Skeletal – Part 7

Arthritis

The term arthritis describes over 100 different inflammatory or degenerative diseases that damage the joints. In all its forms, arthritis is the most widespread,

crippling disease in the US. 1 out of 7 Americans suffer its ravages.

All forms of arthritis have the same initial symptoms: Pain, stiffness, and swelling of the joint. Then, depending on the specific form, certain changes in

the joint occur.

Types of Arthritis

1. Acute Forms of Arthritis Usually result from bacterial invasion. Are treated with antibiotic drugs. The synovial membrane thickens and fluid production

decreases, leading to increased friction and pain.2. Chronic Forms of Arthritis

Include osteoarthritis, rheumatoid arthritis, and gouty arthritis.

Osteoarthritis

Osteoarthritis – “Wear-and-tear arthritis”; Chronic, degenerative condition that typically affects the aged.

Most common form of arthritis.

Affects the articular cartilages. Softening, fraying, and eventual

breakdown of the cartilage. The exposed bone thickens and

extra bone tissue, called bone spurs, grow.

The bone spurs protrude into the joint cavity, which restricts joint movement.

Osteoarthritis: Symptoms

Symptoms: Stiffness on arising that lessens with activity. The affected joints may make a crunching noise

(crepitus) when moved. Joints most commonly affected: Fingers, the cervical

and lumbar joints of the spine, and the knees and hips.

Usually slow and irreversible, but it is rarely crippling.

Osteoarthritis: Treatments

In most cases, its symptoms are controllable with:

1. A mild analgesic such as aspirin2. Moderate activity to maintain

joint mobility3. Rest when the joint becomes very

painfulSome people claim that rubbing

capsaicin (a hot pepper extract) and taking glucosamine helps relieve joint pain.

Rheumatoid Arthritis

Rheumatoid Arthritis – A chronic inflammatory disorder. Onset is insidious and

usually occurs between the ages of 40-50.

It affects three times as many women as men.

Joints affected: Fingers, wrists, ankles, and feet. Joints are usually affected

in a symmetrical manner. For example, if the right elbow is affected, most likely

the left elbow will be affected also.

Rheumatoid Arthritis

Is an autoimmune disorder. A disorder in which the body’s immune system

attempts to destroy its own tissues.

Progression of Rheumatoid Arthritis

1. Inflammation of the synovial membranes.

2. Membranes thicken and the joints swell as synovial fluid accumulates.

3. Inflammatory cells enter the joint cavity and produce pannus, an abnormal tissue that clings to and erodes articular cartilage.

4. Scar tissue forms and eventually ossifies, and the bone ends become firmly fused and often deformed.

Symptoms of Rheumatoid Arthritis

1. All stages involve restricted joint movement2. Extreme pain

Not all cases progress to the crippling stage.

Rheumatoid Arthritis: Treatments

1. Powerful drugs that can neutralize the inflammatory chemicals in the joint space and (hopefully) prevent joint deformity.

2. Aspirin (anti-inflammatory agent)3. Exercise to maintain as much joint mobility

as possible.4. Cold packs to relieve the swelling and pain.5. Heat to relieve morning stiffness.6. Replacement joints are the last

resort.

Gouty Arthritis

Gouty Arthritis (Gout) – Disease in which uric acid accumulates in the blood and may be deposited as needle-shaped crystals in the soft tissues of joints. Uric acid is a normal waste product of nucleic acid

metabolism. Most common in males and rarely appears before the

age of 30. Tends to run in the family, so genetic factors are

definitely implicated.

Gouty Arthritis: Symptoms

• Symptoms:1. Leads to an agonizing painful attack that

typically affects a single joint, often in the great toe.

2. Untreated gout can be very destructive: the bone ends fuse and the joint becomes immobilized.

Gouty Arthritis: Treatments

• Treatments:1. Several drugs are successful in

preventing acute gout attacks.2. Patients are advised to lose weight if

obese.3. Avoid foods high in nucleic acids such as

liver, kidneys, and sardines.4. Avoid alcohol, which inhibits the

excretion of uric acid by the kidneys.

Long-Term Bone Health

It cannot be emphasized enough that bones have to be physically stressed to remain healthy. When we remain active physically and muscles and

gravity pull on the skeleton, the bones respond by becoming stronger.

If we are totally inactive, they become thin and fragile.

Osteoporosis

Osteoporosis – Bone-thinning disease. Afflicts half of women over 65 and 20% of men over

the age of 70. Makes the bones so fragile that even a hug or a

sneeze can cause bones to fracture. The bones of the spine

and the neck of the femur are particularly susceptible.

Causes of Osteoporosis

Estrogen deficiency that occurs after menopause is strongly implicated as the cause of osteoporosis.

Other factors that may contribute to osteoporosis: Diet poor in calcium,

vitamin D, and protein.

Smoking Insufficient weight-

bearing exercise to stress the bones.