Every year, World Bone and Joint Week is celebrated from 12 to 20 October, when health professionals from all disciplines raise awareness about bone and joint diseases and their treatment, management, and prevention. And there is plenty to talk about: by 2020, an estimated 1.71 trillion people suffer from musculoskeletal disorders and these disorders are the leading cause of disability worldwide (WHO, 2021). That's why today we want to give you a brief overview of the main musculoskeletal disorders and provide you with simple tips to help you treat, manage, or even prevent the most common musculoskeletal disorders.

Major bone and joint disorders

Osteoarthritis. This is wear and tear on the joints associated with older age. Over time, the cartilage that normally cushions the joint breaks down and the bones start to rub together, causing stiffness and pain. The pain makes it difficult to move, reduces flexibility, and the joints move less and less - the disease progresses. Osteoarthritis is common in older people and is also more common in women than men.

Rheumatoid arthritis. This is an autoimmune disease in which immune cells begin to build up and attack local joint cells, causing long-term inflammation that eventually damages cartilage and bone. The inflammation caused by rheumatoid arthritis can also damage other parts of the body (Vogelgesang, 2018).

Osteoporosis. Osteoporosis occurs when bone loss occurs faster than the production of new bone tissue. Osteoporosis makes bones weak and brittle, so even the slightest fall or small movement like coughing can cause a bone to break. Osteoporosis is difficult to diagnose early and is most often diagnosed after a fracture (Lane, 2006).

Scoliosis. This is an abnormal sideways curvature of the spine that makes the spine appear S or C-shaped when viewed from the back. Scoliosis is most diagnosed in children and adolescents, but it is not known exactly what causes this condition.

What does the science say?

There is a wealth of research looking at how lifestyle changes affect bone and joint disease. Goh et al. (2019) reviewed 77 randomised trials in a systematic review and found that sport (regardless of type) reduced osteoarthritis-induced knee or hip pain and improved function compared to a control group. The greatest improvement is seen after 2 months of sport, after which the effect gradually diminishes and after 9-18 months is no longer better than usual care. Meanwhile, Hall et al. (2019) compared sport with dietary changes and how these affect overweight or obese people with osteoarthritis in a meta-analysis. They concluded that greater improvement is seen i.e. pain is significantly reduced when sport is combined with dietary changes than when diet is modified alone. Higher intakes of omega-3s, glucosamine and chondroitin, and collagen are associated with better joint health and lower inflammatory processes (Gioxari et al., 2018, Zhu et al., 2018, Benito-Ruiz et al., 2009).

Sport is a highly effective non-pharmaceutical fracture prevention measure in postmenopausal women. Shojaa et al. (2020), in a systematic review of 17 studies, found that resistance sports with a duration of more than 6 months increased bone mineral density in the spine, neck and hips in postmenopausal women. Interestingly, lower intensity sport (< 2 times/week) was more beneficial, i.e., resulted in greater changes in bone density, than higher intensity sport (≥ 2 times/week). In terms of nutrients, protein is essential for good bone health, with higher protein intake being associated with better protective effects on bones in the spine compared to lower protein intake (Shams-White et al., 2017). Bones also need calcium and vitamin D - in a meta-analysis reviewing 8 studies in older people, calcium and vitamin D supplementation reduced the risk of bone fractures by 15% and the risk of hip fracture by 30% (Weaver et al., 2016). Adequate protein intake is therefore important throughout the life cycle, from childhood to old age. 

Tips for healthy bones and joints

As with most diseases, a healthy weight, a good diet and an active lifestyle are the key to looking after your bones and joints.

• Maintain a healthy body weight - too much weight, even a few kilograms, can put a lot of strain on hard working joints.
• Have a balanced diet - your bones need calcium, magnesium, and vitamin D, all of which contribute to the ossification process (Price et al., 2012). And for joint health, you need omega-3 fatty acids, which have anti-inflammatory properties, and vitamin C, which stimulates collagen production (Clark, 2007). By eating enough dairy products, fish, fruit, and vegetables, you should get the right amount of all these nutrients every day.

IMPORTANT: Certain plant compounds such as oxalates and/or phytates can reduce calcium absorption, so plant-based products such as spinach and beans are not good sources of calcium. Caffeine in coffee, tea, energy drinks also reduce calcium absorption, so choose these beverages in moderation (NIH, 2021).

• Get some physical activity - physical activity can help maintain bone density as we age. In addition, sport can help keep joints more flexible, control weight and improve balance - all of which can help prevent bone and joint injuries from slips and falls.
• Try not to sit in one position for long periods of time, as this slows down blood circulation - take 5–10-minute breaks every hour to take a walk, not only to exercise your joints but also to rest your eyes.
• Keep your joint cold, but if you have persistent joint or bone pain, seek help. Physiotherapy, anti-inflammatory drugs, heat, and cold therapy can all be very effective tools to help with problems.

___________________________________________

We all want to move without constant pain, so let's do it now - small steps like getting up from the sofa, taking more frequent walks, or eating a larger portion of vegetables and fish can help improve bone and joint health. We at Level YOU 2.0 want to help you on this journey, provide you with the best health solutions and encourage you to become a better version of yourself.