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Some articles have been used as references in medical research, such as international journal Pharma and Bio science, ISSN 0975-6299.
Musculoskeletal disorders (MSDs) are medical condition mostly caused by work related occupations and working environment, affecting patients’ muscles, joints, tendons, ligaments and nerves and developing over time. A community sample of 73 females and 32 males aged 85 and over underwent a standardised examination at home. Musculoskeletal pain was reported by 57% of those interviewed. A major restriction of joint movement range was frequent in the shoulder but uncommon in other joints(1).
Types of Musculo-Skeletal disorders in elder(2)
3. Rheumatoid Arthritis
4. Polymalagia Arthritis
5. Cervical myleopathy and spinal canal stenosis
7. Low back pain
Rheumatoid Arthritis is defined a chronic disorder as a result of inflammation, affecting mostly the flexible (synovial) joints and tissues and organs in the body. The disease affects more women than men and generally occurs after the ages of 40, causing diminished quality of life of many elders(1). According to CDC, Musculoskeletal disorders (MSDs) affects over 52 millions of adults in the US alone, including 294,000 children under age 18 with some form of arthritis or rheumatic conditions(2). Rheumatoid Arthritis can induced bone loss through elevating bone resorption without increasing bone formation(4). A cross-sectional population-based study of 1042 patients with rheumatoid arthritis showed that RA patients had an increased risk of death from various causes(4a).
B. Treatment in herbal and traditional Chinese medicine
B.3. The Preventive Minerals and Vitamins
Free radical scavengers such as vitamins plays an essential role in reduced risk of rheumatoid arthritis
due to their effects in attenuate the expression of free radical and pro inflammatory cytokines(271)(272)
2.1. Vitamin A
According to the Imam Reza Hospital of Tabriz University of Medical Sciences, antioxidant including vitamin A are found to consist a clinical outcomes and oxidative stress in RA(274).
Patient with rheumatoid arthritis are accompanied with the over expression of the levels of serum leptin and other related cytokines, Dr. Xiong RB and the research team at the Southern Medical Universit said, " VitA.....significantly reduced the levels of leptin, TNF-α, IL-6 and CRP and the ESR(Pro inflammatory cytokines) and significantly increased the levels of IL-10 ( limiting autoimmunity and inflammatory responses),.... (of that) may provide a novel approach for the treatment of RA"(273).. All-trans retinoic acid (ATRA), a biologic key metabolite of vitamin A, showed to suppress the clinical and histologic signs of arthritis in the collagen-induced arthritis (CIA) mice model through downregulated the expression of RANK and prevented white blood cell from differentiating into osteoclasts, causing RA( 275).
Dietary vitamin C did significantly influence on growth performance and immune response, according to epidemiological studies(276)(277).
Dr Al-Okbi SY said" the majority of nutraceuticals studied possess beneficial effect toward chronic inflammatory diseases,.....anti-inflammatory and antioxidant nutraceuticals may serve as complementary medicine for the management of RA(279).
2.3. Vitamin E
Vitamin A similar to vitamin A are found to consist a clinical outcomes and oxidative stress (274)which has been found to play an important role in the inflammation and parthenogenesis of RA(283).
According to studies, diets containing fish oil and vitamin E not only showed a significant pain reduction in patients but also induced a positive effect on autoimmune disease by decreasing proinflammatory cytokines and lipid mediator(280). In the rat model of collagen-induced arthritis (CIA), oral adminsitration of δ-tocotrienol (10 mg/kg) induced a significant impact in lowering paw edema, through it anti inflammatory effects(281).
Vitamin D receptor (VDR), best known for its function in variety of metabolic disorders and in regulation of inflammation, is found to associate to the risk of RA(284), through its expression on reduced risk for FLS-mediated cartilage and bone invasion and erosions by attenuating the pro inflammatory cytokines induced osteoclasts. Vitamin D deficiency is common in rheumatoid arthritis (RA) of which induced pain, fatigue, and limited physical activity as well as poor quality of life(285).
Dr. Kostoglou-Athanassioul and the research team at the Red Cross Hospital, said," vitamin D deficiency is highly prevalent in patients with RA, .......may be linked to disease severity in RA. As vitamin D deficiency has been linked to diffuse musculoskeletal pain, these results have therapeutic implications"(286).
Vitamin K, another vitamin is found to plays an important role as an anti-inflammatory nutrient in bone metabolism(287). According to the cross-sectional study of a total of 158 female RA patients (mean age 62.5 years), oral administration VitK2 significant decreased serum CRP, and inhibited the proliferation of fibroblast-like synoviocytes (FLSs) and the development of collagen-induced arthritis (CIA). in a dose-dependent manner(288).
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(272) The antioxidant vitamins A, C, E and selenium in the treatment of arthritis: a systematic review of randomized clinical trials by Canter PH1, Wider B, Ernst E.(PubMed)