The Relationship Between Osteoarthritis And Peripheral Neuropathy

Osteoarthritis (OA) and peripheral neuropathy are two distinct diseases that affect different areas of the body. Although they are both degenerative conditions, the former leads to the breakdown of the soft tissue in the joints, while the latter refers to damage to the nerves in the peripheral nervous system.

However, all systems and processes in the human body are interconnected and interdependent. This means that even though each of the conditions above has its own causes and manifests itself with unique symptoms, OA and peripheral neuropathy can have similar risk factors, appear at the same time, or have a causal relationship with one another.

Understanding OA and neuropathy, and how they are linked to each other, can help you identify the early signs of these conditions and address their underlying causes. This guide will take you through what you need to know to safeguard your musculoskeletal and neurological health.

Understanding These Two Conditions

To understand how OA influences neuropathy and vice-versa, and while these conditions sometimes manifest themselves concurrently, it is necessary to first look at each disease separately.

Below is a comprehensive overview of each disease, its symptoms, causes, and risk factors. Let’s get started.

Osteoarthritis

Affecting 32.5 million adults in the US and an estimated 500 million people worldwide, osteoarthritis (OA) is the most common joint degenerative disease globally. As a form of arthritis, OA is an inflammatory condition that, over time, wears down the soft tissue (cartilage) in the joint area, which is responsible for cushioning and lubricating joint movements.

As the cartilage wears down, the surrounding bones, ligaments, and tendons are left unprotected against friction and shock. In turn, this can cause bone damage, reduced joint movements, mechanical issues, and deformities.

Being a degenerative disease, OA is rarely caused by direct trauma. Instead, the most common risk factors include aging, genetic factors, posture, excessive stress, and overuse. Being overweight or regularly performing motions that overload the joints are some of the most common risk factors.

Currently, OA is one of the leading causes of disability among older demographics, and causes impairments and reduced productivity to over 8 million working-age adults.

Peripheral Neuropathy

Peripheral neuropathy is a term describing degenerative damage to the nerves located in the peripheral nervous system of the human body – or the ones external to the spinal cord or brain. These nerves are in charge of carrying motor and sensory signals from different parts of the body to the brain and enable autonomic processes such as breathing, digestion, and heartbeat.

To this day, not all aspects of peripheral neuropathy are thoroughly understood. However, it has become clear that erratic blood sugar levels caused by diabetes can damage blood vessels and lead to the death of nerves by severing their supply of oxygen and nutrients. Currently, it is estimated that over 50% of those with diabetes also suffer from nerve damage.

Beyond diabetes, other risk factors that translate into nerve damage include exposure to toxins such as lead and mercury, trauma and collisions, hereditary diseases, infections such as HIV, and medications such as chemotherapy. Smoking or battling alcohol use disorder might also be risk factors for neuropathy because the toxins contained in nicotine and alcohol can damage the protective coating around nerves (myelin).

Depending on whether it affects sensory, motor, or autonomic nerves, neuropathy can manifest itself with a range of symptoms, which often include:

• Pain and discomfort that begins in the hands and feet
• Loss of sensation affecting the extremities
• Inability to feel pain or hypersensitivity to touch
• A burning sensation or stabbing pain
• Spasms, cramps, and involuntary muscle movements
• Loss of balance and impaired coordination
• Loss of bladder or bowel control, erratic heartbeat, and digestive issues

If left unaddressed, neuropathy can lead to complications such as foot ulcers, increased risk of falls, and the need for medical devices such as pacemakers.

Can You Have Arthritis And Neuropathy At The Same Time?

Although both osteoarthritis and neuropathy are incredibly widespread conditions, it isn’t always easy to understand their comorbidity. This is because symptoms might overlap and each disease is often treated individually.

However, evidence is emerging that people with osteoarthritis might have undiagnosed neuropathy and vice-versa. For example, in a 2021 study, nearly 50% of patients with knee osteoarthritis also experienced neuropathic pain. The prevalence of comorbidity was higher in the group of patients with lower education, higher age, and higher body mass index.

So, the two conditions can co-exist. And, in some cases, one might be a risk factor to the other. The section below delves deeper into the connection between OA and neuropathy.

How Osteoarthritis Can Associate With Neuropathy

Not everyone with OA will develop neuropathy, and not every case of nerve damage will directly cause osteoarthritis. Nonetheless, understanding how the two conditions relate to each other can help patients gain a greater understanding of the symptoms, causes, and risk factors of the two conditions.

The Causal Relationship Between OA and Neuropathy

Let’s start by understanding how the joint and nerve systems are connected. According to a hypothesis developed in 2019, nerves and joints rely on each other to maintain the nervous and musculoskeletal systems healthy.

