How to Conquer Arthritis

Dr Vernon Coleman MB ChB DSc

. The word ‘arthritis’ is about as useful and as specific as the word ‘infection’.

Just as there are over a hundred different types of infection so there are over a hundred different types of arthritis which differ enormously in the speed with which they develop, the length of time they last and the amount of damage and crippling that they do. Rheumatoid arthritis and osteoarthritis are both types of arthritis but they are as different to one another as are malaria and tuberculosis – which are both types of infection. Arthritis is so common that most of us will suffer from at least one sort of it at least once in our lives. And because most varieties of arthritis are incurable once the disease has developed it often lasts for life.

Few diseases affect as many people as the diseases in the arthritis group; few cause as much pain, discomfort and disablement and few are the subject of so many myths and so much misunderstanding. The longer you live the more likely you are to suffer from arthritis. It doesn’t matter whether you have an active life or a quiet life – whatever sort of life you lead there will be a type of arthritis that will, sooner or later, affect you to some degree or another.

The ‘good news’ is that although arthritic diseases are usually incurable the symptoms can usually be controlled. Arthritic diseases do not usually kill and if treated with care and respect it is usually possible to minimise the amount of damage that is done and to control the crippling and the pain.

Just a few years ago arthritis sufferers faced a lifetime of disablement and more or less constant pain. We still haven’t found a ‘cure’ for arthritis – any more than we have found a ‘cure’ for infection – but we have acquired a good deal of information which should help you to stop your joints being destroyed, to relieve joint pain and stiffness, to restore lost joint function and to slow down – or even halt – the rate at which the arthritis spreads. Some arthritis treatments are, it is true, potentially hazardous. But many millions of patients around the world have been treated safely and effectively and have learned how to combat their disease.

Whether your arthritis has been caused by ageing, strain, wear and tear, an infection with a bacteria or a virus, an injury, a metabolic or a chemical abnormality, a hormonal abnormality or an immune system problem there will be things that you can do to protect yourself, to maintain your mobility and to keep your pain and stiffness to a minimum.

If the symptoms of arthritis are left untreated – or are treated half-heartedly – then they will invariably get worse. The damage that is done may eventually be irreparable. But if, on the other hand, treatment is initiated early and with enthusiasm then the outlook can be greatly improved.

There are nearly two hundred different joints in an average human body. Your joints make it possible for you to move – to walk, run, skip and to wave your arms around – they absorb sudden shocks (such as when you jump up in the air and then land on a hard surface). Joints can repair themselves when they are injured or damaged and they can replenish their own supplies of synovial – or lubricating – fluid.

Each joint consists of two opposing bones and on the end of each bone there is a layer of white, smooth, gristle like material called cartilage which is covered with a capsule and kept moist with a special lubricating fluid. Tendons attached to the two opposing bones help to hold the joint in position.

Although your joints can protect themselves, and even repair themselves, there are times when things go wrong. Joints, like every other part of your body, can become diseased, injured or infected. Indeed, there are well over one hundred different joint diseases already identified and the chances are that there are quite a few more still unidentified.

The diseases which affect joints fall into six basic categories.

First, there are the inflammatory joint disorders in which the synovial membrane (which is responsible for producing the synovial fluid) becomes red, thick and swollen. The result is that the whole joint becomes red, painful and swollen – and also feels hot. If the disease is allowed to continue uncontrolled the joint will eventually be destroyed. The commonest disorder in this category is rheumatoid arthritis.

Second, there are the types of disease caused by ‘wear and tear’ in which the cartilage covering the end of the bones wears away, leaving bone rubbing on bone. In these diseases – known as ‘degenerative’ the joints involved gradually becomes stiff, painful and difficult to move. The commonest disorder in this category is undoubtedly osteoarthritis although the disease itself is ill-named for it is not, as its name suggests, an inflammatory disease at all. (The suffix -itis suggests an inflammatory disease, as in tonsillitis and appendicitis). Because it is usually caused by ‘wear and tear’ osteoarthritis is more common among elderly people.

Third, there is the type of arthritis in which the inflammation occurs not in or around the synovial membrane (as it does in rheumatoid arthritis) but in the area where the ligaments and tendons join the bones. Diseases where the ligaments or tendons are involved make up the third group of arthritis disorders and the best-known serious disease in this category is probably ankylosing spondylitis which is, after rheumatoid arthritis and osteoarthritis, the third commonest type of arthritis. Disorders in this general category are usually known as ‘periarticular’. Tennis elbow (in which the insertion of the tendon into the bone is damaged) and housemaid’s knee (in which a bursa at the knee joint is damaged and swollen) are other diseases which fall within this group.

Fourth, there are some types of joint disease in which the problems are caused by the development of crystals within the joint. The best-known disease in this category is undoubtedly gout – the well-known pains associated with the disease are caused by the formation of uric acid crystals in the joint space.

Fifth, there are some types of arthritis known as ‘infective’. In this category organisms such as bacteria or viruses get into the joints. The symptoms of infective arthritis can develop quite quickly and the pain can be extremely severe.

The sixth and final type of arthritic disease does not involve the bones or even the joints directly but the muscles which surround a joint. It is not, therefore, a true form of arthritis at all. When muscles are inflamed or strained the resulting symptoms can be very similar to arthritis of the joint itself. Many types of backache fall into this category. Fibrositis – also known as ‘muscular rheumatism’ – falls into this category and can affect several parts of the body at once.

If you want to know more about arthritis (and, more importantly, want advice on controlling the various varieties of arthritis) please read `How to Conquer Arthritis’ by Vernon Coleman. It is available on Amazon.

Copyright Vernon Coleman June 2023