Understanding ARTHRITIS

Osteoarthritis

"Osteoarthritis," states the Western Journal of Medicine, "is in many ways like the weather-ubiquitous, often unnoticed, sometimes dramatic in its effects."  Unlike RA, osteoarthritis (OA) rarely spreads to other body parts but concentrates its erosive influence on one or just  a few joints.  As cartilage is slowly eroded, bone begins grinding against bone.  This is accompanied by bony outgrowths called osteophytes. Cysts may form, and underlying bone thickens and becomes deformed.  Other symptoms include knobby knuckles, grating and grinding sounds that emanate from arthritic joints, and muscles spasms, along with pain, stiffness, and loss of mobility.

In times past, OA was thought to be just another consequence of old age. However, experts have abandoned that long-held belief .  The American Journal of Medicine states:  "There is no evidence that normal joint, subject o common stresses, will break down over the life of a person."  Then what causes osteoarthritis?  Efforts to understand its exact causes are "plagued by controversy," according to the British magazine The Lancet. Some investigators propose that damage to a bone, such as microfractures, may occur  first.  This, in turn, may trigger bony outgrowths and cartilage deterioration. Others think that OA starts in the cartilage itself. As it degenerates and frays, they reason, stress increases on the underlying bone. Pathological changes occur as the body attempts to repair the damaged cartilage.

Who are at risk for OA?  While age alone does not cause OA, the loss of joint cartilage is experienced  more frequently with increasing age. Others at risk may include those who have some abnormality in the way their joint surfaces fit together or who have weak leg and thigh muscles, legs of unequal length, or a misalignment of the spine. Trauma to a joint caused either by an accident or by an occupation in which repetitive  motions overuse  a joint can also set the stage for osteoarthritis. Once deterioration begins being overweight can exacerbate OA. 

Dr. Tim Spector states: "Osteoarthritis is a complex disease that has definite environmental risks factors but there is a strong genetic component."  Particularly susceptible to OA are middle-aged and older women with a family history of the disease. Unlike the disease osteoarthritis, high rather than low bone density precedes the occurrence of OA. Some researchers also cite damage from free oxygen radicals and a deficiency of vitamins C and D as factors. 

Next time: Understanding ARTHRITIS/Treatment

From the Awake! magazine