A New Approach to Joint Health

by Philip A. Cheras, Ph.D.

Osteoarthritis is the major musculoskeletal disease in the Western world. And as the West exports its bad habits indiet and lack of exercise , it is be coming more prevalent throughout the rest of the world.

Osteoarthritis is traditionally treated symptomatically. Even the newest, most advanced treatments target its major symptom: pain. However, new research shows the root causes—and is changing the conventional theories.


Osteoarthritis is a chronic condition characterized by the breakdown of cartilage, which provides a smooth, lubricating cushion between bones and joints. When cartilage breaks down, the cushion is lost and the bones rub against each other, causing stiffness, pain, and loss of mobility.

Our research has centered on the smallest blood vessels in the joint and discovered new reasons as to how osteoarthritis develops. The traditional belief is that the condition stems from the "wear and tear" of overuse or aging. Our work shows that osteoarthritis may also result from impaired blood flow and that wear and tear is not necessarily inevitable.

After two decades of research, we have seen significant, consistent patterns indicating poor joint circulation, including:

Blood clots and fat droplets in the small veins

Leakage of fluid and inflammatory material from the veins into the surrounding tissue

Increased arterial wall thickness and joint pressure

Small islands of dead bone tissue and bone marrow

Increased brittleness of bone

We have also discovered that those with osteoarthritis share abnormalities of the blood including:

Mild clotting with inflammation and a reduced ability to remove blood clots quickly

An increase of factors that raise clotting risk, i.e., high blood pressure and elevated cholesterol, make the blood "sticky" and more prone to clotting

Chemicals in the blood show evidence that clotting is already occurring

Chemicals in the blood that damage cartilage and cause inflammation and pain


The accumulation of clots and fats in the veins and capillaries block blood flow. The body responds by increasing arterial blood pressure in an attempt to force flow to the heart. The backpressure causes veins to leak into joint spaces, resulting in pressure and pain, reducing blood flow, and depriving bone of oxygen and nutrients normally delivered by the blood. If the clots are not dissolved and cleared quickly, bone and marrow cells "starve" and die, resulting in joint deterioration.

A similar scenario occurs in the synovial fluid, which lubricates and nourishes cartilage. Vein blockages degrade its quality and inadequate amounts of this thick, stringy fluid result in more friction and damage to the joints. The body's natural response to this situation is to release chemicals that cause added inflammation, clots, and fat deposits, which further exacerbate the problem. This process continues for years in a vicious cycle of accelerating damage, leading to the onset of pain, stiffness, and limited mobility.

Vascular causation also provides an explanation for how cardiovascular problems are associated with COX-2 inhibitors like Vioxx and Bextra. When in balance, the COX-1 enzyme makes blood clots, while the COX-2 breaks down those clots. The COX-2 inhibitors, by blocking these vital COX-2 enzymes, impair the body's ability to remove blood clots.


Related to the osteoarthritis research is a randomized study of shea oil extract. Derived from the pit of this wild-gathered fruit of the karite tree in Africa, shea products have been used for centuries as a traditional remedy for skin disorders and aches and pains.

Shea oil extract is rich in triterpenes, which offer several promising mechanisms that could target blood issues related to osteoarthritis. Shea triterpenes reduce key inflammatory agents in the blood, reduce coagulation (since coagulation cannot exist without inflammation), and favorably shift the LDL-to-HDL cholesterol ratio, thus reducing fat droplets. FlexNow™ Joint Formula, from BSP Pharma, is the first shea product that concentrates these triterpenes into an oral formula to reduce the aches and pains of joints.

The action of shea is different from chondroitin and glucosamine and may offer a solution that works well in concert with them to both replenish fluid and repair joints. Our research suggests that a significant portion of those taking the shea triterpenes in FlexNow can expect major relief from their joint pain.


Vascular causation demands a different approach if the true root causes of osteoarthritis are to be addressed without serious side effects. Tomorrow's medical approach must be multi-faceted, combining anti-inflammatory action with anticoagulation, clot-dissolution, and reduction of blood fat levels. Together with a healthy diet and exercise, a regimen that blends these strategies could slow or halt osteoarthritis and effectively break the disease cycle at its source.