HOW ARTHRITIS DEVELOPS

HOW ARTHRITIS  DEVELOPS

The mechanical construction of our body makes it
possible for many bones to meet with each other and
these meeting places are called joints. These joints help
in different types of movements. To avoid friction and
strain during these movements, the ends of the bone are
covered with an elastic tissue called cartilage. A synovial
membrane covers the inner surfaces of this joint-
cavities. This membrane secretes a fluid that lubricates
the joint.

This synovial membrane and the tips of the bones are
ramified with several capillaries which carry. nourishment
along with blood to the joints. If any infection or wrong
metabolic byproduct passes through these capillaries,
then the circulation of the nutrients and blood is
obstructed resulting in stagnation and exudation of fluid
into the pocket created by the synovial membrane in the
joint. This causes the joints to become inflamed,
enlarged and swollen. The cartilage, because  of
impaired nourishment, lose their elasticity and Income
dry and brittle. The secretion of the synovial membrane
may also diminish and with the progress of the disease,
may cease completely. The joint will thus dry out,
become congested. rough and stir)‘. This may also cause
the surrounding ligaments and tendons to become
inflamed and to progressively lose their tone and flexibility.

Because of the impaired metabolism and movement,
excessive amounts of calcium and other minerals are
deposited in the joints. Sometimes osteoporosis or
leaching of the calcium and other minerals from the
bones can cause severe destruction of bones and joints.

All these changes are usually accompanied with-
swelling and pain during movement. Subsequently, the
pain becomes absolutely incapable of moving the affected
part of the body. If this development is not checked and
eflectively treated in time, complete destruction of the
joint and impairment of its function will often be the
ultimate result. Along with these signs and symptoms in
the joint, the patient also suffers from other disabilities
in difierent parts of the body. Digestive disorders, often
very chronic, are present in patients of arthritis.
Constipation is often prevalent for many years before the
actual arthritis symptoms begin to reveal themselves.
General fatigue, physical and emotional stress, lack of
sufficient rest, nutritional deficiencies, glandular dis-
orders—all these could occur long before the final
symptoms appear in the joints.

It is important therefore to note that if arthritis is to
be successfully treated, the physician should follow a

holistic approach by recognizing the systemic nature of
the disease and the abnormal conditions as well as
disorders in other parts of the body that need to be
corrected. The present-day approach to the treatment of
arthritis patients, namely, to suppress the pain to give
relief to the inflammation or swelling, does only give a
false sense of relief to the patient; it is dangerous because
the disease continues to progress inside the body and at
one stage or the other, both the patient and the
physician become helpless-the former cannot work with
his joints and the latter cannot reduce the pain and
swelling not to speak of arresting the progress of the
disease. Any attempt, therefore, to treat the patient of
arthritis without realising the close relationship between
the general health of the individual and his arthritis
symptoms will ultimately prove to be futile. Joints in
any part of the body maybe aflected. Depending upon
the nature of the affliction. the disease is called by
different names.

Linving and Thriving with arthritis

I could have titled this chapter "Dealing With Your Arthritis." I want to emphasize, however, that you can do more than just cope with the disease. You can thrive in spite of it. Do not view yourself as the victim of a problem—you are in control. The problems associated with arthritis do not simply disappear when you start exercising, but you no longer have to give up your life because of your arthritis. A good exercise program helps diminish the pain and disability associated with arthritis and allows you to enjoy some favorite activities. My grandmother was still living independently when she died at the age of 100. In fact, she walked several miles a day until her mid-90s, undeterred by her arthritis. Some of you know that even pain in your hands significantly affects the things you can do and your outlook on life. I know of a woman whose arthritis in her hands became bad enough that she had to stop riding horses, her favorite pastime, because she could not hold the reins. She was caught in a vicious circle of decreasing activity and increasing pain, until her doctor diagnosed her problems as arthritis and she started an exercise program. She began a regular exercise program and now enjoys horseback riding and many other activities.

Types of Arthritis

Knowing about the type of arthritis you have and its causes and symptoms can help you best determine your exercise goals and plans. Arthritis is defined as inflammation of a joint, but it often affects more than just the joint, sometimes compromising the tissues that surround a joint and affecting other bodily systems.

Within the joint, the primary tissue affected is the articular cartilage. This tissue covers each inner part of most joints; it helps to disperse forces at the joint surface and allows for smooth movement of the Joint. Loss or irregularities of this cartilage can increase friction within the joint; this is the main manifestation of osteoarthritis. A special lubricant called synovial fluid is produced within the Joint that decreases normal friction and allows the surfaces to glide easily. This process is similar to oil allowing a hinge to move smoothly. Alteration in synovial fluid production is one of the early effects of rheumatoid arthritis. 

