severe or sudden pain in other areas of the leg, it is essential to consult with a healthcare provider to rule out other underlying conditions.

    What are the latest advancements in non-surgical knee treatments as of 2023?

    As of 2023, several non-surgical knee treatments have shown promise in treating knee arthritis. These include regenerative therapies such as platelet-rich plasma (PRP) and stem cell injections. These therapies aim to promote the body’s natural healing processes and may help reduce inflammation and pain in the knee joint.

    Are there effective treatments for knee arthritis that can prevent the need for knee replacement?

    While knee replacement surgery is often the last resort for severe knee arthritis, several effective treatments can help prevent the need for surgery. These include weight loss, physical therapy, and the use of assistive devices such as braces or shoe inserts. In some cases, corticosteroid injections or regenerative therapies such as PRP or stem cell injections can also help reduce pain and inflammation in the knee joint.