DEGENERATIVE JOINT DISEASE:  IS THERE A NON-SURGICAL ANSWER? DEGENERATIVE JOINT DISEASE IS NOT THE SAME AS AGING!

Getting old has nothing to do with chronic pain. Chronic pain has it causes, yes, but they do not include advancing age! Old age is not a disease. Pain is a signal that something is wrong, something has become injured or weakened. For most, this is a signal that the ligaments that stabilize joints have become lax or weak. This pain is signaling then, the onset of most degenerative joint disease.

Following an injury to the ligaments, the bones in the joint, the knee for example, are no longer held in a stable position. This leads to instability in the knee and the bones start crunching. Crunching in a joint is a sure sign that the joint stabilizing structures are in a weakened state. If the joint instability is not treated, the degeneration in the joint will continue. Eventually this will lead to articular cartilage breakdown with the articular cartilage eroding to a point that the knee will become stiff and painful because the knee is now functioning as a "bone on bone" joint.

OSTEOARTHRITIS/DEGENERATIVE JOINT DISEASE (DJD)

Osteoarthritis is the most common form of arthritis affecting most of the population over the age of 50. It is also termed degenerative joint disease because osteoarthritis involves the deterioration of the articular cartilage that lines the joints and related changes in adjacent bone and joint margins. This deterioration occurs because the supporting structures of the joints, primarily the ligaments, become injured. Once this happens the joint has some instability and starts moving excessively. This causes some crunching noises from the joint where the bones start hitting together. The areas where the bones start hitting causes an overgrowth of bone (generally at the joint margins). This shows up on X-rays as bone spurs (osteophytes). This overgrowth of bone, along with the articular cartilage damage, is called osteoarthritis or degenerative joint disease (DJD).

The most frequent sites involved are the weightbearing articulations of the spine, hips, and knees, and the distal interphalangeal joints of the hands. Symptoms of DJD usually include brief joint stiffness upon awakening and joint pain or tenderness following usage, and are associated with the typical characteristic findings on X-Ray.

CAN ARTICULAR CARTILAGE REGENERATE?

Most of the joints in the body are synovial joints, movable, highly versatile, lubricated joints. They provide pain free movement because of the unique properties of their articular cartilage. In synovial joints, such as a knee, the articular cartilage covers and protects the bone ends, preventing friction between the bones, and also acts a "shock absorber," distributing the loads of weight over a larger contact area. Articular cartilage has no blood vessels or nerves. It is composed of a few cells called chondrocytes that are embedded in a sea of collagen, water and specialized protein structures called proteoglycans. It is the condrocytes, that are reponsible for the synthesis of both the collagen and proteoglycans that make up the cartilage.

The ability of the chondrocytes to replicate is really the key question when considering the potential of cartilage to proliferate or to repair itself. It has been shown in studies on adult human cartilage that there is no decrease in cell counts, even in individuals of advanced age. This fact only suggests that condrocytes have the ability to proliferate and repair.

CAN CARTILAGE REGENERATION BE ACCELERATED?

As seen through research, the chondrocytes, upon injury, gain the ability to replicate, proliferate, and generate new cartilage. This key fact is vital to understanding the power of  RIT in proliferating cartilage. RIT involves the injection of various substances including hypertonic dextrose, saline solution, nutritional and homeopathic substances many of which act by causing a mild irritation at the site of the injection. It is believed that with regard to cartilage this irritation acts as an "ignition" to cartilage regeneration. Empirically, this is supported by the numerous patients with no cartilage or those set for hip/knee replacements, who never need them because of RIT.

WHAT IS RIT?

