What is arthritis?

Arthritis is a condition that describes joint pain or joint disease in one or more joints in the body where bones come together, such as the knees, hips, elbows, wrists, fingers and toes. In medical terms, arthritis refers to joint inflammation.  Symptoms can include joint pain, stiffness, and swelling.

More than 100 different types of arthritis and related conditions have been identified, which can be classified in two broad categories: degenerative arthritis and inflammatory arthritis.

Degenerative arthritis:

Degenerative arthritis refers to those types of arthritis where mechanical abnormalities result in degradation of joints, such as when the protective cartilage (the hard, slippery coating) at the ends of bones wears down over time or gets damaged through an injury. When the ends of bones are no longer protected by the cartilage, bones may be exposed and get damaged.  The most common type of degenerative arthritis is osteoarthritis, which is not to be confused with osteoporosis – a condition where the bones in the body becomes less dense and more likely to fracture.

Causes of degenerative arthritis can be hereditary, developmental, metabolic, or mechanical in nature. Aging also plays a major role in the degeneration of joints, but not all elderly people experience osteoarthritis.  With aging the cartilage starts to degenerate by forming tiny crevasses or by flaking.  Other causes or risk factors are excess weight that puts stress on joints, a previous joint injury, infection in the joints, or where there is a family history of arthritis.

The main symptoms are pain and restricted movement in the affected joint(s), and the resulting decrease in movement can also affect the regional muscles and ligaments. As the cartilage wears away and the cushioning surface at the ends of bones degenerates, bone starts to rub against bone.  Apart from the pain in the joint, swelling and stiffness can also be experienced and the pain can become chronic.

 

Inflammatory arthritis:

Inflammatory arthritis refers to a condition where the body’s immune system, which normally generates inflammation to fight an infection once-off, goes haywire and mistakenly continue to attack the joints with uncontrolled bouts of inflammation.  This condition can lead to joint erosion.  The most common types of inflammatory arthritis are rheumatoid arthritis and psoriatic arthritis.  Another well-known type of inflammatory arthritis is gout, where high levels of uric acid build up and form needle-like crystals in the joints, resulting in sudden attacks of extreme pain in affected joints.  It is believed that inflammatory arthritis is caused by a combination of hereditary (a family history) and environmental factors, such as exposure to toxins.

Inflammatory arthritis is regarded as one of about 80 different types of auto-immune diseases. It is characterized by the body’s auto immune system targeting and attacking the lining of the joint capsule as if it is foreign tissue.  This lining is medically known as the synovial membrane, which is a tough membrane that encloses all the parts of a joint.  As the lining becomes chronically inflamed, the inflammation can over time destroy cartilage and bone within the joint.

What is an auto-immune disease?

The body’s immune system is the guardian that protects us from disease and infection. When the guardian detects a harmful substance (e.g. viruses, bacteria, toxins, even cancer cells), the body’s soldiers are released in the form of chemicals from the white blood cells to attack these harmful substances, called antigens.  This raging battle results in inflammation in the affected area.  Once these harmful substances have been destroyed by the antibodies produced by the immune system, the guardian system reverts back to its observational role and the inflammation comes to an end.

However, an over-active immune response doesn’t call an end to the attack mode and can result in healthy cells in the body becoming the new targets to attack and eliminate, leading to one of the many types of auto-immune disorders. In autoimmune related arthritis, the immune system mistakenly begins to identify some of the cells within specific joints as being harmful and launch an attack.  As the control mechanisms that would normally end the inflammation no longer functions properly, the attack on these cells and the accompanying inflammation carries on unabated.

There is also another mechanism that can lead to the development of autoimmune disease. When the immune system notices foreign or harmful substances (called antigens) in the bloodstream, the immune system produces antibodies that attach themselves to the antigens.  This attachment is like painting a bullseye on a target, as the immune system will attack and eliminate these antigen-antibody complexes to prevent them from harming the cells in the body.  If more of these complexes are formed than the immune system are able to cope with, some of these complexes can get deposited in the joints if you have a predisposition for inflammatory arthritis.  These complexes cause inflammation and damage to the affected joints.

A genetic predisposition for an autoimmune disease does not mean that you are certain to develop this illness, as it is to a large extent triggered by factors such as diet (poor nutrition), an inactive lifestyle, exposure to toxins and high levels of stress.

