A Blind Spot in Functional Medicine?
We’ve come a long way in our understanding of functional medicine. Whether it be the connection between the mind and the gut, chronic headache and migraine, or the hidden dangers of everyday toxins, our understanding of the body continues to expand in amazing and life-saving ways.
But that doesn’t mean we as functional medicine practitioners don’t still have blind spots; we absolutely do. Such is the case with the musculoskeletal system: it can play a critical role in the body’s metabolic functions and in chronic disease recovery. But it’s easy to overlook by defaulting to aspects of care such as diet or supplementation.
The truth is, when people actually start to engage and move their muscles, joints, and ligaments, it has a profound impact on metabolic, immunological, and neurological systems.
The musculoskeletal system can play a critical role in the body’s metabolic functions and in chronic disease recovery, but it’s easy to overlook.
The upshot for functional medicine practitioners is this: by focusing on musculoskeletal health as a primary factor in patient health, you can dramatically improve health outcomes for virtually every medical condition.
The Musculoskeletal System as an Organ of Longevity
Of course, longevity and healthspan are all-encompassing, with every system in the body playing its part. But the musculoskeletal system in particular is often called “the organ of longevity” for just how outsized a role it plays in overall health. (This is especially true for patients over 40.)
Why does the musculoskeletal system play such a large part in bodily health? For one, skeletal muscle comprises around 40 percent of overall body weight.
The musculoskeletal system does far more than previously thought.
Imagine that 40 percent of your car’s engine cylinders were running suboptimally—you would certainly notice performance issues! The same holds for the human body: the healthier our muscles are, the healthier we tend to be.
But over the last few decades, medical science has learned that the musculoskeletal system does far more than previously thought. It’s not just the structure upon which the body is built, as important as that is. It’s also a key contributor to the endocrine system.
Metabolic functions of muscles
Our skeletal muscles play a crucial role in various metabolic functions beyond just posture, movement, and spinal support and stability.
Much like bones (see next section), muscles are now seen as an important component of the endocrine system. When exercised, muscles signal the release of myokines, which are extremely important for maintaining overall health. Myokines promote metabolism, reduce inflammation, and improve insulin sensitivity and brain function.
When exercised, muscles signal the release of myokines, which are extremely important for maintaining overall health.
Contracting muscle also signals the release of cytokines, a specific type of myokine. Cytokines play a role in body fat regulation (both white and brown fat). They help the liver metabolize glucose and fat and have a direct impact on the kidneys and white blood cells.
Metabolic functions of bones
Bones have their own role to play in health and longevity.
The skeletal system acts as a reservoir for storing minerals in the body. We all know that bones store calcium, but they also hold on to other essential minerals such as manganese and vanadium.
But our bones also offer us protective mechanisms. For example, when we get exposed to toxic chemicals, the body funnels them into our bones and body fat to prevent them from being stored in our brain, organs, and tissues.
Additionally, the bone marrow within our skeletal systems is involved with hematopoiesis—the production of white blood cells, red blood cells, and platelets.
When we get exposed to toxic chemicals, the body funnels them into our bones to prevent them from being stored in our brain, organs, and tissues.
Furthermore, osteocytes within bone cells have an effect on blood sugar management, brain function, and the release of testosterone.
All of these metabolic functions of bones have led researchers to see the skeletal system in a new light. Once thought to be little more than the body’s “scaffolding,” papers such as “Bone as an Endocrine Organ” are now helping to solidify our bones’ place as a “bona-fide endocrine ‘gland.’”
Metabolic functions of joints
For the most part, the joints’ role is to allow for movement, stability, and weight bearing. But if the joints aren’t functioning well, then it becomes more difficult to activate muscles and release myokines.
Healthy joints are essential to ensuring both muscle and bone can fulfill their metabolic roles.
This lack of movement also stands as an obstacle to bone health, getting in the way of promoting bone density and bone volume. And as we’ll see below, adopting a sedentary lifestyle can bring on a host of other health issues.
So while joints may not be direct contributors to metabolic functions, their support is essential to ensuring both muscle and bone can fulfill their metabolic roles.
Clinical Consequences of Musculoskeletal Deterioration
We continue to learn more about bones, muscles, and joints by viewing them through the lens of the endocrine system. As such, it’s no surprise that musculoskeletal deterioration has been thoroughly linked to adverse health outcomes.
