Arthritis is second only to heart disease as a cause of non-work. Every year, more than
100 different diseases effect the joints. These disease are collectively called Arthritis.
Most of the cases are diagnosed as Osteoarthritis.
The number of Arthritis sufferers is expected to grow from approximately 16% of the
population today, to 18% of the population by the year 2020. Women and Men seem to be
affected equally after the age of 45 up to the age of 55. After the age of 55, women are
more likely to be victims of arthritis than men are. Osteoarthritis is not only more
frequent it is also more severe in Women after the age of 55.
There are more than 100 types of arthritis. We will restrict ourselves here to
speaking only about osteoarthritis. This may not be as narrow a focus as it seems,
because osteoarthritis is by far the most common variety.
Osteoarthritis is the most common form of arthritis affecting the articular cartilage.
Articular cartilage plays an important role in optimal joint function by providing smooth,
low friction surface between articulating bone ends while transmitting load forces to
Cause of Osteoarthritis
Although no one seems to know exactly what causes osteoarthritis (from now on, we'll
simply call it arthritis), the following explanation seems consistent with all the known
Cartilage (together with the synovial fluid) is the material in our joints that provides
the cushioning and the lubrication necessary for healthy, pain-free functioning in the
course of ordinary pursuits. It exists in a state of dynamic equilibrium. By its very
nature, cartilage, as a slippery, load-bearing covering on the ends of the bones that form
joints, is subject to a lot of wear and tear. That is, it is constantly being eroded away
by the activities of everyday living. In its usual highly adaptive manner, the body
removes the worn out cartilage with the help of some enzymes. At the same time, the
body is constantly reconstructing new cartilage. As long as these two processes
remain in balance, our joints remain healthy.
Anyone who has experienced the pain due to arthritis knows how wonderful it is to find
relief, even though temporary, from aspirin, ibuprofen, or some other NSAIDS
(non-steroidal anti- inflammatory drugs). After a while, however, the pain returns,
and your first inclination is to take another dose of the NSAID. As long as this is
occasional, it would seem no more dangerous than taking an aspirin for an occasional
headache. The problem arises when the need for pain-killers is frequent, and perhaps
growing. Every year, about 3000 Americans die from the side effects of substantial
doses of aspirin and other NSAIDS. Another 41,000 people, per year, wind up in the
hospital from them.
For short term use, NSAIDS serve a very useful purpose. But for long term use at
high dosages, as in osteoarthritis, they can be very dangerous. Some examples of the
harm they can cause are the following:
1. kidney damage
2. liver damage
4. gastrointestinal damage
5. asthmatic attacks
6. ringing in the ears
The Secret is in the Synovial Fluid
A membrane called the synovial membrane, which forms a capsule around the ends of the
bones involved, surrounds our joints. This membrane secretes a liquid called the synovial
fluid. It has many functions, all of them important. Among these, it serves as a
lubricant, a shock absorber and a nutrient carrier.
As a lubricant, it is without equal, when the joint is healthy. It makes the joint slicker
than wet ice! When our bodies cant produce enough glucosamine and chondroitin,
however, the normally thick synovial fluid becomes thin and watery. In this state, it
cant do the job it was intended to do as a lubricant.
As a shock absorber, our cartilage, immersed in the synovial fluid, protects our bones
from the tremendous impact they would receive when we walk, run, jump, etc. This
fluid has remarkable properties as a shock absorbing, or hydraulic, fluid. It
belongs to a rather unusual group of liquids known as dilatent liquids. These
liquids are characterised by the rare quality of becoming thicker, that is, more viscous,
when shear is applied to them. Thus, the synovial fluid in our knees and hips assume
a very viscous nature at the moment of shear in order to protect the joints, and then it
thins out again to its normal viscosity instantaneously to resume its lubricating function
between shocks. All this happens over and over again, very rapidly, during the
course of vigorous exercise, such as during an engagement in sports, dancing, walking,
etc. When our bodies cant produce enough glucosamine and chondroitin, this whole
mechanism breaks down, resulting in the pain and decreased mobility that characterises
Now we will discuss the role of our synovial fluid as a nutrient carrier. Cartilage
itself is avascular; that is, it doesnt have any blood vessels. Hence, the
synovial fluid is the liquid that carries the raw materials to the cartilage. Think
of our cartilage as a
sponge immersed in the synovial fluid. When we exercise our knee, for example,
its like repeatedly squeezing that sponge out in a bucket of synovial fluid.
In this way, the glucosamine/chondroitin dissolved in our synovial fluid when we
exercise our knee is constantly supplying our cartilage. With this newly acquired
abundance of nutrients, plus the exercise to supply them efficiently to our cartilage, our
own body can re-build and replace the worn-out cartilage as fast as possible.
What can go wrong with this system? Obviously, for this system to work, our body has
to produce new cartilage as fast as it removes the old, worn-out cartilage. When we are
young this is almost always the case. (Sports injuries are examples of the
exceptions.) The body both produces and ingests glucosamine and chondroitin sulphate
(the building blocks of cartilage), which it then uses to build new cartilage to replace
the old, much as new skin grows to replace that lost to a wound. As we mature,
however, our bodies often cant produce enough glucosamine and chondroitin to
maintain the necessary balance. The result of this imbalance is called
osteoarthritis, or arthritis for short.
Years are not the only factor that tends to lead us toward arthritis, however. Frequently,
young people get it also. Sometimes, this is the result of a sports injury. In such
a case, we call it secondary osteoarthritis, to distinguish it from primary
osteoarthritis, which is usually, but not always, more often associated with people who
are past 50 years old.
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