Osteoarthritis 

Osteoarthritis, the most common form of arthritis, accounts for more than 85 percent of arthritis cases. Osteoarthritis is a degenerative disease that affects the hip, knee, back, and hand joints, as well as others. The causes of osteoarthritis are numerous and can include trauma or infection, but often no cause is identifiable. Mechanical stress, combined with abnormal  

biomechanics, leads to the initial damage to the joint cartilage, which then starts to break down. Immobilization of a joint, such as being in a cast, can also lead to degenerative articular cartilage changes. Repetitive loading and unloading of the joint forces fluid into and out of the joint, getting nutrition to the articular cartilage. When a joint is immobilized, these compressive forces are absent. As damage to the articular cartilage progresses, the joint space lessens and the bone underlying the cartilage experiences abnormal stresses and deforms.

 Doctors diagnose osteoarthritis by correlating a patient's history and physical examination to his or her x-ray and laboratory test results. The amount of joint damage is only predictive of severity of symptoms for a small part of the population, however. Risk factors include female gender, obesity, joint injury, occupation, and smoking. 

Osteoarthritis symptoms can develop slowly or rapidly, depending on the cause of the arthritis, presence of other diseases, activity level, and other influences. For the majority of individuals, however, development of symptoms is gradual and slow. The most common complaint is aching within a joint, accompanied by stiffness after sitting for prolonged periods. This stiffness generally lasts less than 30 minutes and is resolved with gentle movement. Many patients report grating with movement of the involved joint, and as the disease progresses, the joint may become deformed and lose motion. As osteoarthritis results from articular cartilage damage, it may be limited to only one joint and, as noted earlier, occurs largely in the weight-bearing joints.  

Rheumatoid Arthritis 

Rheumatoid arthritis is the second most common joint disease, affecting approximately one to two percent of the adult population, though it can occur at any age. The cause of rheumatoid arthritis is not known, though two primary risk factors are age and female gender. The wrist, knee, hand, and foot joints are most affected. Rheumatoid arthritis is systemic in nature and thus affects tissues throughout the body, with joint involvement being bilateral. Changes in the synovial tissue alter synovial fluid production and ultimately damage the cartilage, bone, and adjacent tissues. Most of the extra-articular tissue changes occur over the long term, though some systemic symptoms are present from the onset. 

Symptoms of rheumatoid arthritis usually start slowly and may be systemic complaints such as fatigue, weight loss, weakness, and general joint pain. In contrast to the stiffness felt with osteoarthritis, stiffness with rheumatoid arthritis lasts for more than 30 minutes. One criterion for diagnosis is morning stiffness that lasts at least an hour. Patients will often have periods during which their symptoms are worse, called exac-erbations—the involved joints may be swollen, warm, and painful. As with osteoarthritis, the joint becomes deformed and loses motion as the disease  

progresses. Joints are more likely to become unstable with rheumatoid arthritis than with osteoarthritis, perhaps because of the changes In the tissues outside the joint. Because It is systemic, rheumatoid arthritis can affect the heart, lungs, and gastrointestinal systems, among others. 

Spondyloarthropathies 

Spondyloarthropathies are a group of arthritic diseases that do not fit Into the previous two classifications. Ankylosing spondylitis, Reiter's syndrome, and psoriatic arthritis are the most common arthropathies, with ankylosing spondylitis being the most prevalent—it affects one to two percent of the population. The causes of ankylosing spondylitis are unknown, though risk factors include male gender, age, Caucasian race, and family history. Like rheumatoid arthritis, ankylosing spondylitis is systemic and causes complications throughout the body, for example in the cardiac and pulmonary systems. Joints of the spine are primarily involved, with some unilateral Involvement in other large joints. Inflammation occurs in other tissues, especially at ligamentous attachments. Initial symptoms are backache and stiffness, more so in the morning. The trunk and neck become symptomatic over time and the individual may also complain of weight loss, excessive fatigue, and fever. 

As noted in the introduction, there are over 100 types of arthritis, with the three that I have outlined composing the bulk of the diagnoses. The joint pain and stiffness Inherent with all types can be significantly reduced with regular exercise. In the next section I discuss the importance of work-ing with your physician. Your doctor will identify not only what type of arthritis you have, but also Issues related to your personal arthritis history, which will determine the type of program you pursue. 

HERBS FOR ARTHRITIS

HERBS FOR ARTHRITIS

Herbal remedies have been found to be extremely effective in treating joint problems and other degenerative diseases. This being the case,why isn’t this information more readily available to the public? Most blame goes to the large pharmaceutical companies and their interminable advertising. They will usually ignore herbal medicines that have traditionally kept people well for thousands of years. These treasures.as well as the benefits from vitamins, minerals, and amino acids, have  also been downplayed.

