In an ever-changing world, prevention and maintenance are as important as ever.
When people hear about joint inflammation, they often associate the term with arthritis, and understandably so.
According the Centers for Disease Control and Prevention (CDC), 23 percent of all adults—more than 54 million Americans—have arthritis. Approximately 24 million of those adults find themselves limited in their activities as a result, including more than one in four reporting severe joint pain, which is a pain level of seven out of 10 or higher.
The impact that arthritis plays in people’s live is apparent (60 percent of U.S. adults who have it fall within the 18 and 64 age range), and unfortunately, it is a part of our daily lives.
Bone, joint and muscle health affects our day-to-day schedules—practitioners can make sure that patients’ natural product needs are not only successfully met but also backed by validated research.
Generally speaking, it is important to understand that the wearing of the bones, joints and muscles with age is perfectly normal. The important part is being aware of this and finding ways to help combat these changes that the body is experiencing.
“As we age, it is natural for our bones, joints and muscles to start feeling the wear and tear of everyday life,” said Perry Antelman, CEO of Rhode Island-based Abacus Health Products, manufacturers of CBD Clinic products. “Muscles can lose strength or shrink. Likewise, bones and joints start to deteriorate with age or by repeated activities. As a result, common musculoskeletal conditions like arthritis can occur. While aging is inevitable, inactivity is among the most common causes of age-related conditions. Light physical activity can help reduce or even reverse certain bone, muscle and joint conditions.”
A type of arthritis, osteoarthritis (OA), is dominating the stat lines for both men and women.
“Osteoarthritis, the degeneration of joints, affects more than 50 million American adults, according to the Centers for Disease Control and Prevention,” noted Hank Cheatham, vice president, marketing and sales, Daiwa Health Development Inc. in California. “Women are affected at nearly a 25 percent rate, while 18 percent of men suffer from osteoarthritis. As Baby Boomers continue to swell the ranks of the U.S. senior population, the prevalence of arthritis will likely increase in the coming decades, according to the CDC. The CDC forecasts that by 2040 there will be 78 million arthritis patients, more than one-quarter of the projected total adult population; two-thirds of those with arthritis are expected to be women. Also, by 2040, more than 34 million adults in the U.S. will have activity limitations due to arthritis.
“Osteoarthritis will affect most people during their lifetimes, many to the point where a knee joint or hip joint requires replacement with a costly and difficult surgery after enduring years of disability and pain,” Cheatham continued. “Damage to the cartilage surfaces is associated with failure of the joint, but that damage only becomes obvious very late in the disease process, and cartilage is just the outermost layer in a complex assembly of tissues that lie deep below the surface.”
Elizabeth Livengood, ND, owner and doctor at Livengood Natural Health, and co-founder/CMO at Restorative Methods (both in Arizona), expounded on Antelman’s advice for combatting these types of issues.
“Joint pain, injury, fracture risk and hence increased mortality rate are all associated with obesity. So one of the simplest ways we can protect our bones and joints is by maintaining a healthy weight. If a person is overweight, losing just 5 percent of their body mass (especially fat reduction) can reduce pain and improve quality and length of life.1-4 Being overly thin also has health risks such as decreased bone density and lower muscle mass, since the person naturally has less resistance with any movement. If they are also sedentary, the risks of low bone density and muscle mass are much greater.”
Dr. Livengood also added that diet and nutrients can play a role, saying that “poor nutrition also has a bearing since bones require minerals which are leached by excess phosphoric acid, such as in soda. Caffeine (e.g. three or more cups of coffee per day) also reduces the absorption of calcium.5 Muscles require protein to repair and rebuild, so a diet with inadequate protein intake makes it very difficult for a person to build muscle or convert fat to muscle, even if they exercise. An appropriate amount of lean protein is 0.8 g/kg of body weight for a mildly active person or 1 g/kg of body weight for a person who exercises daily. Athletes in training intake even more.”
Joy Stephenson-Laws, president and founder of Proactive Health Labs (pH Labs) in California who alluded to the complexity of the musculoskeletal system, concisely broke it down by pointing to various health issues and risks including:
• Bone fractures
• Carpal tunnel syndrome
• Loss of strength
• Decreased stability and balance
• Increased risk of falls, especially with the elderly
• Tension neck syndrome
• Bone loss (osteoporosis, osteopenia)
• Muscle strain
• Ligament sprains
• Joint stiffness and loss of flexibility
It’s important to reiterate Stephenson-Laws’ point, which is that the risk of developing or better managing these conditions can be reduced if the body gets the proper nutrients in the right amounts.
Enzyme Science, a Florida-based company, views the bone, joint and muscle segment through an enzyme state of mind. The manufacturer offers MyoMend in this regard.
