Arthritis is a group of conditions which affect the joints, causing stiffness, pain, and restriction of movement. Literally translated as joint inflammation, from the Greek word “arthron” (joint) and the Latin word “itis” (inflammation), arthritis consists of essentially100 different types of conditions, the most common of which are osteoarthritis, rheumatoid arthritis, and gout.Joints are possibly the most critical part of human anatomy related to physical movement; it would be impossible for us to perform even the simplest of movements without them.
Brilliantly constructed of a complex, synergistic mix of tissue, bone and fluids, joints connect and allow the movement of two bones in tandem while preventing them from rubbing against one another and causing damage. The tasks literally weighing on our joints from day to day are tremendous. Not only are joints essential for body movement, they must also withstand the immense compressive forces – including body weight – that occur during movement.
Our joints get a little help from our bones. A fibrous capsule surrounding the ends of our bones creates a space which allows the juncture of the bones to withstand these potentially large forces. However, the joints must have protection of their own. Tissue lining the joint capsule, known as the synovial membrane, secretes synovial fluid to nourish the cartilage in and around the joint, and cushion it from adjoining bones. Whenever there is damage to one or any part of the joint resulting in stiffness, pain, and a loss of movement, we call it arthritis.
Types of arthritis
Osteoarthritis (OA) is the most common type of arthritis in the United States and, in addition to gout, is directly caused by poor body mechanics and lifestyle choices. A chronic degenerative joint disease, osteoarthritis currently affects some 27 million Americans – a number that is increasing independent of our aging population.
There are two types of OA – primary and secondary. Primary osteoarthritis is generally associated with overall weakening and degeneration of weight-bearing joints. Secondary osteoarthritis is a result of an injury, trauma, or surgery, or the long term effects of obesity. The joints most commonly affected are knees, hips, fingers and shoulders, although any joint can develop arthritis in the case of injury or physical stress.
Osteoarthritis involves the loss of articular cartilage, the formation of bony spurs at the joint margin (osteophytes), inflammation of the synovial membrane, and changes to the subchondral bone. As cartilage in the joint breaks down, bones start rubbing against one another, initializing an irreparable cascade of structural breakdown. The friction of bone on bone causes fragments of bone and cartilage to break off and rub against the bones, creating further irritation and pain during movement. Mobility becomes increasingly restricted and pain increasingly intense; this usually leads to less activity, which worsens the situation, as a lack of physical activity causes our muscles to weaken and decline. Over time, osteoarthritis can also damage ligaments and meniscus membranes, making it difficult to do daily activities including work, play sports or even just walk from place to place without struggle and pain.
Onset and progress of arthritis is usually slow. Symptoms of pain, stiffness, and restricted function don’t usually present themselves until after age 40, and become more prevalent with advancing age. We are told that arthritis is the result of the overuse of joints; this is actually not correct. In reality, the wear and tear associated with arthritic conditions comes from using only a fraction of the joint’s actual range of motion; so it is literally the underuse of joints that causes arthritis. Let me explain. Active joints are generally healthier than inactive joints; but utilizing a joint improperly causes numerous problems. Movement that is tense and uses the body in an unbalanced way, places needless stress on certain areas of the body, including joints. Likewise, stronger muscles can compensate for weak or underdeveloped muscles, straining some unnecessarily while permitting others to atrophy. This creates a torque effect on joints, damaging the joint as well as the surrounding muscles while causing a reduction in the circulation of joint fluid. As the muscles continue to tighten, the capacity of joints to use their full range of motion is compromised.
Improper movement can also distort posture, which contributes to an unequal distribution of weight and pressure on all parts of a joint. If only a small part of a joint is forced to absorb all of the pressure of impact, the result is damage to the cartilage.
If we habitually stand on one leg, carry a heavy bag exclusively on one shoulder, sit with our legs crossed, perform the same exercise routine over and over, and spend much of the day sitting in a slouched position, we are contributing to the limited mobility of our joints and therefore predisposing ourselves to arthritic conditions. In fact, as you will see, it is our own abuse of our bodies that leads to the breakdown of our joints, and the onset of arthritis. On the positive side, there are numerous forms of exercise and therapies to assist us with proper and beneficial movement.