If You Have Osteoarthritis, Here’s How to Give Your Cartilage the Best Chance to Heal

Osteoarthritis is a painful, debilitating condition that affects millions of people around the world and puts a significant drain on our healthcare system. More than 32 million Americans live with osteoarthritis, and the rate of osteoarthritis worldwide has increased by 113% since 1990.

In the U.S., insurance companies spend $149.4 billion per year on medical costs for osteoarthritis, and annual out-of-pocket expenditures are $36.1 billion, for a total of $185.5 billion.

As the efficacy of hip and knee replacements improves, rates of joint replacements continue to rise—especially in younger demographics. The National Center for Health Statistics found that between 2000 and 2010, the number of hip replacement surgeries in people ages 45–54 more than doubled. Scientists are also making great strides in discovering how to repair and grow cartilage more effectively, developing biotechnology that will ultimately reduce the need for joint replacements.

These advances in medical technology are welcome because they reduce chronic pain and improve function for millions of people, but unfortunately they don’t address the underlying causes of osteoarthritis. They also substantially increase medical costs and fuel a mentality that our bodies will inevitably break down, but that’s no problem—we can just get our joints replaced!

We should not be pushing our bodies until they break. Osteoarthritis is very often preventable or manageable with lifestyle habits, so we have an enormous opportunity to reduce chronic pain and healthcare costs by taking this condition into our own hands. In this post I’ll talk about the symptoms and risk factors for osteoarthritis; the controllable lifestyle causes; how cartilage repairs itself; and how to best take care of yourself in order to let your joints heal.

Diagnostic signs, symptoms, and risk factors for osteoarthritis

Osteoarthritis occurs when cartilage, the connective tissue that protects the ends of your bones, wears away. This gradual breakdown can occur in any joint, but most often affects the parts of the body that bear weight and get used the most: the hands, spine, hips, and knees. As cartilage gets worn away, joints become stiff and painful, and bone rubbing against bone can cause deformity of the joints.

Your doctor may use an x-ray or MRI to look for signs of osteoarthritis, which include:

• Joint space narrowing: A result of loss of cartilage
• Osteophytes (bone spurs): Bony growths that form in order to protect and stabilize the joint
• Subchondral bone cysts: Sacs filled with fluid that form inside joints
• Subchondral sclerosis: Thickening or hardening of the bone just below the cartilage surface

By BruceBlaus – Own work, CC BY-SA 4.0

Symptoms of osteoarthritis include:

• Joint pain or achiness
• Joint stiffness, especially when waking up or after being inactive
• Swelling or tenderness in the joints
• Crunching or crackling sound or grating sensation in joint(s) when moving
• Loss of flexibility and range of motion
• Bony outgrowths in fingers or toes
• Joint deformity

Common risk factors include:

• Age: The risk of osteoarthritis increases with age.
• Excess body weight: Excess weight puts pressure on joints and causes systemic inflammation, which increases joint damage and pain.
• Female gender: Women are diagnosed with osteoarthritis significantly more often than men.
• Joint injury: A previously injured joint is more likely to develop osteoarthritis.
• Repetitive use: Our body mechanics when doing repetitive activities can wear away our joint cartilage over time.
• Muscle weakness or joint laxity: These factors can make joints unstable and misaligned, putting strain on joint tissues
• Chronic systemic inflammation: Recent research is focusing on the role of inflammation in the destruction of joint cartilage and worsening of osteoarthritis symptoms.

In the next three sections, I’ll discuss the three most common controllable risk factors for osteoarthritis.

Controllable factor #1: Habitual posture and movement patterns

If you maintain healthy, balanced posture and movement throughout your life, you should suffer little joint degeneration. The problem is that because of muscle memory—the automatic way our nervous system learns and remembers muscular patterns—we tend to build up chronic muscle tension and gradually adopt dysfunctional posture and movement habits over time.

When joints are misaligned or compressed by tight muscles, more pressure is put on cartilage than it is designed to withstand. Excess pressure and strain is also put on cartilage when we overuse a particular joint, which often occurs in sports training or repetitive physical work. Cartilage gradually breaks down under pressure as we misuse and overuse our joints.