“At Enzyme Science, we look at the bone, joint and muscle category of formulas from an enzymatic perspective,” said Ryan Sensenbrenner, director of trade marketing. “At the end of the day, this consumer is looking to be able to live freely without discomfort and be able to have mobility conducive to the lifestyle that they want to live. Enzymes are the energy of life. They are catalysts for every chemical reaction in our body. While the benefits of supplemental digestive enzymes are well-known, when taken on an empty stomach, enzymes can also work therapeutically within the bloodstream. Proteolytic enzymes function by assisting with ‘the three D’s.’ They help the body remove cells that are Dead, Damaged and Don’t belong.”
Sensenbrenner went on to say that “Our flagship formula for this category is MyoMend, a combination of proteolytic enzymes that are taken on an empty stomach. This product has a tremendous advantage in that it is a vegan enzyme source. Vegan enzymes are more active than animal sources across a wide pH and temperature range, so individuals can take fewer capsules and get greater benefit. MyoMend contains a unique blend of proteolytic enzymes that work systemically to help break down damaged proteins, speeding up recovery and promoting flexibility and mobility.* Rutin is known as a vital phytochemical which serves as an antioxidant and is associated with improvement of physical fatigue.* In combination, enzymes and rutin naturally accelerate muscle and tissue repair and provide optimal wellness.*
Illinois-based Carlson Laboratories, which offers Nutra-Support Joint and Enhanced Mobility among other products, feels that supporting the bones, joints and muscles starts with calcium.
“Let’s begin with calcium. The Food Surveys Research Group issued a statement in 2014 that said that calcium intake in older adults was not adequate to support healthy bones,” explained Jolie Root, the company’s senior nutritionist and educator. “Calcium intake should be a priority in the management of bone and joint health.
…Calcium supplementation can make up the low calcium intake in all age groups. Older individuals are the groups most likely to be using supplements, although calcium gummies can be an agreeable option for children and adolescent women. Young women need to establish optimal bone density during adolescence because poor bone density during the teen years is a risk for the development of osteoporosis later in the woman’s life. Younger people are not the only candidates for calcium gummies though because calcium tablets can be very large and hard to swallow, so older people may prefer gummies too.”
Root also advocated the importance of supporting calcium with both vitamins D and K. And if patients are looking for additional supplements, curcumin, omega-3s, ribose and tart cherry are viable options.
Adam Sutter, quality director with ChildLife Essentials in California, maker of Organic Vitamin K2 Drops, was in agreement, adding that “nutrients such as calcium, vitamin D3 and vitamin K are responsible for building bone, while other natural supplements and medicines may help to rebuild cartilage, tendons and ligaments. Research on collagen supplementation appears to show that the individual collagen amino acids, particularly proline, when circulating in the blood cause our body to ‘think’ collagen is being broken down and thus it activates collagen repair mechanisms.”
CBD has also garnered plenty of attention within the natural products community for the benefits that it offers the endocannabinoid system. “CBD is a great natural remedy. The human body contains a series of receptors that are designed to use cannabinoids—in fact your body makes its own,” said Melissa Davis, national education director for Colorado-based Elixinol. The endocannabinoid system, or ECS, is made of a series of receptors that are found throughout the immune and nervous systems. These systems are waiting for cannabinoids like CBD and others to help the body find its optimal state. Cannabinoid molecules attach to these receptors, do their work, and then are broken down by enzymes. Researchers are looking into how cannabinoids are processed by the ECS and how they aid in pain management, sleep issues, stress issues, inflammation and mood.
“At Elixinol, we are taking our CBD and pair it with other natural supplements and ingredients to help people find products that address certain needs, like inflammation. Our Body Comfort CBD capsules are perfect for those looking to support joint health. The capsules feature full-spectrum CBD oil and 275 mg of boswellia. Also known as Indian frankincense, boswellia is an herbal extract taken from the Boswellia serrata tree. The extract has been used for centuries in Asian and African folk medicine and has shown to help with body discomfort by reducing leukotrienes throughout the body, thus reducing inflammation. …Topicals are also extremely popular, as a lot of people are simply more comfortable using them. Our Sports Gel and Hemp Balms provide a targeted localized benefit to the consumer. Definitely ideal for relief in certain areas of the body.”
Speaking of the aforementioned topicals, CBD Clinic also provides patients with options to choose from. “Topical products like CBD Clinic commonly feature naturally-derived active ingredients in compliance with the FDA (U.S. Food and Drug Administration)-monograph for OTC (over-the-counter) topical ingredients, including camphor, a cooling and heating oil extracted from the camphor tree; and menthol, a cooling compound extracted from the mint plant,” Antelman said. “These ingredients are blended with only the highest quality CBD hemp oil or extract and other natural emollients to nourish the skin in the process. These products are easy to integrate in a clinician’s everyday sessions. They can be used before or after exercise or treatments to target pain directly at the source of discomfort where patients need it most without concern about it entering the bloodstream. They can also be used for selfcare.”
