About Arthritis
One of the frustrating things about Arthritis from an Osteopaths perspective is the widespread belief that Arthritis is an inevitability of age and something that just needs to be suffered.
Arthritis is a condition of the joints. A joint is made up of two surfaces of bone that articulate (move) with each other. The surfaces are lined with a special surface called articular cartilage which protects them. The joint is encapsulated by a wrapper known as synovial membrane which produces the fluid which lubricates, cushions and nourishes the inside of the joint. It is then surrounded by ligaments which are strong bands of tissue that strengthen and protect the joint, then wrapped again by the muscles that cross the joint to initiate movement and stabilise it.
Arthritis occurs when the inner structures of these joints become damaged and worn. This leads to stiffness, pain and inflammation.
Why does it happen?
This is a much more complicated question. It is not an inevitability of age and it is not caused by too much exercise. Otherwise we would be able to put a precise best before date or upper mileage limit on our bodies.
Probably the best analogy to use is to compare our joints with the tyres on our cars. If you look up how long a tyre should last, the estimate will vary hugely between 15,000 and 60,000+ miles. Some of this variation is down to the type of tyre and what it’s made from. But most sources you look up will point to how the car is driven and how well it’s looked after. Harsh acceleration and heavy braking, tyre pressures and road surfaces, wheel alignment and extremes of temperature can all affect the longevity of a tyre. It’s not about the age of your tools, it’s about how you use them and how well you look after them. Our bodies like to move. It may seem odd that use would protect from wear, but there are a couple of important things that happen when we use a joint that benefit its health.
- Synovial Fluid – The fluid mentioned above that is produced by the inner lining of the joint which protects, cushions and lubricates it, is stimulated by movement and heat. If we don’t move the joint the production of the fluid decreases and the function of the joint is impaired. Production of this fluid will also be affected by circulation. This is why joints in the hands and feet can feel stiff in the cold when blood is taken from our periphery to maintain core temperature. Lack of blood and warmth in the extremities decreased synovial fluid production and the joints became stiff.
- Stability – The stability of a joint depends on the muscles surrounding them. Lack of movement and exercise leads to weaker muscles with decreased tone, this leaves the joints unstable and more prone to strain. Even minor strains caused by ordinary day to day activities can become damaging to joints over a length of time.
What activities cause Arthritis?
We are regularly told by patients that their arthritis has been caused by playing squash, running or by manual work etc. This cannot be true as we treat plenty of elderly squash players, runners and builders whose joints are healthy. Doing a strenuous activity may be a contributing factor but playing sport and having an active job are more likely to protect you from wear and tear than cause it if the circumstances are correct. So, what can cause activity to lead to arthritis?
- Posture – The shape and mechanics of our body can lead to wear in a joint in the same way that misaligned wheels can cause wear in a tyre. Joints are designed to move a certain way and in a certain range. If this is altered by changes in posture, then the function of the joint can be compromised.
- Repetitive strenuous movement – Every time we use our body, we damage it. In normal circumstances, that’s absolutely fine. The ache you feel after exercise is the effect of small-scale damage (microtrauma) to the muscles and is actually part of the process that makes them stronger. If a movement is repetitive and strenuous then the same aspects of the joint and surrounding tissues are being repeatedly damaged, and damaged too often to effectively repair. In the long term this can lead to wear and tear. Our body likes to move, but ideally this movement should be varied and not repeatedly overload any one area.
