In the advent of Spring with flowery daffodils and hyacinths breaking through the snow and mud; with the lengthening of daylight, we find ourselves eager to step outside and stretch our legs on the foot path, in the garden or along the sandy beach. Those with personal or with family histories of arthritis or gout may find their joints stiff with Winter’s disuse.
The human joint is a communication of bone to bone with stretchy ‘Ligaments’ connecting them and with muscles attached to the bone by ‘Tendons’. When the muscle contracts it shortens which pulls on the connected bone and changes the position of the joint. An overstretched or injured muscle and tendon is a called a “Strain” and if the ligament was involved it is called a “Sprain”. However the two terms are often interchanged to no real effect, unless you are taking a terminology test. The bony joints are cushioned by padding on the bones called ‘Cartilage’ and by spongy fluid-filled sacs between the bones called ‘Bursa’. Tougher sacs between the spinal bones are called ‘Discs’. Fluid thick as egg white protein and called ‘Synovial’ meaning ‘egg-like’ fills the sacs/discs and flows between the joints to keep them ‘springy’.
The most common form of stiff joints is known as ‘Osteoarthritis’ meaning ‘bone (osteo) –joint (arth) –inflammation (itis)’. This condition is often associated with the wear of advancing age, with the increased burden on the joint from overweight or with the extreme trauma on joints experienced by career athletes. Everyone ages thus everyone experiences a degree of osteoarthritis if they live long enough.
The double goal of preventive medicine with Osteoarthritis is to maintain mobility through routine stretching exercises and to preserve the structural integrity of the joints in general through good dietary habits.
There are formal exercise programs that are not stressful to joints and that improve or maintain their function. These include: Yoga, Pilates and Tai Chi systems. Learning a stretching system early in life and continuing a lifetime of practice can delay or prevent the onset of stiff joints. However these programs can begin at any age in life. Each of these systems can be modified to adapt to age and to disability. Therapeutic massage can stretch unused or contracted muscles and tendons to improve joint function to begin an exercise program or to aide in healing after injury.
Joint integrity is impaired by the shrinking of natural cushions like the synovial fluid within the bursa or disc until bone scrapes against bone. The body will try to build a bony bridge between the bones – ‘Fusion’ – if the natural cushions disappear. If fusion occurs then the original joint movement will be lost. The spinal discs tend to flatten with age. A ruptured disc means that the sac has broken open spilling out the cushioning fluid. Countering dehydration by regular, moderate water intake can maintain these joint fluids. Many modern habits of coffee, cola and tea drinking cause dehydration. Aging decreases the unconscious signals in the brain that tell us to drink water, so intentional water drinking needs to replace these signals.
‘Glucosamine’ is a naturally occurring protein (an amino acid) that research has shown can help to slow the loss of joint cartilage and to preserve the joint fluids when taken as a dietary supplement. Other nutritional supplements are in medical study to determine their joint protective properties: Chondroitin, Vitamin D, Ginger, Turmeric, and Omega-3. Each person’s body chemistry and digestion works a little differently, so, discuss supplements with your health specialist if you want to develop a dietary program to meet your needs.
There is a secondary type of arthritis that is not directly related to increased use. Inflammatory joint diseases include: Rheumatoid Arthritis, Psoriatic Arthritis, Anklosing Spondylitis and Gout. The cause of each of the inflammatory disorders may differ but the results are the same – joints that are chronically inflamed from attacks by their own immune system leading to deformation of the joint, stiffness and impaired function. Here the goal is to decrease the potential for inflammation and to preserve joint function.
In 80% of people with Rheumatoid Arthritis the physician can test for an immune system antibody known as “rheumatoid factor”. 15% of people with Psoriasis develop Psoriatic Arthritis after age 40. Psoriasis is a non-infectious, chronic inflammatory disease with skin patches of thick scales from an overproduction of skin cells. These scales are in turn attacked by the person’s own immune system. Anklosing Spondylitis is inflammatory arthritis that targets the spine. Gout is joint inflammation associated with sharp crystal depositions from uric acid. It is initially treated by a change in diet that decreases the intake of purine-forming foods such as red meat and seafood.
Inflammation is a natural yet complex process. The chronic inflammation of these joint diseases requires the combined assistance of trained healthcare professionals like Rheumatologists, Physical Therapists and Nutritional specialists.