This is a big topic with complicating factors, so this article focuses on OSTEO-ARTHRITIS (OA). The connective tissue disorders such as rheumatoid arthritis, polymyalgia & fibromyalgia will be addressed in a separate article because their primary triggers vary from OA.
Osteoarthritis is the process of wear and tear of joints. The primary tissue affected is the joint cartilage, but with progression, joint capsules, ligaments, muscles and bone are all involved in varying degrees. It is characterized by stiffness and pain, and eventually loss of function.
Why does the cartilage wear out? Here are a few important factors to consider.
Soft cartilage (nutrient deficiency)
Disturbed joint alignment (injury)
Pressure (body weight)
Chronic inflammation (allergy, food intolerances, infections)
Acidity (western diet)
In practice there is usually a combination of these triggers, as such identifying which are present is key to slowing or reversing the condition.
How do you know you have osteoarthritis rather than rheumatism (RA)? As OA is a process of wear and tear it usually affects specific joints with a history of injury or over-use. By comparison RA is a systemic condition and therefore tends to present bilaterally or even symmetrically, with a characteristic pattern of joint involvement. It is likely you will already know if there is RA in the family by looking at your parents and grandparents hands, and likely they will tell you because it hurts.
Osteoarthritis is NOT inherited. Influencing factors may well be inherited but those only predispose you to OA, rather than predicting it.
Let's look at those causative factors.
Soft cartilage. Cartilage receives its nutrition by diffusion from the bone it is attached to. This is understandably a slow process. Inadequate nutrition means cartilage may be softer than it should be, and therefore runs the risk of wearing out before time. The molecular matrices which make cartilage rely on just about every essential nutrient thus a deficiency of almost anything may result in poor cartilage. At the top of the list are minerals. Using glucosamine or MSM supplements has become very fashionable, and even advised by many GP's, but that approach misses the bigger picture. Your body should already be making adequate glucosamine; if you're deficient it can't do that well. Its far more important to address the deficient nutrient, because that will predict a failure somewhere else in your body, not just in glucosamine synthesis. It is quick and easy to test for nutritional deficiencies, so you can spend your money on supplements that work rather than buying expensive prawn shells! (that's where glucosamine comes from, hence the shellfish allergy warning).
Disturbed joint alignment. Joints who's resting position is no longer in neutral balance, suffer increased compressive forces through facing cartilages. Hence the most commonly affected joints are weight bearing, i.e. ankles, knees and hips. Poor alignment however can affect any joint, frequently seen some years after direct trauma to a joint, or where injury produced compensatory patterns dragging multiple joints out of neutral. Hence we see arthritic necks in people who fell on their bums at a young age. Patterns of compensation are produced by muscular contractions trying to maintain your overall balance. If there was no compensation to misalignment after injury, you would fall over! Unfortunately those muscular contractions become chronic, reducing blood supply into joint tissues. Poor blood flow leads to poor nutrition, leading to soft cartilage (and poor health of the surrounding tissues too). The combination of multiple minor knocks each requiring a little compensation is one reason increasing stiffness is felt with advancing years, especially in active people.
Pressure. Obviously increased body weight puts more pressure through weight bearing joints. Being over-weight on its own is not really the cause of OA however. OA is not the provenance of fat people. Being overweight and having poor muscle tone, unable to carry the body in an easy balance, is far more likely to produce arthritic ankles, knees and hips. Being overweight is usually a sign of a poor diet, so we can also surmise poor nutrition to the joint tissues and misalignment in many joints as the frame slowly collapses under the strain.
Chronic Inflammation. Inflammation includes a process which confers stickiness to red blood cells (RBCs). When RBCs stick together, they form clumps which block capillaries (the smallest blood vessels), starving their target tissues of nutrition. Eventually cells forming those target tissue die. I that happens in your heart, you have a heart attack, if it happens in the brain, that's called stroke. If it happens around the joints, it leads to arthritis. Long-standing inflammatory states may be influenced by many environmental factors, but the single biggest cause is the wrong food. This doesn't just mean poor quality food, it means food which your body reacts adversely to. If you're concerned to know what those foods are, you can get yourself tested very easily. Sugars, refined products (including most bread), packet foods and fast food are all culprits.
Acidity. Our bodies have chemical mechanisms which automatically control the pH level in the blood. It is held within very narrow parameters; uncontrolled fluctuations produce coma and death! But there's a problem. Those chemical buffers have a limit, and once that limit is reached, a backup mechanism kicks in. The backup mechanism uses calcium, an alkaline mineral, derived from the skeleton to counter over acidity in the bloodstream. So what causes over-acidity? We need to look at the 'ash' of digested foods. A lemon for example is acidic in its raw form; after digestion however it is highly alkalizing. A burger bun, coffee, beer, steak, a loaf of bread and even whole grain rice are ALL highly acidifying, requiring pH neutralizing. If you have been eating a lot of those things for years, (typical modern western diet) your chemical buffers will be exhausted and that calcium will keep being pulled from your skeleton. In the world today osteoporosis figures are going off the charts, despite advice to drink more milk and use calcium supplements from the pharmacy. Calcium supplements in this scenario is in fact contra-indicated because you want the calcium in your bones, not in your tissues. Look at people with osteoporosis, they are all really stiff, because their calcium reserve is in their joints instead of their skeleton! The instruction to put it back in the bones is hormonal, but that instruction isn't given if your diet remains acid forming. The range of inflammatory chemistry is also acidic, and in themselves degenerative to joint tissues. If you have arthritis, acid forming foods will only make it worse. As a guide, ALL fruit and vegetables are alkalizing, everything else is acidifying. Take a snap-shot view of the food on your dinner plate and judge if it's in roughly the right proportions. 80% alkalizing : 20% acidifying.
To conclude, it is better to prevent OA rather than letting it get bad and expecting to fix it. Advanced OA dictates joint replacement and represents a significant reduction in quality of life. Structural imbalances will be identified by a decent practitioner long before bony changes show up on X-ray, thus preventing progression. Nutritional issues can be highlighted too. Your starting point should be to look carefully at your diet and get a routine treatment.
Article by David Wells 2021