Natural ways to reduce the discomfort of arthritis:

Inflammatory arthritis:  The excessive formation of antigen-antibody complexes is closely related to having an unhealthy digestive tract in the body.  The digestive tract is designed to digest food and extract nutrients through the lining of the gastro intestinal tract into the bloodstream in order to fuel and nourish the cells in the body, while the lining remains impermeable to toxins and other undesirable substances. (Please see the Health Insight blogs on the Microbiome).

Poor dietary and lifestyle habits, including chronically high levels of stress, can over time lead to an overpopulation of harmful bacteria in the gut and inflammation in the gut wall, resulting in damage to the cellular structure of the lining of the digestive tract. This lining then becomes permeable to harmful substances and incomplete digested food, especially half-digested proteins.  A dysfunctional digestive tract and the resulting antigen-antibody complexes that are formed can lead to a wide variety of medical conditions, including autoimmune related arthritis.

A healthy diet and lifestyle, especially reducing the amount of stress that you are subjected to, can help to restore an unhealthy digestive tract and reduce the amount of inflammation in the body. Taking a good probiotic, preferably from human origin, would also assist in this regard.

Apart from following a healthy diet such as the Mediterranean diet (please see the Health Insight blog on the Mediterranean Way), it is important to mechanically chew your food thoroughly in order to enhance the breakdown of nutrients.  The teeth breaking down the food mechanically works in tandem with the digestive tract breaking down the food chemically.  Drinking plenty of water also assists with the digestive process.

Apart from getting regular moderate exercise, it is also important to get adequate physical rest for the affected joints and deep, restful sleep – when the body produces hormones that contribute to healing and the growth of tissue in the body.

Learning to deal with and managing stress levels play an important role in fighting inflammation in the body.

Degenerative arthritis:  While the symptoms of degenerative arthritis, such as osteoarthritis, can range from mild to severe and affects people differently, the best way to deal with arthritis is to self-manage the condition and to determine which practices work for you and which practices and lifestyle factors (e.g. diet, exercise) you need to change to ensure a better quality of life.

Staying active with regular physical activity is important to keep the joints flexible, coupled with specific exercises to strengthen the muscles and connective tissue around the affected joints for added support, in order to relieve some of the pressure on the joint. Without exercise, the muscles, tendons and ligaments shorten and tense up, resulting in stiffness, which can be painful.  Exercise also boosts the production of the lubricant fluid (synovial fluid) which supplies oxygen and nutrients inside joints.  Weight loss efforts also benefit from exercise.

Excessive repetitive movements should be avoided, as it puts additional strain on the joints; while swimming and water aerobics are exercises that reduce strain on joints.

As carrying excessive weight (usually around the waist) puts additional strain on the weight-bearing joints such as the spine, knees and hips, it would reduce the effects of arthritis if you reach and maintain a healthy weight.

Eat a healthy, balanced diet and add foods with known anti-inflammatory properties and foods that are rich in antioxidants to help reduce inflammation naturally. Foods known for their anti-inflammatory properties include tomatoes, olive oil, green leafy vegetables, nuts, fatty fish like salmon, mackerel, tuna, and sardines, and fruits such as strawberries, blueberries, cherries, and oranges.  Food rich in antioxidants include spinach, kale, beans, beetroot, pecan nuts, artichokes, strawberries, blueberries and even dark chocolate.  Omega 3 fatty acids as found in fish oil supplements are known inflammation fighters and have been shown to reduce joint stiffness and pain.

Hot and cold therapies can be tried for pain relief, such as a long hot bath, heating pads or ice packs.

In severe cases, joint replacement may be an option, depending on medical advice.

Sources:

List of different types of arthritis.  Published 23 June 2015 and reviewed 9 February 2019.  Disabled World.  (www.disabled-world.com)

Autoimmune diseases: Types, facts and information.  Updated 16 March 2018.  Disabled World.  (www.disabled-world.com)

How to build your immune system: Diet and exercise.  Reviewed 16 March 2018.  Disabled World.  (www.disabled-world.com)

Arthritis self-management: What you need to know.  Arthritis Foundation.  (www.arthritis.org)

Arthritis.  Published 7 March 2018.  Mayo Clinic.  (www.mayoclinic.org)

Natural relief from arthritis pain. Published 8 May 2017.  Healthline.  (www.healthline.com)

Natural remedies for rheumatic arthritis.  Published 3 April 2018.  WebMD.  (www.webmd.com)

How to manage arthritis naturally.  Published 3 November 2014.  Dr. Ben Kim.  (www.drbenkim.com)

Images sourced from Google.

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