Types of Arthritis
Arthritis comes in two primary forms referred to as osteoarthritis & rheumatoid arthritis. It manifests in the form of pain, swelling and stiffness of the affected joints. Osteoarthritis is the most common form of arthritis. It is also known as ‘wear and tear’ arthritis and tends to affect those over 40 years of age.
The term osteoarthritis is somewhat misleading, because its literal meaning is ‘joint inflammation’. Although there is a component of joint inflammation with this condition, the primary pathological process is progressive joint degeneration. Osteoarthritis is the degeneration of the articular cartilage of weight bearing joints, due to repeated stresses.
What a normal joint looks like
A joint is present at the articulation of two or more bones. The bony surfaces forming the joint are covered by a layer of cartilage. The cartilage allows for smooth movement of the joint surfaces. The joint is enclosed by a capsule. The capsule is lined by a synovial membrane which produces the synovial fluid. This fluid acts as a lubricant and a source of nourishment for the cartilage.
What happens to the joint with Arthritis?
During the lifespan of an individual, joints are subjected to a lot of stresses. This can cause wear and tear of the joint cartilage. When these stresses are continuous over prolonged periods, the cartilage does not get time to heal and finally breaks down. The joint surfaces are then exposed causing friction during movement. This can result in the formation of bony spurs or ‘osteophytes’. The cartilage itself does not have a nerve supply and therefore Is not a source of joint pain; however, the outer surface of bone is innervated and is thought to be a source of pain in those with joint degeneration.
In addition the synovial membrane gets thickened and is unable to produce enough synovial fluid. Thus, with age the natural lubrication of the joint is also lost. As a result the joints may become stiff. As one ages, the muscles also weaken. The muscles provide support to the surrounding joint and decrease the load which the joint is subject to.
On a radiological examination, osteoarthritic joint will show:
- Loss of joint cartilage
- Bony outgrowths/Osteophytes
- Thickened joint capsule
- Reduced synovial fluid
- Narrowing of the joint space
What are the Causes of Arthritis?
- Repeated Stresses: Osteoarthritis mainly affects the cartilage of weight bearing joints such as knee, hip and spine. Although, depending on the individual’s profession other joints like hand and shoulder may also be affected.
- Age: Arthritis is commonly seen in people above the age of 45
- Gender: Women are more susceptible to developing osteoarthritis, especially after menopause.
- Genetic make-up: Some people have weak or defective cartilage which makes them prone to osteoarthritis.
- Previous injury: A prior trauma, fall or a fracture around the joint disturbs the line of force around the joint. This results in abnormal force distribution through the joint which increases the risk of osteoarthritis.
- Obesity: Increased body weight puts undue stress on the spine, hips and knees. This accelerates the arthritic changes.
- Lack of exercise: Joints require regular movement to remain healthy. Movement helps to “feed” the joint by encouraging movement of synovial fluid and nutrients into the joint which feed the cells that comprise the various joint structures.
Other considerations – Diet and Arthritis
- Research by Rolf Peterson looking at the bones of the moose of Lake Superior has shown that many suffer with arthritis. One might automatically presume that this is due to a particularly harsh environment which requires excess joint loading. As it turns out, nutritional factors in early life have been linked to the development of arthritis in the moose in later life.
- Obesity has also been linked to arthritis. Recent research has suggested a potential link between obesity and arthritis. This connection may be due to the inflammatory nature of the environment in such individual which may act as a driver of premature cartilage degeneration.
Physiotherapy treatments include acupuncture, therapeutic exercise, massage, and accessory techniques to improve joint mechanics.
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