Bone loss
When the musculoskeletal system starts to deteriorate, it comes with myriad warning signs. For example, a decrease in bone marrow and bone mass can lead to a reduced ability to produce new blood cells (hematopoiesis). This starts a chain reaction, as the lack of blood cells promotes anemia, weakens the immune system, and reduces growth factors for healing from injury.
When the musculoskeletal system starts to deteriorate, it comes with myriad warning signs.
Additionally, as mentioned above, bone acts as a toxic reservoir. A decrease in bone mass can therefore also lead to increased levels of toxic chemicals like lead, arsenic, mercury, and cadmium circulating in the body, as the bones release previously stored chemicals.
And, of course, conditions like osteoporosis directly lead to a greater risk of bone fractures.
Muscle loss
Muscle loss comes with its own set of health challenges.
Sarcopenia, for instance, increases all-cause mortality by between 29 and 51 percent. Sarcopenia is also a major risk factor for physical instability, poor quality of life, and frailty syndromes, the last of which increases the risk of falls by 1.5–3 times and is strongly linked to increased death rates.
Sarcopenia increases all-cause mortality by between 29 and 51 percent.
Reduced muscle mass can also lead to an impaired ability to regulate core body temperature. The skeletal muscles, along with brown fat, are crucial biological means of keeping warm. (Patients who are always cold and require a jacket at all times may have reduced muscle mass, which is a serious red flag.)
And, as discussed above, muscles are key in the release of myokines, which are vital for so many of the body’s processes. When fewer of these messenger proteins are released, increased inflammation, decreased insulin sensitivity, and reduced brain function are often expected outcomes.
Joint deterioration
Decreased joint functionality, whether from wear and tear (i.e., osteoarthritis) or autoimmune issues (e.g., rheumatoid arthritis), directly leads to stiffness, pain, and reduced ability to move. Lack of movement excessively promotes inflammation and systemic deterioration throughout the body’s systems.
It’s no wonder that the saying “sitting is the new smoking” is so much in vogue these days.
Such a sedentary lifestyle leads to all manner of negative health outcomes, including increased rates of depression and anxiety, loss of microbiome diversity, and greater risk of cardiovascular disease, cancer, and even dementia.
It’s no wonder, then, that the saying “sitting is the new smoking” is so much in vogue these days.
Musculoskeletal Health Is Critical to Overall Health
Given all of this, it makes sense that improving musculoskeletal health should be a critical component of all of your patients’ treatment protocols. Getting those in your care to engage in regular physical movement—or working toward that goal—is a must if you want healthier patients.
Historically speaking, the problem has been that conventional treatments don’t take this linkage into account. Or if they do, they use a downstream approach—primarily focusing on managing the symptoms of musculoskeletal conditions—rather than an upstream approach, addressing the underlying factors and root causes that contribute to musculoskeletal deterioration in the first place.
Improving musculoskeletal health should be a critical component of all of your patients’ treatment protocols.
As functional medicine practitioners, we tend to do better at recognizing the relationship between physical activity and healthspan, but how often do we focus on nutraceuticals, supplementation, and diet, and not so much on the musculoskeletal system?
If, on the other hand, we started with musculoskeletal health and added other treatments as required, I believe we would see improved health outcomes in those we treat.
Degenerative Joint, Muscle, and Bone Conditions – Clinical Strategies and Treatment Applications by Dr. Datis Kharrazian
Addressing this gap is the goal of my new online course, Degenerative Joint, Muscle, and Bone Conditions – Clinical Strategies and Treatment Applications. In it, you’ll learn about the critical role of the musculoskeletal system’s metabolic functions and movement in chronic disease recovery.
I’ll also teach you how to identify and treat conditions like sarcopenia and arthritis at their root to dramatically improve client health outcomes. We’ll cover degenerative joint conditions, progressive bone loss, muscle dysfunction and aging muscles, principles and strategies to build muscle mass…and a lot more.
With this course, you’ll be empowered to address critical aspects of chronic disease management that often go overlooked and directly improve health outcomes for virtually every client you work with.
The course is open to licensed practitioners, medical doctors, nurse practitioners, health coaches, and other health professionals. Be sure to register today!
