Rheumatic and joint diseases are a major focus in my department, as we are also a nationally renowned center for rheumatology and orthopaedics.

If you take the secondary diagnoses into account, it is certainly 60-70% of all patients here who suffer from joint pain, rheumatic diseases or other pain syndromes such as chronic back pain or chronic neck pain. Particularly in the case of knee joint arthrosis, ankle joint arthrosis, back pain and neck pain, we see obesity or metabolic dysregulation as decisive contributory factors for chronic pain.

We can also see from our health care data that our multimodal therapy concept with fasting, nutritional therapy, physiotherapy and medicinal plants as well as methods such as acupuncture or leech therapy often achieve very good results, so that surgical intervention can often be avoided. Word of this has spread, so that demand is correspondingly high.

People talk about “joint wear and tear” and doctors often use the same vocabulary with patients. What is meant by this? The joint cartilage has degenerated so that it is no longer possible for the joint surfaces to slide against each other without causing pain.

However, this view is very mechanistic and promotes so-called replacement part medicine - both on the part of doctors and patients, resulting in the extremely frequent use of artificial joints, particularly in Germany. In reality, however, the situation is more complex.

Pain in the joint is caused by the formation of so-called pain mediators in the synovial fluid. This occurs not only as a result of mechanical stress - such as obesity - but also due to years of malnutrition, such as a diet containing too much animal protein and too much intake of unfavorable, inflammatory fatty acids, such as the arachidonic acid contained in red meat. In addition, it is by no means clear whether joint cartilage can regenerate to a certain extent, even though medical science has so far mostly denied this.

I agree with the previous speaker's comments and would like to add the following. In the past, osteoarthritis was classified as a wear and tear disease, a degenerative disease. In the meantime, a different view has prevailed.

On the one hand, research has shown that osteoarthritis also has an inflammatory component. This means that clear signs of inflammation can be seen on the synovial membranes and in the cartilage tissue, not as pronounced as in classic rheumatism, but still recognizable. On the other hand, metabolic disorders are also said to play a role in the development of osteoarthritis, i.e. obesity or abdominal fat, as well as metabolic diseases such as type II diabetes, can clearly promote the development of osteoarthritis. In addition, hyperacidity of the connective tissue and the condition of the joint environment with the relevant tendons, muscles and ligaments also play an important role.

We can exert an excellent therapeutic influence on all of this, so that osteoarthritis can no longer be regarded as the fated wear and tear of a joint. That's why I think it's very critical when doctors repeatedly communicate findings with quotes such as “Your knee is broken”. Even if osteoarthritis cannot be cured in the classic sense, it can certainly be improved.

In my opinion, this is due to malnutrition, lack of exercise and poor posture - often also after joint replacement in the hip or knee, which changes the posture and can sometimes exacerbate complaints in the joints that have not yet been operated on. This in turn leads to further joint replacements. I know patients who have had new hip and knee joints within two years. With respect: I think that's absurd!

In my experience, the majority of cases are also due to poor diet, obesity and lack of exercise. This is an interesting point in that it used to be believed that overuse due to physical work and too much exercise damaged the joint. Of course, there is also arthrosis and wear and tear due to overuse, e.g. in the past in mining workers. Today, however, the main problem is a lack of movement - and, as my colleague Dr. Matejka has already mentioned, chronic poor posture. This then leads to reduced blood flow to the joint structures and reduced nutrition of the cartilage tissue. The lack of exercise or the one-sided strain caused by monotonous movement and too much sitting also often leads to poor posture. This can lead to knee pain or hip osteoarthritis due to foot problems. Or, conversely, osteoarthritis of the hip can cause back and neck pain. This also indicates that holistic thinking is necessary here. Otherwise it can happen, for example, that a knee joint is operated on and the symptoms do not improve sufficiently. Or that the pain is alleviated, but then severe pain occurs elsewhere.