RIT is a simple, natural technique that stimulates the body to repair the painful area when the natural healing process needs a little assistance. Notice I said "a little assistance". Because often, that's all the body needs, the rest it can take care of on it's own. In most cases, commonly prescribed anti-inflammatory medications and more drastic measures like surgery and joint replacement may not help, and often hinder or even prevent the healing process. The basic mechanism of RIT is simple. The proliferative/building solution of dextrose, saline solution, nutritional and homeopathic substances is injected into the "ah-shi" acupuncture points at the affected ligaments or tendons, which purposely leads to local inflammation. The localized inflammation triggers a wound healing cascade, resulting in the deposition of new collagen, the material from which ligaments and tendons are made. New collagen shrinks as it matures. The shrinking collagen tightens the ligament that was injected and makes it stronger.

RIT involves the treatment of two specific kinds of tissue: tendons and ligaments. A tendon attaches a muscle to the bone and involves movement of the joint. A ligament connects two bones and is involved in the stability of the joint. A strain is defined as a stretched or injured tendon; a sprain, a stretched or injured ligament. Once these structures are injured, the immune system is stimulated to repair the injured area. Because ligaments and tendons generally have a poor blood supply, it is difficult to get nutrition into the cells and difficult to get rid of waste products in the cells at the injury site.  Incomplete healing is common after injury to the tendons and ligaments. This incomplete healing results in these normally taut, strong bands of fibrous or connective tissue becoming relaxed and weak. The relaxed and inefficient ligament or tendon then becomes the source of chronic pain and weakness.

The greatest stresses to the ligaments and tendons are where they attach to the bone, the fibro-osseous junction. The most sensitive structures that produce pain are the periosteum (covering of the bone) and the ligaments. It is important to note that in the scale of pain sensitivity (which part of the body hurts more when injured), the periosteum ranks first, followed by ligaments, tendons, fascia (the connective tissue that surrounds muscle), and finally muscle. Cartilage contains no sensory nerve endings. If you are told that your cartilage is the cause of your pain, you have been misinformed; the cartilage cannot hurt because they contain no pain sensing nerves. If there is cartilage damage, the ligaments are typically the structures that hurt. Ligaments are weakest where they attach to bone. The periosteum is the most sensitive area to pain and the ligaments second. It is now easy to understand why this area hurts so much. This is where the RIT injections occur, and thus eliminate the chronic pain of many conditions including arthritis, mechanical low back pain, degenerative disc disease, cartilage injury, and sports injuries.

RIT works by exactly the same process that the human body naturally uses to stimulate the body's healing system, a process called inflammation. The technique involves the injection of a proliferant (a mild irritant solution) that causes an inflammatory response which "turns on" the healing process. The growth of new ligament and tendon tissue is then stimulated. The ligaments and tendons produced after RIT appear much the same as normal tissues, except that they are thicker, stronger, and contain fibers of varying thickness, testifying to the new and ongoing creation of tissue. Yes, you have read correctly.. The ligament and tendon tissue which forms as a result of RIT is thicker and stronger than normal tissue, up to 40% stronger in some cases!

In 1983, Y. King Liu performed a study using the knee ligament in rabbits. This study was done in order to quantify the strength of the tissue formed by RIT. In this study, a proliferant was injected into the femoral and tibial attachments of the medial collateral ligament, the inside knee ligament. The ligaments were given five RIT treatments and then compared to non-injected ligaments. The results showed that in every case RIT significantly increased ligamentous mass, thickness, and cross sectional area as well as the ligament strength. In a six-week period, ligament mass increased by 44 percent, ligament thickness by 27 percent, and the ligament bone junction strength by 28 percent. This research was yet another attestation to the effectiveness of RIT, showing that RIT actually causes new tissue to grow. Imagine what it would mean to an athlete to run 40 percent faster, jump 40 percent higher, or be 40 percent stronger? This new growth of stronger, healthier tissue is the normal and desired outcome with RIT.

