Arthritis and Rheumatism (musculoskeletal problems)

Arthritis And Rheumatism

(An Overview)

Almost every person is affected at one point by aches and pains in the joints or muscles. We all know what sore muscles feel like from overuse or what a sore back feels like when we lifted something too heavy.

But some people seem to be more prone to getting sore muscles or sore joints than others. In the past it was thought that as we get older we all will eventually get one of these diseases. However, newer research has shown that there are a number of factors that lead to a higher risk for developing arthritis and rheumatism, much like there are risk factors for diabetes or for heart disease. In the following I will briefly describe these known risk factors.

Risk Factors

• It is only in recent years that physicians are realizing that certain risk factors that lead to heart disease or cancer are also often risks for developing arthritis and rheumatism. It seems that if there is a dysbalance of certain metabolites called "eicosanoids", then these diseases can develop. These tissue hormones, which are derived from essential fatty acids from food, include such substances as prostaglandins, thromboxane, leukotrienes, hydroxylated fatty acids and others. In Ref. 1 these hormones are reviewed in detail and Dr. Sears distinguishes "good" from "bad" eicosanoids. With regard to arthritis there are too many "bad" eicosanoids made that lead to inflammation of joints (Ref.1, p.167).In the various chapters regarding the different forms of arthritis I will explain some of the various known mechanisms of inflammation. As the "bad" eicosanoids are associated with the syndrome of insulin resistance (high levels of insulin in the blood), a special diet can stabilize and even cure arthrits and rheumatism. Such a diet without refined sugar and with no starches, but appropriate amounts of protein and complex carbohydrates as well as a small amount of fat is the "zone diet" and I can only recommend this to anyone who is afflicted with such a disease (Ref. 2).
• There has been a link noticed between hardening of the arteries (=arteriosclerosis) and degenerative disc disease as well as between hardening of the arteries and degenerative joint disease (Ref. 3). The explanation given is that with arteriosclerosis of the nutritional vessels not enough nutrients and oxygen reach the discs of the intervertebral bodies and the lining of the joints resulting in degenerative changes. Inflammation sets in secondarily with the release of prostaglandin E2 and other inflammatory mediators, which leads to pain and loss of motion (Ref. 4).
• Anything that ages a person faster such as heavy smoking will also lead to accelerated degenerative changes in joints and discs. Arthritis and back pain are therefore common among this subgroup of people.
• There can be genetic reasons for some people who get arthritis or rheumatism. For instance, we know that psoriasis patients can get a psoriatic arthritis and psoriasis is a genetically linked skin disease. Ankylosing spondylitis, Reiter's disease and some forms of rheumatoid arthritis and lupus can all be found more often in certain families. However, the genetic transmission is not fully understood in all cases.

Disclaimer:

This outline is only a teaching aid to patients and should stimulate you to ask the right questions when seeing your doctor. However, the responsibility of treatment stays in the hands of your doctor and you.

References:

1. B. Sears: "The age-free zone".Regan Books, Harper Collins, 2000.

2. B. Sears: "Zone perfect meals in minutes". Regan Books, Harper  Collins, 1997.

3. MI Jason Clin Orthop 1992 Jun;(279):40-48.

4. D Hamerman et al. J Am Geriatr Soc,Vol. 47(No.8)1999: 1016-1025.

5. Ferri: Ferri's Clinical Advisor: Instant Diagnosis and Treatment, 2004 ed., Copyright © 2004 Mosby, Inc.

6. Rakel: Conn's Current Therapy 2004, 56th ed., Copyright © 2004 Elsevier