The role of NO in the management of OA

[andrewBwinter]

Sorry for the short forms on Nitric Oxide and Ostreoarthritis.

I have been looking at alternate management methods for my hip OA and discovered by accident that when I take my pre-workout (L-Citrulline) and head to the gym, the pain in my hip goes away. A vasodialator might be the answer.

Hence this article indicating that increased NO may offer relief from OA. Since T is not effective at all for me in reducing OA discomfort (nor should it be?) I was thinking of other substances and I landed on Cialis or Viagara. Perhaps 5mg daily Cialis will help as well for a longer duration. I think we all agree that Cialis has excellent off-label benefits and this may be one as well.

L-Citrulline really has helped greatly, all be it for only a few hours. Given that low-dose Cialis has great benefits, it might be an option since I refuse to load up on NSAIDs.

Interesting read:

Nitric oxide and cardiovascular effects: new insights in the role of nitric oxide for the management of osteoarthritis - Arthritis Research & Therapy

Nitric oxide (NO) is an important mediator in both health and disease. In addition to its effects on vascular tone and platelet function, it plays roles in inflammation and pain perception that may be of relevance in osteoarthritis. Many patients with osteoarthritis take nonsteroidal...

arthritis-research.biomedcentral.com

 

[Willyt]

As someone who has dealt with hip OA for years, I'm going to give you advice that you probably don't want to hear as a powerlifter guy.

The only thing that has consistently helped alleviate the pain over the years is to identify what activities/movements trigger the pain and try to avoid them. No question it sucks. I had to give up some of favorite hobbies like trail running and BJJ. But I knew deep down what was aggravating the O/A. It requires brutal honesty.

Of course, it doesn't mean you have to stop exploring ways to reduce the inflammation or to strengthen the muscles around the hip (that definitely helps).

Then at some point you just get fed up and replace 'em so you can keep doing what you love. I just spoke with an 85 year old guy who has been skiing like a madman for the past 20 years on steel hips!

 

[andrewBwinter]

Fair enough. Over the past year I have eliminated squatting patterns other than deep primal squats for mobility. I don't deadlift heavy any more and have chosen isolation exercises for my legs. I was hopeful that once starting TRT I would experience some relief from the OA the way I no longer feel any DOMS after a heavy workout; since cartilage is not vascular, no luck.

Ultimately it's about day to day management and not "picking the scab" as Stu McGill would say. Make no mistake, I will need a replacement in 2-3 years.

What I found by accident and what the article articulates, is the benefit of NO to daily management of OA which after removing aggravating factors, is the main goal. Walking and hiking with my wife and our dog now requires a little bit of prep before heading out.

Which reminds me, time for my daily 5mg.

 

[Willyt]

Sounds like you are well on your way. Let us know how the NO works out over time. I find that TRT unfortunately makes my hips slightly worse, presumably because of the water retention but who knows.

Strengthening the muscles around the joint is one thing that has helped me over time and that I do religiously. I wish I had started 20 years ago. 10 minute routine with the band below.

Sling Shot Hip Circle

Strengthen your hip abductors and external rotators while training better form and alignment for your squats and deadlifts. Get yours at Rogue today!

www.roguefitness.com

 

[lunchbeast]

I guess I'd expect NO supps to work similarly to heating pads - by increasing circulation to the affected area. Varying degrees of success...

 

[fun2drive]

Had both hips 09-10 and knees done 17 and have had zero issues. Range of motion as good as or better than before. But I have exercised all my life and did pre-surgery exercises to strengthen my areas needed.
The surgeon is the key. Repeat the surgeon is the key. I found two docs in the US with the best post recover and lowest infection rates. I met with the first one in Cincinnati and he has done all surgery since. Last visit last year looked at the z-rays and could detect no wear. Said come back in 7 years. Another key I has custom make protasis make for my knees. Did not have that when hips were done because they didn’t have this then.
Man really research this if you intend to do a replacement. I have no limitations what so ever. Hope this antidotal reply helps.

 

[lunchbeast]

Had both hips 09-10 and knees done 17 and have had zero issues. Range of motion as good as or better than before. But I have exercised all my life and did pre-surgery exercises to strengthen my areas needed.
The surgeon is the key. Repeat the surgeon is the key. I found two docs in the US with the best post recover and lowest infection rates. I met with the first one in Cincinnati and he has done all surgery since. Last visit last year looked at the z-rays and could detect no wear. Said come back in 7 years. Another key I has custom make protasis make for my knees. Did not have that when hips were done because they didn’t have this then.
Man really research this if you intend to do a replacement. I have no limitations what so ever. Hope this antidotal reply helps.

Do you run? Out of all the things I can't do anymore because my knees, I miss that the most.

 

[Willyt]

I was thinking of other substances and I landed on Cialis or Viagara. Perhaps 5mg daily Cialis will help as well for a longer duration. I think we all agree that Cialis has excellent off-label benefits and this may be one as well.

L-Citrulline really has helped greatly, all be it for only a few hours. Given that low-dose Cialis has great benefits, it might be an option since I refuse to load up on NSAIDs.

Did you end up trying daily Cialis for the arthritis? Did it have same positive effect as the L-Citrulline?

I have been experimenting with micro dosing of tadalafil and have been through several stop-start cycles to better understand the benefits & side effects. While I haven't had enough time to draw a definitive conclusion, I noticed a significant decrease in my hip and knee pain when on tadalafil. Within 48 hours of stopping, the pain would come back.

Again, it is still early days and I need to eliminate some variables to make sure. But promising nonetheless....

Here is 2011 study I came across regarding tadalafil and arthritis (and could barely understand)
https://bpspubs.onlinelibrary.wiley.com/doi/full/10.1111/j.1476-5381.2011.01469.x

 

[andrewBwinter]

Did you end up trying daily Cialis for the arthritis? Did it have same positive effect as the L-Citrulline?

I have been experimenting with micro dosing of tadalafil and have been through several stop-start cycles to better understand the benefits & side effects. While I haven't had enough time to draw a definitive conclusion, I noticed a significant decrease in my hip and knee pain when on tadalafil. Within 48 hours of stopping, the pain would come back.

Again, it is still early days and I need to eliminate some variables to make sure. But promising nonetheless....

Here is 2011 study I came across regarding tadalafil and arthritis (and could barely understand)
https://bpspubs.onlinelibrary.wiley.com/doi/full/10.1111/j.1476-5381.2011.01469.x

Yes and no. I do use L-Citrulline before workouts and the difference is measurable. The challenge for me is to take it daily since it gets expensive. I am at 2.5 daily for Cialis and I find the morning when I take it, the pain is diminished. So the question for me becomes how much of any one thing(s) am I willing to take. I have settled on 2.5 "tada!" In the morning with L-C pre-workout on gym days. (eod) That seems to give me a good combination of pain relief without loading up on NSAIDs.

Some days I almost rush down the stairs without any issue at all. I have also cleaned up my diet and added fresh juice every morning:
Carrots
Apple
Ginger
Radish
Brussel sprouts
Celery
Beets (when I remember to buy them)

You'll see natural pain relievers (sulphur) and a vaso-dialator (beets) in the mix.