The nerves that surround the joints play a vital role in controlling blood flow to those areas and supplying the joint tissue with essential nutrients and oxygen. On the other hand, the high levels of inflammation in the joints affected by OA can contribute to surrounding nerve damage.

This relationship causes these main effects:

• Damaged nerves in the joint are unable to deliver position signals to the brain, which can contribute to a loss of balance and coordination.
• Improper sense signaling can affect how the body distributes loads during movements, which can cause improper mechanics and worsen OA
• Affected sensory nerves can interfere with how pain is experienced, causing heightened OA discomfort
• Deformities and improper mechanics (which are common in people with OA) can put pressure on and irritate nerves that would normally be unaffected by the same motions, thus leading to nerve damage.

Shared Risk Factors

Neuropathy and OA might have a few common risk factors.

Firstly, being overweight or obese is among the leading causes of type 2 diabetes which, in turn, is the main risk factor for neuropathy. People with high BMI are also more likely to develop osteoarthritis because of the excessive loading and stress on the joints.

Additionally, OA is an inflammatory disease, meaning that the generation of soft tissue in the joint is caused by irritation and inflammation. Inflammation also plays a role in neuropathy by causing demyelination (the loss of the nerves’ protective sheath). Both inflammatory conditions can be made worse by the use of alcohol or nicotine.

Other factors that might contribute to both OA and neuropathy include aging, mechanics, and genetics.

Symptoms Of Osteoarthritis With Peripheral Neuropathy

Understanding the differences and similarities between the symptoms of OA and neuropathy is critical to identify the onset of either of the two conditions and choosing a treatment option that goes beyond simply providing pain relief.

Osteoarthritis (OA) affects almost 33 million adults in the United States alone. Much like peripheral neuropathy, which affects the extremities of the body’s nervous system, osteoarthritis is a condition that often manifests in the fingers and toes of patients who have been diagnosed with it.

But patients who suffer from OA can expect to experience its symptoms in most joints throughout the body. The symptoms of OA, when compared to peripheral neuropathy, are not entirely the same and patients who are familiar with the nonsurgical treatments for peripheral neuropathy often look elsewhere to treat the conditions of OA.

Below are some of the telltale signs that a patient might be battling both OA and neuropathy.

Nerve Pain

Peripheral neuropathy causes tingling, burning, and numbness in the extremities.

Nerve pain remains an enigmatic condition to treat, mostly due to the wide range of signs it manifests itself with. Some of the most common and best-known symptoms of peripheral neuropathy include tingling, burning, and numbness in the extremities. This is because the nerves in the hands and feet are the first ones to be affected, and the ones responsible for carrying the most evident motor and sensory signals to the brain.

When nerve damage occurs, patients are likely to experience a heightened, burning, or stabbing pain, often accompanied by unfamiliar sensations or abnormal responses to stimuli (i.e.: feeling pain in response to stimuli that should be painless).

Where the nerve pain is located depends on what nerves have been damaged. In the case of patients affected by both OA and neuropathy, nerve pain might concentrate around the joints and become more evident during joint movements. More commonly, this pain affects the nerves that connect joints to one another, such as in the case of hands, feet, wrists, ankles, elbows, and knees.

Joint Pain

OA manifests itself with symptoms of bone spurs, stiffness, and pain specifically targeting the joints. Unfortunately, there have been cases where patients have peripheral neuropathy with OA.

When this happens, the areas around the joint might begin to experience stabbing and burning sensations (if sensory nerves are affected) or muscle spasms, cramps, and fasciculations (if motor nerves are affected).

Treatment Approaches

Both OA and neuropathy are considered clinically challenging to treat, mostly because they can derive from a range of causes and each patient is likely to experience different symptoms.

However, after a thorough examination of the manifestations of each condition, healthcare providers might recommend surgical or non-surgical therapies to both ease a patient’s symptoms and treat the underlying cause of OA or neuropathy.

Below are the most common treatment options offered to patients today.

Surgical Options

Surgery tends to be the last resort for people struggling with OA, and it is only recommended in case a patient is battling a severe end-stage symptomatic condition.

On the other hand, surgery for neuropathy is most commonly administered when the nerve pain is caused by other conditions that add excessive pressure on the nerves, such as carpal or cubital tunnel syndromes. These procedures aim at decompressing or releasing the nerves, which can lead to pain relief but aren’t able to reverse the neurological damage caused by neuropathy.

Here are some of the most common surgical options available today.