When cartilage breaks down, cartilage cells are damaged. Our immune system does not discriminate between physical trauma and infectious invaders. When either of these threats is perceived, the inflammatory response kicks in to remove harmful stimuli and begin the healing process.

Inflammation that occurs immediately after an injury, called acute inflammation, allows damaged cells to be removed from the area and initiates the healing process. But chronic, localized inflammation can occur when we’re constantly damaging our cartilage in one or more joints. It will continue as long as the source of the problem—the habitual movement pattern that damages the cartilage—is present.

Once joint protection is gone, our bones try to protect and stabilize the joint by becoming thicker and growing bone spurs and cysts. All of these changes typically cause pain, inflammation, and limited movement. Muscles surrounding the painful joints tighten reflexively, worsening the condition by limiting range of motion.

These painful, structural changes caused by repetitive misuse are preventable virtually all of the time, and can be reversible when osteoarthritis is mild to moderate. You simply need to give your joints a chance to heal by releasing chronic muscle tension, retraining your posture and movement patterns, and avoiding overuse of the damaged joint(s).

Controllable factor #2: Chronic systemic inflammation

In the last section, I explained how chronic inflammation in one joint (localized inflammation) caused by overuse and/or misuse can damage that single joint. But we also need to be aware of how chronic inflammation throughout our body, called systemic inflammation, is affecting us.

Systemic inflammation has been found to play a role in virtually all chronic lifestyle-related diseases, and osteoarthritis is no exception. There are a number of different factors that contribute to this type of inflammation, and one of the biggest factors for nearly all of us is the food we eat.

Unfortunately, a lot of nutrition research tends to focus on individual nutrients, either by adding them to test subjects’ diets for a period of time, or by tracking symptoms of single nutrient deficiencies. For example, you may see omega-3 fatty acids advertised as being helpful for reducing symptoms of osteoarthritis, and this may indeed be true. But does taking an omega-3 fatty acid supplement counteract eating a diet full of inflammatory foods? Certainly not.

It’s more important—and logistically, much more difficult—to study the effects of overall dietary patterns on our health. A 2021 study of knee osteoarthritis patients found that those who ate a “Western diet” had worse symptoms and joint function than patients who ate a “Mediterranean pattern” or “vegetable pattern” diet.

Likewise, a 2023 review of relevant studies of diet and osteoarthritis found that the Mediterranean dietary pattern and the “Prudent” dietary pattern (which is similar to the Mediterranean pattern) reduced the progression of symptoms, while the Western dietary pattern increased the progression of symptoms. Diets higher in fiber led to reduced symptoms of joint damage and pain.

So, diets based on whole, unprocessed foods that are high in vegetables, fruits, legumes, whole grains, and fish lead to less inflammation and osteoarthritis symptoms than diets that include processed foods, added sugar, large amounts of certain animal products, and unhealthy fats like trans fats.

In addition to diet, there are other common lifestyle factors that increase inflammation and risk of osteoarthritis. Psychological stress contributes to the progression of inflammatory diseases, and a 2022 review found that a majority of studies showed a relationship between chronic stress and arthritis development.

Exposure to toxins including heavy metals, industrial chemicals, and pesticides is linked to development of osteoarthritis.

Even having an imbalance in the electrical energy in your body—which is quite common nowadays—is linked to inflammatory conditions such as osteoarthritis. Infrared images show a dramatic reduction in painful inflammation after just a few nights of using Electron Transfer Technology (ETT).

Controllable factor #3: Excess body weight

The third major controllable risk factor for developing osteoarthritis is body weight. It has long been assumed that the reason excess body weight increases the risk of osteoarthritis is because of the pressure that body weight puts on joints. A study of 157 obese patients with osteoarthritis in the knees found that for every 1 kg of weight loss, the load put on the knees was reduced by 2.2 kg. A similar study of 142 knee osteoarthritis patients found even more significant results: for every pound of weight loss, approximately four pounds less force was put on the knees.

The relationship between body weight and damage to joint cartilage is clear, and it’s now recognized that the inflammation that goes along with excess weight is also a major factor in developing osteoarthritis. Obesity increases the risk of osteoarthritis not just in weight-bearing joints, but in joints throughout the body. This is because adipose (fat) tissue is a major source of inflammatory substances. These substances are then recruited into joints and lead to pathological changes in the joint tissue.

