ARTHRITIS

The word "arthritis" comes from the Greek arthron meaning "joint" and the Latin itis means "inflammation".  So arthritis literally means joint inflammation.  There are so many types of arthritis but the most common is Osteoarthritis and Rheumatoid Arthritis.
 

Recently, I was tidying up my home library and I found two old books on Arthritis which I had completely forgotten about.  One was written by Stephen Terrass and the other by Patrick Holford.  I read the books again and found a lot of interesting information.  According to Stephen Terrass, it is believed that arthritis has been around for some time.  Scientific literature tells us that the fossil of a large, swimming reptile called the platycarpus, which lived almost 100 million years ago, showed evidence of arthritis.  Signs have also been detected in the bones of cavemen, and in the spines of several 8,000 year old Egyptian mummies.  And in Roman times, it was considered such a burden that the emperor Diocletian exempted citizens with severe arthritis from taxes.  Wouldn't it be nice if this is applicable today? Because I think most of us would be eligible for tax exemption!

It was also said that OA being the most prevalent form of arthritis affects three out of four people over the age of 50.  A fatalist would say that arthritis is almost a certainty - like death and taxes.  However, the author points out that this is far from the truth because it can be prevented. I agree with that because so much of research have been carried out today and most of us have become more educated and conscious of our health.  Apart from genetics, research has pointed out that our diet and lifestyle can cause arthritis.  Therefore, we hold much of the ability to eliminate such problems.  Of course, medicines and treatments are important but the one sure thing to cure arthritis is to prevent it in the first place.

Rheumatoid Arthritis

One of the most common arthritis is Rheumatoid Arthritis (RA).  RA is a form of inflammatory arthritis and an autoimmune disease that causes the body to attack its own soft tissues and joints. As a result of the attack, fluid builds up in the joints, causing pain in the joints and inflammation that is systemic - meaning that it can occur throughout the body. RA most commonly affects the joints of the hands and feet but it can also cause elbow, shoulder and neck problems. Joint swelling is often more pronounced in RA.
 

The cause of RA is still unknown but most scientists agree that a combination of genetic and environmental factors is responsible. Researchers have identified genetic markers that cause a tenfold greater probability of developing RA. There are nearly three times as many women as men with the disease. In women, RA most commonly begins between the age of 30 and 60. It often occurs later in life for men.
 

Juvenile Rheumatoid Arthritis (JRA) is another auto-immune condition but it tends to affect children and adolescents. There is a broad spectrum of JRA with some patients having just one joint involved and others having many problems. The most commonly involved joint is the knee. The only cure for JRA is joint replacement. I have come across two people who have JRA with severe joint damage at the knees. One of them got both of her knees replaced at age 28 while the other did a bilateral TKR at age 31. While TKR helped them to gain their life back, their biggest challenge was finding an OS who was willing to do TKR for them at that young age.

Osteoarthritis

Osteoarthritis (OA) is the most common type of arthritis.  In my earlier post on OA, I mentioned that it is commonly thought that OA is caused by a wear and tear condition due to ageing.  However, studies have now shown that OA may be caused by other factors such as inflammation.
 

I came across Dr Robert H. Shmerling's blog where he said that he heard about a joke when he first started studying arthritis  -  A 90 year old man sees his doctor complaining of pain in his knee.  His doctor asks him, "What do you expect? You are 90 years old".  The old man replies, "Yes, but my other knee is also 90 and it feels fine".  Isn't this hilarious?  And I think it proves a point.
 

It was also said that studies conducted on runners in 1998 over a nine-year period showed that members of a running club ages 50 and older had no higher incidence of OA than an otherwise similar group of non-runners. 
 

What about people who suffers from arthritis of the hands?  It was said that when OA affects the hands, this is the best argument against a direct connection between use (or overuse) and OA. Finger joints with OA look very similar to the knees with OA, yet not everyone bears weight on the hands. If 90% of people are right handed and if OA was purely use-related, there ought to be a lot more right hand arthritis compared to left hand arthritis but this is simply not the case. 

So what causes OA if its not the wearing out of joints?  Apparently, OA may not be caused by one single factor.  It can be caused by a combination of factors such as advanced age, obesity, genetics or injury. However, I find it hard to understand why OA is affecting more and more younger people.  Some of them are not even obese, did not experience any injury, are physically active and healthy.

According to Dr. G's blog, he said that he started to experience arthritis symptoms at 46 years of age.  He did not have any of the traditional risk factors like obesity, joint over-use or sport injuries so he started to think why he is getting OA so early in life.  He found through his own research that OA is not a disease of ageing or degenerative disease.  He said that more and more research over the past 10 years is showing that OA starts out very similar to other chronic diseases like heart disease, stroke, diabetes etc.  Ageing is not the cause.  It is chronic inflammation.  It is the bad type of inflammation which is also responsible for a lot of other diseases.

I have much earlier shared a link to a study by Stanford University School of Harvard in my post on OA still exists after TKR?  The study suggests that OA results from inflammatory process, not just wear and tear.  It was observed in the study that there were increased numbers of certain specialized inflammatory proteins early in the progress of OA, before it becomes symptomatic which suggested that inflammation might be a driver, rather than a secondary consequence of the disease.  Right now, they don't have anything to offer OA patients to treat their underlying disease but it would be incredible to find a way to slow it down.

All the above information suggests that there is a paradigm change in the underlying disease of OA.  Perhaps this explains why it is affecting more and more younger people. The more I researched, the more it is pointing to this direction.  In my earlier post on "pH Balance and Arthritis", it was said that an acidic body may lead to inflammatory diseases.  I wonder whether all these findings are connected.  Anyhow, I am certainly hoping that the experts find a solution soon in order to prevent or slow down OA.  Until then, lets be more proactive by taking a good look at our diet and lifestyle and start making necessary changes.  Even if it can't reverse our arthritis condition, maybe it can help to prevent more damage.



Arthritis