The following are some of the major and more popular herbs that are used for arthritis. Space precludes an exhaustive discussion of dosages and potential contraindications, so I suggest that you consult aqualified naturopathic physician or herbalist to discuss your particular health issues and determine what herb. or combination of herbs. may work best for you. Be sure to let them know what other prescription drugs or supplements you are taking. Because herbs are powerful medicines, self-medication with unfamiliar herbs is not a good idea. I recommend reading Steven Foster’s  Medicinal Herbs : An illustrated Guide along with the other books and studies listed in appendix B under “Vitamins and HerbSupplements.”

what is osteoarthritis?

what is osteoarthritis?

Osteoarthritis is sometimes called 'wear and tear or 'degenerative joint disease'. h is the most common form of arthritis and occurs when the cartilage in your joints becomes thinner over time, or extra bone is laid down around the joint in response to injury or strain. Osteoarthritis can affect any joint in your body, although it most commonly affects joints in your hands, hips. knees and spine.
 Typically it affects just one joint, but, as with arthritis of the fingers. several joints can be affected.

Osteoarthritis gradually worsens over time, and no cure exists. It is a natural side-effect of aging. just like gray hair and wrinkles, and in the same way some people will be affected more than others. There are treatments that can relieve pain and help you remain active. By taking steps to exercise you can actively manage your osteoarthritis and gain control over the associated pain.

signs and symptoms

The progression of the bony changes associated with osteoarthritis is slow. The symptoms also develop slowly and worsen over time. The list below outlines the most common symptoms and when you arc most likely to notice them.


• pain in a joint during or after use, or after a period of inactivity
. • swelling - in some cases bur not always.
 • tenderness in the joint when you apply light pressure.
 • stiffness in and around a joint. which may be most noticeable when you first wake up in the morning or after a period of inactivity.
 • loss of flexibility. which may make it difficult to use the joint for normal /functional tasks.
 • grating sensation when you move the joint.
 • bone spurs, which appear as hard lumps, can form around the affected joint and are seen clearly on X-rays.


Although most commonly felt in the hands, hips, knees and spine, it is possible to develop arthritis in other joints. especially if you have been injured nr placed unusual stress on a joint. It is uncommon for •stecorthritis to affect your jaw, shoulder. elbows, wrists or ankles, but it is possible if you have sustained a fracture or played a span that has increased the stress through a particular joint.

what causes Osteoarthritis Its?

  Osteoarthritis occurs when the cartilage covering the ends of bones in your joints becomes thinner over time. The smooth surface of the cartilage becomes rough. causing irritation. Eventually, if the cartilage wears down completely, the surface ends of your bones become worn and your joints become painful. This additional pressure on the bones can make them swell.

In most cases it isn't clear what causes osteoarthritis, but research has shown that it's a combination of thugs. including being overweight. ageing, joint injury or stray. family history and muscle weakness. The most likely causes are:

• Age osteoarthritis typically occurs in older adults. People under 40 rarely experience osteoarthritis.
• Sex: women are more likely to develop osteoarthritis, though it isn't clear why.
• Bone deformities some people are born with joint deformities or defective cartilage, which may increase the risk of osteoarthritis.
• Joint injuries injures that occur whcn playing sports, or from an accident, may increase the risk of developing osteoarthritis.
• Obesity: carrying more body weight places more stress on your weight-bearing joints, such as your knees.
• Other diseases that affect the bones and joints diseases that increase the risk of osteoarthritis include gout, rheumatoid arthritis, Paget's disease of bone and septic arthritis.

12,000 people a year will develop RA. RA affects three times more women than men and onset is generally between 40 and 60 years of age, although you can get the disease at any age. There are around 12,000 children under the age of 16 with the juvenile form of the disease.

We're still not sure what causes RA. Unfortunately there is no cure, but much more is now understood about the inflammatory process associated with the disease and how it can be managed. This book aims to show you how with self-management you can help yourself, and minimize the impact of the disease on your quality of life.

The good news is that if you are diagnosed and treated early, your prognosis is significantly better than it was 20-30 years ago, thanks to research and the development of drugs which can modify the active disease process. Early diagnosis is critical, and research shows that a 3-month window of opportunity exists from onset of symptoms to starting treatment, which can prevent irreversible joint damage. Many people diagnosed now have a good quality of life in spite of having RA, and don't suffer the joint deformity that was once associated with the condition. Research also shows that in reality it can be up to a year between symptoms developing and the start of treatment. It is very important that people know how to recognise the symptoms and see their GP as soon as possible. GP education is also needed to ensure prompt referral for diagnosis and treatment.

 

What Is Juvenile Arthritis?

What Is Juvenile  Arthritis?
Each case of JIA is unique, however, and not every individual who has the disease will experience the same type of symptoms. Its also important to note that juvenile idiopathic (or rheumatoid) arthritis is quite different from the adult form of rheumatoid arthritis. In fact, according to Dr. Sur, some forms of JIA are not present in adults. Adults with arthritis also typically have rheumatoid factor present in their Hood, which isn't always the case in children. Fun her more, arthritis can affect a child's growth and the disease may go into remission after a number of years. which isn't true for adults.

