What is it?
Joint pain in the hip, knee, or feet all typically occur in those who are obese. The joints associated with these areas bear the weight of our frame and help to keep us upright. Stress on these joints, as our bodies adapt to changes in weight and body shape, can often lead to debilitating discomfort.
The most common joint complaint is knee pain. The knee bears the brunt of increased weight and abnormal angle-stress from obesity. The knee is also subject to sudden twists and bends of unexpected slips and falls. This is often a problem for those who are obese and perhaps not as agile or flexible due to the excess weight. Minor tears in the ligaments, tendons, and cartilage (that result from these slips and falls) promote inflammation and swelling.
Foot pain is a frequent complaint of obese patients. Foot pain can arise from the ankle joint, the nerves to the foot, and ligaments (plantar fasciitis or heel spur). All three conditions are more common in obesity for the same reasons noted with knee pain. The human foot was designed to bear weight down the shank of the leg and heel, rather than towards the toes (as it must do in obesity because of having a larger abdomen).
Hip pain is the least frequent and most severe type of joint damage related to obesity. Pain from the hip joint is typically felt on the front of the hip. Hip pain requires expert diagnosis and rehab; you will need to see a joint specialist and possibly a physical therapist as well.
What causes it?
Joint pain and obesity are bedfellows. Joint pain may occur from increased strain and tearing of joint support (ligament, tendon, cartilage, bone) due to excessive weight and from abnormal joint angles from distorted weight distribution.
On another level, joint pain is related to your body’s ability to repair damaged collagen – the support protein for the ligaments, tendons, cartilage, and bone. Obesity is associated with changes in your body’s hormone levels – the ones that impact your ability to repair collagen. Those who are obese tend to have low testosterone levels and low growth hormone levels, both of which are essential to collagen repair. Obesity is also associated with elevated level of cortisone, which destroys collagen. As we age, our ability to repair damaged collagen also decreases, making obesity and aging a very troubling combination.
What role might cytokines play?
Fat cells produce cytokines that promote immune inflammation that damages joint structures. The combination of increased weight, abnormal angles of movement, and increased immune damage with diminished collagen repair destroys joints and causes pain with disability. Those who are obese have more problems with joint injury because their bodies produce too much of a protein enzyme (metalloproteases) that destroys collagen. Since overproduction of this enzyme is linked to out-of-balance cytokines, PrescriptFit can offer significant benefits.
What results could I expect with MNT?
Knee pain often improves with the MNT Plan via decreased weight and diminished inflammation. In our clinic, decreased pain and medication requirements are seen long before major weight changes. Expert rehabilitation is vital. Abnormal weakness is just as important as obesity in promoting abnormal knee-angle stress. Ab strengthening should be a practiced daily in those with back, hip, knee, or foot pain.
For improving foot pain, the Plan fosters weight loss and positive changes to posture that occur with reducing abdomen size. In addition, exercise and physical therapy as well as heel pads and arch supports will likely speed recovery. In our clinic, those using the MNT Plan often note improvement in foot pain, although usually at a slower rate than those experiencing improvement in knee pain.
How can I measure symptom change on the plan?
First, you need to be clear about what might be causing your joint pain. Talk to your doctor about what type of pain you have, when you first noticed it, the severity, and what treatment combination might be best for you. Next, you want to have a measurement of how severe the joint pain is for you. This will give you a baseline to compare with future measurements.
Most importantly, you (and your doctor) need a way to measure progress over time. Talk with your doctor at each regular visit about your symptoms and how they might change using the Plan.