Osteotomy

Osteotomy is a surgical procedure that attempts to reestablish proper mechanics of the joint by reshaping the bones located in the area affected by OA. During the procedure, the bone tissue is removed or reshaped, so that the bones deformed by arthritis can fall back into place and continue to support the joint’s movements.

Arthroscopic Surgery

Most commonly performed to repair the damage caused by osteoarthritis of the knee, arthroscopy is a minor and minimally invasive surgery that involves the use of an arthroscope.

The tube is inserted into the joint area via a small incision, and it is maneuvered to examine the damaged area and determine what is causing the pain. If further interventions are needed, the surgeon might use the arthroscope and other tools to mildly reshape the bones and soft tissue in the damaged area to relieve pain and improve mechanics.

Arthroplasty

One of the most prominent surgical solutions for OA was discovered in the 1950s and 60s by Dr. John Charnley, who successfully treated the condition with an invasive procedure called arthroplasty. The procedure was widely successful and continues to be the preferred method for the surgical treatment of osteoarthritis.

In a medical assessment and survey of advancements in treating OA, Professor K.D. Brandt of the Indiana University School of Medicine found that “[r]ecommendation of total joint arthroplasty for the patient with OA, however, is tantamount to an acknowledgement of the failure of medical management. The surgical procedure is often performed after the patient has experienced years, or even decades, of pain and disability” (2004).

Patients who have sought treatment for their OA who are familiar with the “medical management” referred to by Professor Brandt may not have even considered that arthroplasty is only considered for patients who have suffered from its symptoms for years and even decades.

This means that even patients who would choose to undergo drastic surgery to relieve their pain may not have the same recommendation from their doctor before years or even decades of living with debilitating pain.

While this news may not be surprising to some who have sought immediate and lasting relief for their pain, it is no less of a disappointment. Still, there are those who are wary of surgical procedures to cure their OA and have lasting relief from pain and understandably so.

Elective, non-emergency surgery is a heavy decision that would weigh on the mind of any patient. Naturally, most patients will seek milder and non-invasive or nonsurgical solutions, solutions that will help them manage the pain.

Nonsurgical Treatment Alternatives

When we speak of nonsurgical options for treatment, we consider that these treatments are not always recommended or even effective for many patients who suffer from the pain of any condition.

However, for OA, seeing how it has affected and continues to affect millions of adults in the United States alone and given that patients live an average of 30 years with this condition, there has been extensive research done in search of a treatment or a cure that does not involve extensive and invasive surgery.

Additionally, the prevalence of OA has nearly doubled since the 1950s and is rising alongside life expectancy and obesity rates. The steady increase in the number of cases has contributed to a steady and persistent level of research into a treatment for the condition and this should be a welcome relief for anyone seeking said treatment.

Unfortunately, research from several in the medical community conclude that effective treatment for osteoarthritis is elusive and often lacks the efficacy desired by both patients and their doctors.

With the need for effective nonsurgical treatment of osteoarthritis being sought by patients, even professionals in the medical community like Professor Brandt are frustrated at the lack of effective options available to their patients.

Professor Brandt– after surveying the available options, their limited benefits, and many side-effects– states that “. . . we surely need better and safer drugs to treat OA symptoms” (2004).

The last thing patients of OA want to hear is that the symptoms they are attempting to treat with better and safer drugs are met with sometimes worsening side effects.

Because of this, it is vital for healthcare professionals to maintain a holistic approach when attempting to treat the underlying causes of OA and neuropathy. A comprehensive understanding of how lifestyle factors, genetics, and medical history can play a crucial role in determining which nonsurgical treatment (or combination of treatments) should be recommended.

Taking this into consideration, below is an overview of the nonsurgical treatment options available today.

Nutraceuticals

One of the most common nonsurgical treatments for OA is the use of nutraceuticals.

Nutraceuticals are dietary supplements that claim to improve the life expectancy and health care of an individual when used in tandem with healthy foods. The general assumption of nutraceutical efficacy works in tandem with the patient’s willingness to live a healthy lifestyle.

The specific nutraceuticals that treat OA include glucosamine and chondroitin methylsulfonylmethane. These compounds have both analgesic and chondroprotective properties, which allow them to ease pain and delay the degeneration of cartilage.

The efficacy of these treatments has been debated among peers in the medical community for decades. Notwithstanding, Dr. Begum Yurdakok Dikmen counters that nutraceuticals have been introduced as a form of treatment over the centuries and that many suffering from osteoarthritis look to them for a solution.

In a study on nutraceuticals done in 2016, Dr. Dikmen grappled with the fact that “[r]egulations regarding the quality and safety of nutraceuticals are still being debated . .” (2016). This is in part due to the medical community’s skepticism of nutraceuticals being seen as an alternative medicinal treatment for OA.