For those looking for additional options, Indiana-based herbal formula brand Rebel Herbs offers Jointade, three products containing a combination of boswellia, ginger and turmeric.
“I will speak to Rebel Herbs Jointade triad: it can be used for muscles and joints—there is a topical that can help decrease inflammation and pain while increasing circulation,” said Juliette Sweet, ND, the brand’s director of clinical education. “The capsules also have the same properties but the added benefit of boswellia. Boswellia has been shown to increase the joint space (rebuilding cartilage).
“…Then,” Dr. Sweet stated, “we also have an herbal vapor which is fast acting to reduce joint pain. It goes systemic which is nice because sometimes individuals have a challenging time assimilating capsules to help with joint pain if they have GI (gastrointestinal) issues. That being said, the most benefit is if patients use the topical, take the capsules to reduce systemic inflammation and help repair cartilage along with the vapor for acute pain.”
The market for this particular segment looks quite promising, as indicated by its projected growth in the coming years.
“The natural market for bone, joint and muscle support is one of the largest and most competitive categories in the industry,” stated Jason P. Edwards, CEO of Rebel Herbs. “The bone and joint supplements market worldwide is projected to grow to $9.4 billion (U.S.), driven by a projected 6.6 percent compound annual growth rate (CAGR) through 2024.”
And the natural products at patients’ disposal are being utilized by both the older and younger generations.
“Based on our experience in working with clients and patients at pH Labs,” said Stephenson-Laws, “I would say there is a robust and growing market for natural remedies and supplements for promoting bone, joint and muscle health. It’s also worth mentioning that we continue to see more and more younger clients asking about these products. We first noticed this trend a few years back, and this market segment continues to expand more quickly than the traditional demographic for these products, which tends to skew older. … Part of this growth, of course, can be readily attributed to the last of the Baby Boomers starting to feel the effects of getting older on their bones, joints and muscles and looking for natural remedies to treat them. But the rest, which is significant, I attribute to younger generations being far more educated than previous ones on the importance of taking care of their musculoskeletal systems proactively before they start to experience joint degradation, loss of strength and muscle mass and decreasing bone mass and strength.
“… In addition to calcium, the perennial go-to for bone health, we also see our clients showing increasing interest in other key nutrients important to musculoskeletal health such as magnesium, chondroitin, glucosamine, SAMe (S-adenosyl-L-methionine), vitamins K2 and D3 and many others. As they gain a greater understanding of the roles—alone and together—these nutrients play in the bone, joint and muscle health, the greater the growth in sales of these products will be.”
Alternative medicine to treat chronic pain are also expected to show impressive numbers, including the use of CBD as a treatment option.
As mentioned by Antelman, “North America holds the largest share in the chronic pain treatment industry, estimating a projected revenue of $32 billion in 2018, reaching $2.3 billion in topicals alone, according to Allied Market Research. Topicals are expected to reach $3,730 million by 2025, including naturally-derived ingredients like capsaicin, camphor and menthol. IBISWorld has projected that the field of complementary and alternative medicine will reach $17.9 billion this year, however, the current pandemic has shifted this projection. That said, holistic medicine is still expected to be adopted by Americans as more insurance companies and employers recognize its value. According to Global Newswire, the U.S. leads the aromatherapy market with a revenue share of 43.6 percent in 2017. The CBD industry is estimated to reach $20B by 2024, however the FDA is still collecting data to support the myriad anecdotal claims. As it stands now, the market cannot legally make medical claims on these ingredients. Currently, nine studies funded by the National Institute of Health (NIH) and National Center for Complementary and Integrative Health (NCCIH) are underway to explore the efficacy of cannabinoids and pain.”
As alluded to throughout the article, there is a direct correlation between weight management and the bone, joint and muscle support sector.
“Energy and weight management, general health, bone and joint health, immunity, gastrointestinal health, cardio health, diabetes and anti-cancer are the major application segments of the market for dietary supplements. Energy and weight management accounted for the largest market share—30 percent in 2019, owing to the rising trend of online weight loss programs and government initiatives for promoting a healthy diet,” Cheatham said. “Rising prevalence of chronic diseases, such as arthritis, cardiovascular problems and diabetes as well as the advantages associated with plant-extracted remedies over synthetic drugs are factors expected to drive the market over the forecast period. Rising geriatric population has created various opportunities for product manufacturers as most people at this age cannot meet their Recommended Dietary Allowances (RDA) due to insufficient nutrient intake which results in driving the demand for dietary supplements for the elderly. “As a result of environmental awareness, trends led by young consumers, and greater knowledge about wellness, many of today’s consumers are demanding greater transparency in the products they purchase. More consumers want to know where their products come from and what their ingredients are.”
