7 Ways I Treat Arthritis Before Considering Surgery | Dr Vonda Wright | #170

**Dr. Vonda Wright** (0:00)
Today, I'm going to be talking to you about how I treat arthritis. But first, what is arthritis? So you know that you are made of bones, tendon, ligaments, muscles, and cartilage. Cartilage is the smoother than ice. For you physics people out there, it has a coefficient of friction that is smoother than ice. It is the end cap, like a bumper of every bone. So look, I've brought my femur again, as I often do. This is the knee end of the femur.
Cartilage is the end cap that fits over here, like the chrome bumper on your car. What that does in joints, in every joint, is to make your joints glide so smoothly you don't even feel them until you do feel them when your cartilage starts to degrade. That can happen for so many reasons. It can happen due to trauma. Your car gets wrapped around a tree and your knee hits the dashboard, or you're a football lineman and you're 20 years old, and you crash so much that the cartilage, which we get one set of, starts to flake off. Or what if you dislocate your kneecap? Lots of young women dislocate their kneecaps, and the trauma of bones hitting against each other can cause arthritis. But that is only one and the rarest reason for arthritis. Other reasons include chronic inflammation, heavy loads across the joint. Normally, joints bear four to seven times body weight anyway. And then the heavier and more body weight we bear, the more load on our cartilage. There are so many reasons. There are even autoimmune diseases for arthritis. But today, I'm talking about osteoarthritis, which is wear and tear. And why is that important? Well, so many reasons, but it is known that women have a rapid increase in their arthritis and joint degradation when estrogen walks out the door. And why is that? Well, like so many other skeletal tissues, cartilage has estrogen receptors that help maintain the matrix. So once estrogen walks out the door, many women come to me with knee pain or hip pain that they've never ever had. And I x-ray them and I find that the joint space is narrowing. And what that indicates to me is they're losing their cartilage layer. So when someone comes to me with arthritis, and my job as a sports surgeon is to keep you on the ball field, to keep you in your backyard, to keep you functioning and not send you to my knee replacement colleague for as long as we can. And so there are many ways to do that. And maybe you're going to an orthopedic surgeon for this, and the first answer you hear is, let me just give you a shot of steroids and you can be on your way. Well, for many, many years, that was the main answer that orthopedic surgeons had for you, but I want you to consider whole person care of your arthritis. And so that's what I'm going to be talking to you about today. If you were in my office, this is what you would see. I am an educating surgeon and I teach my patients. And so I would draw this out for you and I would send it home with you. So that's what we're doing today. How I'm going to treat your arthritis, this is a partnership, this is a whole-person venture. So number one, how are we going to treat your arthritis? Well, surprisingly, number one, if you are a midlife woman, you are going to make a decision about optimizing your hormones.
I know I sound like a broken record if you have listened to me a lot before, but why wouldn't we return to the root cause? One of the root causes of rapid increase in arthritis in women is loss of our hormones. So we need to get in front of optimizing them. Estrogen, progesterone, testosterone, mostly estrogen. How do you do that? Well, if you're a data person and want to read the data first that I'm going to send you to Estrogen Matters, the book by Avron Blooming and Carol Tavris. It's all the data on whether hormones are safe for you or not. There are so many good books on how to find out about your hormones and make your decision. And then you're going to have to find a hormone, a savvy clinician. Now, not many clinicians in this country, less than 7% of medical students, less than 30% of all OB-GYN doctors have received formal education in this. So many of us, including me, have done our own education to become experts in this. And we can help you. So keep searching for someone who can help you with your hormone optimization. It is a root cause of arthritis. Number two, whether you decide to do this or not, there are so many other things you can do.