People understand Arthritis to be a disease of the joints. Indeed, the symptoms of the disease manifest in the joints. But, it should be considered a disease of the entire body. Although the symptoms may appear in a particular part of the body, no disease is exclusive to that specific part. When a part of the body suffers, the rest of the body does get affected. Appreciation of this fact will help us take a holistic view of our bodies rather than treating it as an assembly of various organs and tissues.
Any disease ending in ‘tis’ at the end of its name indicates Inflammation. So, Arthritis is an inflammatory disease of the joints. One may ask if Inflammation is the cause of Arthritis or vice-versa?
We will discuss Osteoarthritis (OA) as this form of Arthritis is most common. The old concept of OA was that it is a wear and tear disease, which happens to people in older age. We will discuss the new findings on the causes of Osteoarthritis.
At Perfect Svasthya we do not associate a disease with old age. You may say that a disease is more common in old age, but you should not call any disease an “old age disease”. It is presumptuous that people in older age are unhealthy and prone to several diseases. The disease may be more common because most people do not lead a healthy lifestyle when young and hence experience health issues in their mature years.
In the 1980s, histopathology of the synovium in Osteoarthritis demonstrated abundant Inflammation in Osteoarthritic patients. Goldenberg et al. (1982) noted that inflammatory synovitis is often present in osteoarthritis (1).
Modern imaging modalities demonstrate that osteoarthritis is a complex of multi-tissue pathologies. It involves Inflammation of synovium, cartilage, and subchondral bone. The changes in synovium appear before visible cartilage degeneration has occurred. The synovium lining layer thickens, and it produces inflammatory cytokines. The modern imaging modalities and synovium examination has confirmed that synovium remains inflamed in all stages of Osteoarthritis. Several studies also demonstrate that synovitis (Inflammation of synovium) causes pain and poor function. We can therefore infer that synovitis is the first stage in the development of Osteoarthritis.
A 2017 review published in ‘Arthritis Research & Therapy’ by Alexander Mathiessen and Philip G. Connaghan indicates that synovitis is essentially osteoarthritis (2).
The Inflammation of the synovium naturally affects the functions of synovium, one of which is the secretion of synovial fluid. If the synovial fluid becomes insufficient, the friction between the bones will damage the articular cartilages.
Many scientific studies demonstrate that synovitis (inflammation of synovial membrane) is the cause of pain. What seems clear is that the solution for osteoarthritis is in addressing inflammation. Reduction of Inflammation reduces pain.
The top priority in treating Osteoarthritis is pain and inflammation. Two enzymes predominantly promote inflammation. They are cyclooxygenase-2 (COX-2) and 5-Lipoxygenase (5-LO). By inhibiting the pathways of these enzymes, we can reduce pain and inflammation. The Inhibition should be only of COX-2 and not COX-1 because the latter produces prostaglandins that activate platelets and protect the lining of the stomach and intestines.
Several natural anti-inflammatory substances have been evaluated scientifically for their efficacy in alleviating pain and inflammation. They inhibit COX-2 without inhibiting COX-1. The most effective of the natural anti-inflammatory substances is Perna canaliculus – also known as Green Lipped Mussel. This species is from New Zealand.
Lifestyle changes are also essential because they are responsible for causing Osteoarthritis (OA).
Avoid eating inflammation producing foods as described below:
- Trans fats (cakes and pastries)
- Vegetable oils and seed oils (rich in Omega-6 fatty acids)
- Packaged foods (infested with toxic flavor enhancers)
- Sugar rich colas
- Refined carbs
- Excessive alcohol
- Processed meat
Include physical activities in your daily routine. Walking and Yoga are excellent. Stress can also cause inflammation. Meditation may help in managing stress.
To enjoy restorative sleep, make your dinner light and free from proteins. Maintain a gap of a minimum of 3 hours between your dinner and bedtime. Do not watch TV, cellular and computer screens at least an hour before you go to bed. All of them interfere with the production of melatonin in the brain that is essential for your quality sleep.
Movement is essential for joyful living. Do all you can to restore the wellness for your joints.
- Inflammatory synovitis in degenerative joint disease. D L Goldenberg, M S Egan, A S Cohen. J Rheumatol. Mar-Apr 1982;9(2):204-9.
- Synovitis in osteoarthritis: current understanding with therapeutic implications. Alexander Mathiessen, Philip G Conaghan. Arthritis Res Ther. 2017 Feb 2;19(1):18. doi: 10.1186/s13075-017-1229-9.
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