Joint Health Part II – Disorders and Causes

In the Part II Joint Health, we will now discuss some of the key joint concerns and their likely causes. We will then follow up with a final article of this series on various natural ways to preventatively care for our joints.

Important note before you read further, I am a Naturopath and not a medical doctor and certainly not a specialist nor expert of the joints. The purpose of this article is to provide introductory level education on this subject and it is not intended as a replacement for the medical diagnosis or advise, which you are encouraged to seek help from should you have any of the joint challenges.

As mentioned in the Joint Health Part I, not all joint disorders are due an arthritic condition. Nonetheless, one cannot talk about joint concerns without addressing some of the most common forms of arthritis. To introduce this topic, let’s first take a look at some statistics (from the CDC, National Institute of Arthritis and Musculoskeletal and Skin Diseases of NIH and Arthritis Foundation):

  • Nearly 50 million people in the US have some form of arthritis or chronic joint symptoms.
  • It is estimated that by the year 2020, 60+ million people in the United States will have arthritis.
  • Over one million Americans will be stricken with arthritis every year.
  • Rheumatic diseases are the leading cause of disability among persons age 65 and older.
  • Approximately 26.9 million adults in the United States have the most common form of arthritis, osteoarthritis, also called degenerative joint disease. Most persons over the age of 65 are affected with osteoarthritis in at least one joint, making this condition a leading cause of disability in the US.
  • Rheumatoid arthritis, the most crippling form of arthritis, affects approximately 1.3 million Americans and two to three times more women than men. Further, the average onset for rheumatoid arthritis is between the ages of 30 and 50 years old.
  • Nine out of 10 people who have lupus are women, and lupus is three times more common in African-American women than Caucasian women.

Many forms of arthritis exist, each of which has a different cause. The most common form of arthritis, osteoarthritis, occurs following trauma to the joint, wear and tear on a joint, following an infection of the joint or simply as a result of aging. Abnormal bone growth or compromise to the cartilage itself is the most likely cause of osteoarthritis. Cartilage is the firm, rubbery tissue that cushions your bones at the joints, and allows bones to glide over one another. See picture below. If the cartilage breaks down and wears away, the bones rub together. This causes pain, swelling, and stiffness. Bony spurs or extra bone may form around the joint. The ligaments and muscles around the joint become weaker and stiffer.

Osteoarthritis usually starts to appear in middle age. Just about most of the population has some of its symptoms by age 70. Before age 55, osteoarthritis occurs equally in men and women. After age 55, it becomes more common in women. Many of the joint related injuries or fractures (including the cartilage and ligaments) can lead to osteoarthritis later in life. It has been found that sports activities that involved direct impact on the joint (knee or ankle) or throwing actions (elbow or wrist) also increase the risk of arthritis due to excessive wear and tear when it is not injured. That is not to say that we should not participate in any of the exercise activities. Instead by all means keep on doing them but in moderation and do it with care. Just as excessive exercise can cause more wear and tear of the joints, so does excess body weight. Long term overweight condition increases the risk of osteoarthritis in the hip, knee, ankle, and foot joints.

So early detection and prevention is key to avoiding osteoarthritis. Typical symptoms may be frequent cracking sounds from joint movements. Joint swelling to a size larger than normal. Some may feel limited range of motion or tenderness in the joint when pressed, or a painful movement that is suppose to be normal and painless. Any or all of the above symptoms are good indicators for you to start taking care of your joint. No blood tests are useful in figuring out joint issues as the cartilage contains no blood vessels or nerves and receives its nutrients by diffusion from the synovial fluid and from the bone. Only careful examination of the x-ray photography will reveal the detailed joint issues.

Rheumatoid Arthritis (RA) is the joint inflammation and/or its surrounding tissues. It may even affect other organs. Dr. Paul Davidson, M.D., Professor of Medicine at the University of California Medical Center, described disorders that affect tendons, joint capsules, ligaments, fascias, bursas, cartilages and muscles as “soft-tissue rheumatism,” and distinguished these conditions from “arthritis” per se, which affects hard tissues. RA related conditions are generally known as an autoimmune disease – the body’s immune system mistakenly attacks its own healthy tissue(s). Somewhat similar to fibromylgia, except RA affects joints on both sides of the body equally. Fingers, wrists, feet, ankles and knees are the most commonly affected areas. Typical joint symptoms may include: Morning stiffness that lasts more than an hour. Pain at the joint is often felt on both sides of the same joint. Range of motion is gradually lost over time and may even show signs of deformation. Long-term un-dealt with RA, may damage lung tissues, cause hardening of the arteries, neck bones damage, inflammation of the blood vessels, etc…