Thus, weight loss reduces the risk and severity of osteoarthritis in two ways: by reducing the mechanical load on weight-bearing joints, and by reducing the production of inflammatory substances that damage cartilage in the joints.

Cartilage can heal—if you give it the chance

Your cartilage constantly grows and maintains itself throughout your life. It was long believed that cartilage had a limited ability to repair itself because chondrocytes, the cells that produce and maintain cartilage, could not migrate out of their designated area. However, recent research has shown that chondrocytes actually can migrate, more or less depending on the specific situation and environment.

And in 2019, researchers from Duke University in North Carolina and Lund University in Sweden published a fascinating study in which they measured protein turnover in articular cartilage in human hips, knees, and ankles. They found that human cartilage has a greater innate ability to regenerate itself than previously thought. Their findings show a potential link to a capacity “for regeneration that might be exploited to enhance joint repair and establish a basis for human limb regeneration.”

There is still much to be learned about how cartilage repairs itself, but it’s clear that it has greater ability to repair itself than we thought—we simply need to give it the chance.

Unfortunately, there are two factors that get in the way of cartilage healing.

First is the fact that most cartilage does not have a blood supply of its own, so it relies on the pumping action from joint movement to diffuse blood and other nutrients through joint fluid. Too much compression and too little compression both spell trouble for cartilage; it needs a moderate amount of movement, involving regular loading and unloading of weight, to remain healthy.

Due to the indirect way in which cartilage receives nutrients, its healing process is fairly slow. And if cartilage repair can’t keep up with the rate at which you do damage, cartilage will continue to get worn away until it’s gone for good.

The second hindrance to cartilage healing is the fact that most people don’t know exactly what to do in order to most effectively let their cartilage repair itself. Many people are willing to rest their joints in order to let them heal, but rest alone does not fix the underlying controllable causes, which may include deeply learned patterns of body use, chronic systemic inflammation, and excess body weight.

How to move forward in your healing process

Here are steps you should take when trying to heal osteoarthritic joints:

1. If a certain activity caused your joint damage or makes it worse, stop or significantly reduce the activity while you heal. Your cartilage cannot heal itself if you keep damaging it.

2. Practice Clinical Somatics exercises on a daily basis. The exercises release the chronic muscle tension that compresses joints, and allow you to retrain imbalanced posture and movement patterns that put unnatural strain on joints.

3. As you release your tight muscles and change your habitual patterns of body use, you can also begin a gentle strengthening routine in which you repetitively load and unload your joints, very gradually increasing weight over time. *This should be done under the supervision of a qualified physical therapist.

4. Explore dietary changes in order to reduce systemic inflammation and lose weight, if necessary. A great way to start an anti-inflammatory diet is with the Whole30 program.

5. Explore other ways to reduce systemic inflammation, like reducing stress, eliminating toxins, grounding, regular cold exposure, and red light therapy.

6. Incorporate movement and physical exercise into your daily life in order to reduce inflammation and lose weight, if necessary. Of course, this should only be done to the degree that you can while not increasing your osteoarthritis pain. Swimming can be a good option, as it takes pressure off the joints. Tai chi and Qigong are very gentle forms of movement that do not stress the joints. Regular sauna sessions can burn calories and give you a cardio workout without moving.

If you have a joint replacement or cartilage transplant, you should support your recovery by practicing Clinical Somatics exercises. The exercises will speed your recovery, release your chronic muscle tension, restore natural posture and movement patterns, and prevent future joint damage.

Always pay attention to warning signs of osteoarthritis, like crunching sounds and pain in your joints. Allowing your cartilage to heal is much easier early on in the process than it is after significant damage has occurred.

Osteoarthritis does not have to be an inevitable part of the aging process. We have a tremendous ability to prevent and manage it with self-care, and by doing so we can reduce worldwide pain and suffering as well as healthcare costs.

Recommended reading:

The Pain Relief Secret: How to Retrain Your Nervous System, Heal Your Body, and Overcome Chronic Pain by Sarah Warren, CSE

Somatics: Reawakening the Mind’s Control of Movement, Flexibility and Health by Thomas Hanna