The most common joint disease

By Dr. W. Gifford Jones

January 29, 1989

Aristotle was right. There are no boy philosophers. Advancing years may imbue us with a touch of wisdom. But getting older leaves much to be desired. Like old rusty cars our bodies insidiously begin to break down. Osteoarthritis is one of the major degenerative problems. Doctors have always attributed this malady to excessive wear and tear. Now one researcher says it's just another myth that this common joint disorder results from excessive mileage. He claims there is a way to reverse this age-old plague.

Osteoarthritis goes back to he beginning of recorded time. Birds and reptiles exhibit this affliction. It's been found in the skeletons of dinosaurs. Even whales supported by the buoyancy of water share this disability.

If you live long enough, it's hard to escape osteoarthritis. Dr.Patrick Rooney, a Rheumatologist at McMaster University, says 80 per cent of people 55 years of age and older show X-ray evidence of osteoarthritis. There are more young males with this disease, but women are more likely to suffer from severe osteoarthritis.

Osteoarthritis originates in cartilage supporting the bony joints. Cartilage is about 75 per cent water and is like a sponge, with one important difference. It requires a huge amount of pressure to force out the water. After spending a day on our feet we stand about 3/4 of an inch shorter.

Dr. John Bland, associated with the Clinical Immunology unit at the University of Vermont, writes in Executive Health Report that a properly functioning joint will not wear out. It's simply too efficient.

Bland suggests the lubrication of a pig's knee is four times more efficient than the lubrication of a jet engine. And that the friction between cartilage covered surfaces inside the joint is the same as between two cubes of ice.

So what is happening when our joints begin to develop arthritis? Bland reports that arthritis has never been found in sharks because their skeletons are 100 per cent cartilage. But when other animals and man developed bony joints nature evolved a system of maintaining these structures.

Chondrocytes are the key players. These cells produce cartilage, but also manufacture enzymes that attack cartilage. Cartilage, like bone, is therefore being constantly broken down and renewed and also remodelled by physical stress. Joints, like jet engines, however, can falter when chondrocytes break down.

Dr. Bland says several factors such as genetics can set chondrocytes on the rampage. At times this results from endocrine, biochemical or metabolic influences. Or the instigating agent may be inflammation in the joint from overuse ,an injury or diabetes.

These factors cause chondrocytes to proliferate. This in turn increases the amount of enzymes that destroy cartilage. Once there's more destruction of cartilage than repair, patients develop osteoarthritis. But Professor Bland says osteoarthritis does not always follow a downhill course. And we must to get rid of the idea that cartilage can't repair itself.

How can patients who have early osteoarthritis try to rejuvenate their joints? Bland gives the same advice to arthritic sufferers as to those with sexual problems. If you don't use it you lose it. The key is the right combination of rest, exercise and weight bearing. Exercise , he stresses , is the "pumping mechanism" that pushes nutrients into the joint providing the chondrocytes with the means to repair cartilage.

With exercise one patient started to show less arthritic changes in the hips at 85 years of age. Improvement continued each year and was verified by X-rays until he died at 95.

Bland admits there is a role for medication . After all it's hard to exercise when you're in pain. But this approach should constitute just 10 to 15 per cent of the overall treatment.

Cortisone may occasionally be needed to inject into arthritic joints. But in the opinion of Bland and other doctors aspirin is still the miracle drug. Unlike the newer anti-inflammatory drugs aspirin has been around for over two thousand years. And it has an unparalleled track record for decreasing inflammation and pain.

I think Professor Bland has a point. It's important to keep the body well-oiled and active. Stagnation is always a peril. Tie up a ship to dock and it gets rusty, and barnacles form on its hull. The longer you leave them there the harder it is to remove them.

W. Gifford-Jones M.D is the pen name of Dr. Ken Walker graduate of Harvard. Dr. Walker's website is: Docgiff.com

My book, �90 + How I Got There� can be obtained by sending $19.95 to:

Giff Holdings, 525 Balliol St, Unit # 6,Toronto, Ontario, M4S 1E1

Pre-2008 articles by Gifford Jones

Canada Free Press, CFP Editor Judi McLeod