THE CONCEPT BEHIND RIT

George S. Hackett, M.D,  after 20 years of experience using RIT, arrived at the conclusion that injured ligaments were the primary cause of chronic pain. Injured tendons were the second most common cause. He referred to this weakness in the ligaments and tendons as laxity. RIT involves the injection of substances that stimulate new tissue growth at the junction between the fibrous tissue (ligaments and tendons) and the bone. Most objects (animate and inanimate) break down at a junction site because this is the weakest part of the structure; this is especially true in weight bearing joints. A good example of this is when the leg of a chair is wobbly or loose. This is usually due to a loose connection where the leg attaches to the seat of the chair. By tightening the attachment of the leg to the seat, the chair becomes more stable.

Dr. Hackett used the word "weld," which is a very accurate description of RIT.  RIT welds the ligaments and tendons to the bone. When welding steel, the welder is applying a very hot probe or flame to melt two pieces of metal together. Two large pieces of metal would require welding many areas all along the long seam. Why do so many spots need to be welded? The reason is to make a stronger connection. If one area weakens in the future due to wear and tear, the others will hold the structure together.

This is the concept behind RIT. All of the injured tissue must be treated for injuries for chronic pain to be eliminated. RIT causes the proliferation of new ligament and tendon tissue exactly where the injections are given. It is just like spot welding.  It strengthens the exact spot where the weld or injection takes place. The more RIT injections, the stronger the weld.

ARE YOU AN IDEAL CANDIDATE FOR RIT?

RIT stimulates the body to repair the painful area. For the patient who has localized areas of pain or the person who has had a recent injury from an accident, RIT is a very effective treatment to strengthen those specific areas and eliminate the pain. Realize, however, that RIT starts the growth of new healthy, strong tissue. Your body--your own immune system--grows the tissue. For the person who has terrible digestion, chronic fatigue, irritable bladder; and a host of other chronic nutritional, hormonal, allergic problems, these deficiencies and illnesses should be corrected so the body will be able to respond to RIT.

The ideal RIT candidate has the following:

1. Pain originating from a ligament or tendon

2. Strong immune system

3. Willingness to improve and receive follow-up visits

4. Healthy diet

5. Positive mental outlook

For Arthritis and Fibromyalgia

Most people who suffer from arthritis and Fibromyalgia have a portion of their pain or all of their pain from ligament and tendon injury. Most muscle spasms occur because the underlying ligaments are weakened and the muscles spasm to stabilize the joints, as occurs in Fibromyalgia. The same can be said for arthritis except the body is stabilizing the joints in this condition by overgrowing bone. This overgrowth of bone is called arthritis.

RIT allows the stabilizing of joints by causing a strengthening of ligaments, thereby eliminating the muscle spasms of Fibromyalgia and the need for the body to overgrow bones occurs in arthritis.

WHEN RIT DOES NOT WORK

The most common reasons why a person may not attain 100 percent improvement with RIT are the following:

1. Inadequate (depressed) immune system

2. Nutritional deficiencies

3. Hormonal deficiencies

4. Other factors causing the pain that are not being addressed

5. Correct area being treated but repair not yet complete

6. Wrong area being treated

This last fact is often overlooked. A good example of this relates to patients with lower back pain. All that is typically needed for eliminating the reason for back pain is for the patients to receive RIT to the lower back at the sacroiliac joints. In a small percentage of the people, the sacroiliac joint remains weakened because the pelvic joint in the front pubic symphysis also needs to be treated. The sacroiliac ligaments, in this instance, will only maintain the strength that is attained with RIT if the pubic symphysis is also treated.

The information on this website is presented as information only and not as a self-help guide. Never alter or change your health management or begin any new health plans without first consulting your personal health care provider. Some statements on this site regarding the value of nutritional supplements have not been evaluated by the FDA.

As with any medical technique, RIT may not be effective for every individual and there are risks involved. These risks should be discussed with your personal health care provider. Results achieved with some may not be typical of all.

There is no known cure for arthritis. RIT and nutritional supplements can help alleviate, reverse or end arthritic pain by treating an underlying cause that contributes to degenerative disease, ligament laxity. Strengthening ligaments and other connective tissue can help prevent bone on bone arthritis from developing.