Abacus Health Products is primarily focused on the connection between CBD and how it impacts the body. “As a company that creates natural pain-relief formulations containing CBD, we pay close attention to the ongoing research surrounding hemp-derived CBD and its potential benefits to the human body. In fact, we have conducted small preliminary studies with our employees to ensure that our products will not cause anyone to fail a THC-drug test,” Antelman said. “Our data supports the theory that our products, which are not transdermal, do not present a risk for anyone concerned about a THC-drug test by using our products alone. Likewise, our chemists and regulatory advisors regularly review peer-reviewed journal articles regarding the most up-to-date research on naturally-derived ingredients that are efficacious as stabilizers, penetration enhancers, or show promising therapeutic benefits. We plan to conduct further research on our final products in the future.” pH Labs takes a bit of a more macro approach in the sense that the company is continuously searching for ways that nutrition impacts one’s health and lifestyle. Evidence of this is demonstrated via a published book and conducted studies.
“Given pH Labs’ mission to educate people on how to best protect their health—including their bone, joint and muscle health—we are always interested in, and make it a point to stay on top of, the latest research in the role nutrition and lifestyle play in getting and staying healthy,” said Stephenson-Laws. “To that end, pH Labs researched and published a book titled Minerals – The Forgotten Nutrient: Your Secret Weapon for Getting and Staying Healthy that gives readers important, easy-to-understand information on the role minerals play in creating a solid foundation for health. The book includes, of course, how minerals contribute to healthy bones, joints and muscles. pH also conducts ongoing research on the latest developments in BJ&M (bone, joint and muscle) health, which we publish on our website. Topics have included the link between vitamin B6 and carpal tunnel syndrome; the importance of zinc and copper for healthy bones; and changing protein needs for muscle health as people age. All blogs are available at no charge.”
Over the years, as research and technological capabilities have improved, the approach towards bone, joint and muscle health have evolved. “The approach to bone, joint, and muscle support has evolved greatly over the past several years from a more reactive approach to one that focuses on proactive preventive measures to extending and enhancing health for life,” Sutter noted.
According to Edwards, this is also due to in part to an increase in life expectancy.
“With Baby Boomers living longer and the aging population growing, aches and pains are a growing concern,” he explained. “Most people want to be active through their older years. Whether because they want to enjoy their retirement years or they must continue to work through their twilight years, the need to stay active and the reality of joint pain have converged on one of the largest population demographics in the country. Nearly 20 years ago, glucosamine and other nutrients were the most popular way to keep joint pain free, but now, patients are looking for better and faster ways to feel the results in addition to nutrients that will over time help their overall joint health.”
However, having all of this information at our fingertips has caused people to become more active, despite the risks that are always present. “Musculoskeletal treatments are so much more integrative and comprehensive today. Decades ago, we were told to drink our milk and worry about our bones after we retire. Now, we know that prevention is indeed the best medicine, since it’s very difficult to replace bone loss and much easier to prevent it.,” Dr. Livengood concluded. “In the past, people may have been more active simply in daily living. Now, with the advent of automation and computerized everything, we have to intentionally seek out physical movement. The upside is that many people are physically active these days. The downside is that this can lead to injuries or earlier onset of OA. With all the nutritional and hands-on therapies that have been popularized by athletes, it’s very common now for patients to seek a complete package of care rather than just a prescription when they are faced with injuries or musculoskeletal diseases.”
*These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure or prevent any disease.
1 Christensen R, Bartels EM, Astrup A, Bliddal H. Ann Rheum Dis. 2007 Apr; 66(4):433-9.
2 Riddle DL, Stratford PW. Arthritis Care Res (Hoboken). 2013 Jan; 65(1):15-22.
3 Toda Y, Toda T, Takemura S, Wada T, Morimoto T, Ogawa R. J Rheumatol. 1998 Nov; 25(11):2181-6.
Healthy Take Aways
• According the Centers for Disease Control and Prevention (CDC), 23 percent of all adults—more than 54 million Americans—have arthritis.
• If a person is overweight, losing just 5 percent of their body mass (especially fat reduction) can reduce pain and improve quality and length of life.
• The bone and joint supplements market worldwide is projected to grow to $9.4 billion (U.S.), driven by a projected 6.6 percent compound annual growth rate (CAGR) through 2024.
For More Information:
Abacus Health Products, www.cbdclinic.co
Carlson Laboratories, www.carlsonlabs.com
ChildLife Essentials, www.childlifenutrition.com
Daiwa Health Development Inc., www.dhdmed.com
Elizabeth Livengood, ND, www.drelizabethlivengood.com, www.restorativemethods.com
Enzyme Science, www.enzyscience.com
Proactive Health Labs, www.phlabs.org
Rebel Herbs, www.rebelherbs.com