However, Dikmen states that nutraceuticals are still being considered by governmental bodies that will continue to “. . . develop strategies together with the public to enlighten the benefits supported by solid scientific evidence”.

Understandably, skepticism continues to be a persistent hindrance for the use of nutraceuticals in the treatment of osteoarthritis. This skepticism lies not only in physicians with patients who suffer from osteoarthritis but in the patients themselves.

Many would rather consider a lasting treatment that they know will work for them before ingesting a nutraceutical with which they are unfamiliar.

A study conducted by Marco AntônioPercope de Andrade M.DPh.D. concluded that glucosamine hydrochloride, a nutraceutical, “ . . . had no effect on pain management” when it came to treating osteoarthritis (2015).

Dr. de Andrade confirmed that results from more familiar sources for nutraceuticals such as avocado and soybeans were less conclusive and “. . . may have positive effects on knee and hip OA, but long-term results could not be confirmed”.

These conclusions on the benefits of nutraceuticals are both disappointing and frustrating especially for those who are seeking relief from the pain. While some patients who suffer from OA may feel a small amount of relief from the pain when using nutraceuticals, lasting relief will not be found.

Viscosupplementation

There are perhaps more nonsurgical options that will help– options that are made available through Relatyv.

In the year 2000, a clinical trial evaluating the efficacy of another nonsurgical treatment known as viscosupplementation was conducted.

While the clinical trials of viscosupplementation were in their infancy, Dr. John Watterson found that “. . . the lack of systemic side effects and the potential lasting effects make it an appealing option” (2000).

The process of viscosupplementation is best described as a loosening and relaxing of the joints that feel stiff and rusted over. This nonsurgical option uses a safe compound called hyaluronic acid.

Hyaluronic acid has been FDA approved for decades and Dr. Watterson attests to this benefit by stating that “[t]he US Food and Drug Administration approval of hyaluronic acid as a device has avoided the need for meeting the more stringent criteria for approval as a drug”.

Decades later, the use of hyaluronic acid in viscosupplementation has remained an effective and affordable solution to treat osteoarthritis. Relatyv uses this treatment for osteoarthritis in conjunction with its proprietary pain-relieving Neuralgesia treatment protocol.

While viscosupplementation relieves and loosens the joints affected by OA, Neuralgesia treatments further reduce the pain. Many patients experiencing the symptoms of OA report relief after only one Neuralgesia treatment session with Relatyv.

Patients experience greater mobility, strength, and requisition of the motor skills they used to enjoy completing their daily tasks.

Our Secret To Treating Arthritis-Related Neuropathy With Success

Because of how neuropathy and OA are interrelated and, sometimes, codependent, both degenerative diseases can be addressed using a similar approach.

Relatyv’s proprietary Neuralgesia treatment program is an effective solution to manage and ease the pain and symptoms associated with both conditions when weighed against other options.

Patients who choose not to rely on pharmaceuticals, perhaps fearing the risk of dependency or addiction, and patients who are wary of seeking surgical treatment to alleviate pain should look to Neuralgesia therapy with Relatyv for a solution to their pain.

Based on the research and findings that emerged over the past decades, Relatyv leverages a combination of viscosupplementation therapies and proprietary Neuralgesia treatment programs. The hyaluronic acid injections remain an effective option to lubricate the joints affected by OA and support the regeneration of damaged tissue, while Neuralgesia treatments further reduce pain through Combined Electrochemical Treatment (CET), Remote Therapeutic Monitoring (RTM), proprietary Neurassage therapeutic techniques, and lifestyle counseling.

Many patients experiencing the symptoms of OA and chronic pain report relief after only one Neuralgesia treatment session with Relatyv. Patients experience greater mobility, strength, and requisition of the motor skills they used to enjoy completing their daily tasks. The treatment is simple, non-invasive, and does not require the use of medications.

Relatyv is on a mission to bring Neuralgesia therapy to the millions of patients suffering from chronic pain who are not content with or willing to risk the conventional treatment options currently available. Thanks to our next-generation pain management protocol, we offer the opportunity to patients to relieve chronic pain and return to living their lives to the fullest.

Treat These Two Conditions With One Effective And Safe Treatment

Understanding how degenerative conditions such as OA and neuropathy relate to each other remains challenging. And, finding the right treatment for your needs can be even more difficult.

Nonetheless, thanks to recent advances in regenerative medicine, today’s patients have the opportunity to explore alternative treatment options that don’t involve pill-popping or surgery. And, Relatyv, with its innovative treatment protocols, is at the forefront of this revolution.