It is important to note that juvenile idiopathic arthritis was referred to as juvenile rheumatoid arthritis and sometimes even juvenile chronic arthritis (JCA) until recently.

"A few years luck, the classification for juvenile idiopathic arthritis was revamped and will likely be revamped again in the future," says Dr. Cron. According to Dr. Cron, the cause of JIA is unknown, and by definition, it's not associated with any other underlying disease, like lupus.

 Presently, there are several forms of JIA. "Ultimately, genetics will probably assist in the most appropriate classification of the subtypes of childhood arthritis. The current system lumps what used to be called juvenile rheumatoid arthritis with the spondyloarthropathies—HI.A•B27•associated diseases that frequently have enthesitis [inflammation of the point where a bone connects with a tendon or ligament] in addition to arthritis. These subcategories were developed in part because the course and outcome somewhat differ between the subgroups, and for research purposes it is usually important to compare apples to apples and not to oranges."

Arthritis

Arthritis means joint inflammation, and refers to a group of diseases that cause pain, swelling, stiffness and loss of motion in the joints. 'Arthritis' is often used as a more general term to refer to the more than 100 rheumatic diseases that may affect the joints and which can also cause pain, swelling, and stiffness in other supporting structures of the body such as muscles, tendons, garments, and bones. Some rheumatic diseases can affect other parts of the body, including various internal organs. Children can develop almost all types of arthritis that affect adults, but the most common type of arthritis that affects children is juvenile rheumatoid arthritis. It is characterized by Inflammation of the cartilage and lining of the body's joints, generally accompanied by an increase in the fluid in the joints. The feet seem more susceptible to arthritis than other parts of the body, because each foot has 33 joints, which can be afflicted, and the feet bear the entire body -weight that results in pain.

Arthritis can be a disabling and occasionally a crippling disease. In some forms it appears to have hereditary tendencies. While the prevalence of arthritis increases with age but people from infancy to middle age are potential victims and people over SO are the primary targets. The disease can result in loss of mobility and independence. But there is a good news for the victions of arthritis. The good news is that there is an alternative approach. Arthritis con be prevented and the underlying causes can be eliminated. If one stops or reverses the progression of this disease early enough one can hope for a complete recovery. If the disease has already resulted in considerable damage to joints, even then the disease can be controlled to a great extent.

Anatomy of the Bones

There are different types of arthritis and they may affect different parts of the body like the shoulder bone, back bone, elbow, hand and wrist, hip, knee and toe. To understand how these diseases affect the various joints it is very necessary to know their anatomy.

Can osteoarthritis be prevented?

Can osteoarthritis be prevented?

 "That's a question I'm often asked," replied the doctor."Given the current lack of understanding of the mechanisms involved, the answer for now is probably no, but there is a lot of research going on with the goal of changing that.

 "One fascinating approach is to find ways to speed up the cartilage repair process. A group of hormone-like chemicals—called cytokines—secreted locally in joints influences the maintenance of cartilage, suggesting that it may be possible to promote cartilage repair using one or some combination of these chemicals. Although no such treatment is ready for investigation in humans as yet, the concept is clearly promising.

 "A more mundane approach," the doctor noted,"might be to reduce the wear-and-tear process by maintaining appropriate body weight and minimizing activities that are thought to damage cartilage.The role of diet beyond appropriate weight maintenance is controversial. For example, vitamin C, once considered to have protective capability, now appears to increase the severity of osteoarthritis of the knees at high doses, that is, more than 500 milligrams daily. 


 "On the mechanical side, a great deal of research has gone into developing an understanding of the forces that are exerted on the cartilage surfaces in a weight-bearing joint like the hip or knee during walking, running, twisting, carrying, climbing, and other physical activities. Since the actual weight-bearing surface is small—less than a square inch in a knee, for example—this translates into hundreds of pounds per square inch, with peak pressures in the tons with certain kinds of motion. It's no wonder that these surfaces can break down over time. 

The doctor added,"A third approach might be to supply the building blocks of cartilage for the body to incorporate without having to synthesize them from scratch. That is the theory behind the use of such agents as glucosamine and chondroitin sulfate, which are biochemicals important in the structure of cartilage and other connective tissue. Although there is little evidence that taking these substances by mouth has any benefit in cartilage maintenance, they do provide symptomatic benefit for some people with osteoarthritis, and they appear to be safe to use. On the other hand, a recently published Italian study suggests that there may actually be some slowing of the progression of osteoarthritis of the knees in people who take glucosamine. Clearly, further study of this issue is needed before we can determine the value of this approach." 
Stella then said,"I think I know a few people with osteoarthritis. How common is it?"