Grandma Moses had arthritis in her hands at age 76 when she began painting the folksy, whimsical scenes of American life that made her famous. Despite her condition, she created hundreds of paintings, many of which can be found in major museums all over the world.
Kim Kardashian, American media personality, businesswoman, and star of Keeping Up With the Kardashians was diagnosed with psoriatic arthritis in 2019 after experiencing pain and stiffness in her hands that made it almost impossible for her to pick up a toothbrush. Taking medication helped her immensely and she has said that she hopes her story will help others with autoimmune diseases realize there is “light at the end of the tunnel.”
Armed with a thorough knowledge of arthritis, how to control its symptoms, and all the many techniques you can use to manage this disease (all of which you’ll find in this book), you too can be well on your way to taking charge of your condition and getting on with your life!
Chapter 2
Osteoarthritis: The Most Common Form
IN THIS CHAPTER
Whether you call it osteoarthritis, degenerative arthritis, or degenerative joint disease, osteoarthritis (OA) is the painful result of cartilage breakdown. When the tough, rubbery substance that cushions bone ends no longer does its job, the bone ends can’t slide easily across each other within the joint. That’s when pain and stiffness can settle into a joint. Suddenly, your knee or lower back aches, your hip burns, a finger joint swells and throbs, or your shoulder stiffens up. You can’t bend and flex the painful joint like you used to; its range of movement is limited. Most of all, it just plain hurts!
But what happened to mess up your cartilage in the first place? To understand what went wrong, here’s a look at how things work in healthy cartilage.
Considering Cartilage
Healthy cartilage is absolutely essential for joints to function properly and painlessly. Slick as polished marble and tough as galvanized rubber, cartilage protects the ends of your bones from wearing each other away where they meet inside a joint. It also provides a smooth, slick surface so bone ends can glide easily across each other. And cartilage is an excellent shock absorber, cushioning the bones and soaking up the impact created by movement and physical stresses. Without intact cartilage, bones grind away at each other and bear the brunt of the impact of movement. Eventually, the joint itself can be damaged or even destroyed.
Four elements help cartilage do its all-important job:
Water: Sixty-five to 80 percent of cartilage is water — a crucial substance that lubricates the joints, cushions bones, and absorbs shock.
Collagen: Elasticity and a superb capability to absorb shock make collagen an integral part of healthy cartilage. A connective tissue that helps hold bones, muscles, and other bodily structures together, collagen is the mesh-like framework that provides a home for the proteoglycans.
Proteoglycans: These large, oblong molecules are covered with centipede-like “arms” that weave themselves securely into the collagen mesh and soak up water like a sponge. Then, when pressured, they release water. Thanks in part to the proteoglycans, cartilage can mold itself to the shape of the joint and respond to the ever-changing amount of pressure within the joint capsule.
Chondrocytes: These cells follow the principle “out with the old and in with the new” as they break down and get rid of old proteoglycan and collagen molecules, forming new ones to take their place.
Water, collagen, proteoglycans, and chondrocytes all work together to keep your joints moving like well-oiled machinery. When the pressure is released from a joint, say your knee when you lift your leg to take a step, water rushes into the cartilage, nourishing, bathing, and plumping it up. The water-loving proteoglycans, woven securely into the collagen web, soak up water and hold on to it until pressure is applied to the joint (that is, you take another step). Then the water and wastes rush out of the cartilage. But as soon as the pressure is off, the proteoglycans thirstily soak up the water again. The resilient collagen stretches and shrinks to accommodate joint pressure and water content, so your cartilage can bounce back after being flattened out.
But if your cartilage loses its ability to attract and hold water, it becomes thin, dry, cracked, and unable to provide a slippery surface (see Figure 2-1). No longer plump and resilient, it makes a poor shock absorber and cushion for the bones, particularly affecting the weight-bearing joints.
© John Wiley & Sons, Inc.
FIGURE 2-1: Osteoarthritic joints have narrowed joint space, and thin, rough, broken-down, or completely missing cartilage.
You can visualize the action of the cartilage by thinking of two cans of soup facing each other end-to-end with an almost-filled water balloon in between them. As you press the soup cans together, the water balloon changes shape to accommodate the pressure, but never lets the cans actually touch. When you release the pressure, the water balloon (like your cartilage) resumes its old shape.
Identifying the Signs and Symptoms of Osteoarthritis
How do you know if the joint pain you’re suffering from is due to osteoarthritis? Most of those with the disease have at least one of the following symptoms:
Joint pain: Most people experience joint pain as a deep-seated ache radiating from the inner core of the joint. The feeling is distinctly different from a muscular ache and may come
