CHAPTER FIVE
DEGENERATIVE JOINT DISEASE
Of the 17 million arthritis sufferers in the United States, over 10 million have degenerative types of arthritis. Sometimes called osteoarthritis, the degenerative joint disease occurs twice as often as rheumatoid arthritis and usually begins later in life. In fact, almost everyone will get “a touch of rheumatism” sooner or later, if he lives long enough.
Usually osteoarthritis is mild. It seldom cripples, but often produces pain. Weather changes, storms, and cold may aggravate the symptoms, making the sufferer somewhat of a weather prophet. This type of arthritis confines its attack locally to individual joints and rarely spreads to distant joints or affects the whole body. Primarily osteoarthritis is a matter of “wear and tear” of the mechanical parts of the joint, the cartilage cushions wearing out as the patient becomes older. Most often affected are weight bearing joints, such as the knees, hips, or spine. One variety of this disease, which does not seem to have anything to do with strain on the joints, affects younger women. The joints of the fingers are the chief points of attack, often showing bony enlargement on the hands, called Heberden‘s nodes. These can be quite painful.
In the normal joint where two bones meet, their ends are covered with layers of smooth elastic material called cartilage. These surfaces are designed to slide smoothly across each other, lubricated by the joint fluid. In
osteoarthritis the bone ends become thicker, then bony spurs develop. The surrounding ligaments and membranes may also become thickened, changing the whole shape of the joint.
Muscles in the region of the arthritic joint tend to become tense and contract unnaturally as a reflex reaction to pain. They may likewise become weak. Obviously when the mechanical system breaks down in this way, the joint is not going to work properly.
important structures and continue living free from pain.
Although many people have x-ray changes characteristic of osteoarthritis without symptoms, most patients develop pain in or around the joint. This may be mild aching and soreness, or a nagging constant pain. The pain of joint disease is caused by pressure on nerve endings, and by tense muscles and their rapid fatigue. Sometimes pain is felt at a distance from the joint where the trouble is. Second, one experiences the loss of ability to move his or her joints easily and comfortably. Usually part of the problem is an advancing muscular weakness. Obvious distortion of the joints will develop later. X-rays often aid doctors to make a correct diagnosis.
Early treatment is helpful to limit the troublesome symptoms. I place great importance on healthful mental influences. Recommended nutritional
measures with a natural vegetarian diet are nearly identical to principles mentioned above for rheumatoid patients. Chili-containing creams such as
Zostrix are valued to quell the ache of chronic joint pain. Containing the
ingredient, capsaicin, the cream appears to affect a chemical “pain
messenger,” substance P, responsible for transmitting pain signals along nerve pathways to the brain. The capsaicin cream, which burns slightly on the skin, triggers the release of substance P from the nerves in the area where it’s applied.
Hot packs, special baths and other forms of external heat, combined with rest, and exercises to protect the joints from stress and strain, may all be helpful. Most important for any overweight or obese patient, though, is a weight reduction program. Remember that osteoarthritis is a chronic disease and may last for life. This makes obvious the conclusion, for treatment must continue for a long time. Disability can nearly be prevented by early attention to the above simple measures.
GOUT
Gout is an acutely painful form of arthritis, attacking at least one million victims in the United States. This disease usually results from an inherited defect in body chemistry. Uric acid, a normal body substance is either overproduced or delivered faster than the kidneys can get rid of it. Great
excesses of uric acid form needle-like crystals in joints, leading to severe inflammation. The affected joints become hot, swollen, and exquisitely tender.
Although gouty arthritis can settle in almost any part of the body, the large joint of the big toe is attacked most commonly. Your diet must be regulated to lower the uric acid intake. This can be done most naturally by eliminating meat and cola beverages, then substituting unrefined whole grain cereal foods, fruits and vegetables. The use of hot packs, or in the case of extremely acute inflammation ice packs, may reduce the inflammation and bring rapid resolution.
Also dangerous for patients with gout is the crystallization of uric acid in the kidneys. Actual stone formation can occur with the typical symptoms of colic in the ureter. Occasional deposits of uric acid, called tophi, can occur in the skin around the ears, the hands, and the elbows. Strict control of dietary uric acid, elimination of alcohol and caffeine, and adequate fluid intake are good preventive measures. A physician should be consulted when difficulty arises.
Other types of joint pains may be related to bursitis, tendonitis, and the other painful afflictions of musculoskeletal tissues discussed in chapter two.
Finally, it is important to emphasize a few major misconceptions about arthritis. First of all, arthritis can be a serious disease. It is very important to make an accurate diagnosis, particularly of the rheumatoid type. Many people are under the impression that nothing much can be done for arthritis. This is definitely untrue. With early, proper, and continued treatment, a great deal can be done.
A short stay in a lifestyle or wellness center for nutritional education, hydrotherapy, and diagnostic evaluation is well worth the time and money. Sometimes all progressive crippling can be prevented. Distortion of the joints, which has already occurred, may be greatly reduced if not corrected. It is likewise not true that arthritis affects only old people. Some of the elderly were struck with arthritis when they were relatively young. Juvenile forms of rheumatoid arthritis are also known and rarely may be seen from infancy. Find out what kind of arthritis it is, then go to work in removing the cause, aiding nature in her valiant effort to combat this problem.