Statistics show that RA can happen at any age, but is more common in middle age. Women get RA more often than men. There is no one test that can determine for sure if you have RA. Nevertheless, it has been found that Rheumatoid factor and anti-CCP antiobdy tests can be useful to doctors to determining the RA condition. Because of its auto-immune nature, it would be good to test for food sensitivity or allergies test. Common food allergens include wheat, rye, oats, and barley (all of which contain a protein called gluten). Antigluten antibodies have been found in many people with RA. The journal of Rheumatology (1994, 21:1192) has shown that a deficiency in the liver’s “sulfation,” one of its 11 pathways of detoxification, leads to arthritis. This is why garlic, onions and MSM sulfur help: they strengthen sulfation. Many studies have linked infection, genes, and hormone changes to RA.

While Rheumatoid Arthritis initiates its inflammatory actions from the joints and can spread its inflammation to other tissues and organs, the reverse can also be true. The term Reactive Arthritis is often used to describe general joint pain and swelling triggered by an infection or inflammation started somewhere else in the body (intestines, genitals, or urinary tract). The joints in your knees, ankles and feet are the usual targets of reactive arthritis. Inflammation also may affect your eyes, skin and urethra when you have reactive arthritis. Reactive arthritis isn’t as common. For most people, signs and symptoms of reactive arthritis come and go and it is hard to pinpoint let alone diagnose.

Lupus is a chronic inflammatory disease that occurs when your body’s immune system attacks your own tissues and organs. Inflammation caused by lupus can affect many different body systems — including your joints, skin, kidneys, blood cells, brain, heart and lungs. Chronic means that the signs and symptoms tend to last longer than six weeks and often for many years. Lupus can be difficult to diagnose because its signs and symptoms often mimic those of other ailments. The most distinctive sign of lupus — a facial rash that resembles the wings of a butterfly unfolding across both cheeks — occurs in many but not all cases of lupus. Some people are born with a tendency toward developing lupus, which may be triggered by infections, certain drugs or even sunlight. While there’s no cure for lupus, treatments can help control symptoms.

The Lupus Foundation of America estimates that at least 1.5 million Americans have lupus. The actual number may be higher; however, there have been no large-scale studies to show the actual number of people in the U.S. living with lupus. It is believed that 5 million people throughout the world have a form of lupus. Lupus strikes mostly women of childbearing age (15-44). However, men, children, and teenagers develop lupus, too. Women of color are 2-3 times more likely to develop lupus. People of all races and ethnic groups can develop lupus. More than 16,000 new cases of lupus are reported annually across the country.

Lyme Disease (LD)is a devastating bacterial infection condition caused by spirochete (Borrelia burgdorferi) that is carried by deer ticks, which is quite common in North America, especially in the northeast region of the U.S.. An infected tick can transmit the spirochete bacterium to the humans and animals it bites. If left untreated, the bacterium travels though the bloodstream to various tissues (skin first, then joints, nervous system, and possibly other organs) by causing inflammation in those regions. Due to a lack of deterministic symptoms (appears to manifest itself in different forms in different people) and the limitations in available blood tests, LD is very difficult to diagnose, let alone treat.

But one thing is clearly known, that it is of bacterial form and it is related to our body’s immune system to fighting this bacterium. If treated with antibiotics early enough, LD is almost always readily cured. In most cases, identifying a tick bite and its bulls-eye red skin pattern is critical in realizing its potential danger. Of course, not all ticks are necessarily infected with the B. burgdorferi bacterium, but one should not take chances by boosting the immune system right away to help the body to combat this unique bacterium. There is so much to share on LD alone that we will have to digress from the Joint Health topic to do its justice. So, we will do that in some other time.

Notice some of the key and common unhealthy conditions across these serious joint issues (highlighted in brown font color) seem to suggest that infection, inflammation, immune, auto-immune, over-weight, excessive exercise are very much a part of the joint health (or disease). Common sense tells me that if we can get these main items under control, our joints will be happier and healthier. In our next and final article, we will look deeper into the possible underlying causes to these common joint pain issues and share with you alternative ways on how to manage them.

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Posted by Paul

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