Joint pain is one of the major problems faced by the elderly population affecting their lifestyle as it limits them from their daily routine activities. Although it mostly affects elderly population but adults are also not immune from it, according to CDC data around 23% of all adults which accounts for more than 54 million people in the US and out of these 54 million, 24 million adults are limited in their activities which can have a big impact on a country’s economy.
To understand what causes arthritis, first we need to know what arthritis is. Arthritis is the medical term used for inflammation in joints; it is a progressive degeneration of joints. Joint will be swollen, it will have severe pain, enough to limit your activities, there will be redness all over it and it will be hot on touch.
A healthy joint consists of two bones, each with its layer of cartilage surrounded by synovial fluid, cartilage prevent bones to rub on each other and allow them to glide for the joint to move and synovial fluid helps to reduce heat produced as a result of friction.
Here are the 4 factors that contribute the most to arthritis:
The problem with arthritis is that as we age, the cartilage starts to degenerate, a process called wear and tear. Degeneration of cartilage makes the joint space narrow and the bones start rubbing each other during the joint movement producing excruciating pain. Friction is also increased generating heat, making the joint hot on touch, and producing other signs of inflammation as mentioned above
Now the question is why the cartilage in our joints starts to degenerate? Answer to this question is that there is a special type of cell present in our bones called chondrocytes which are involved in the maintenance of the cartilage, chondrocytes produce and are embedded within the extracellular matrix, which is a gel-like material and contains collagen type II, a protein that provides structural support as well as proteoglycans like chondroitin sulfate, keratin sulfate, and hyaluronic acid.
This type II collage along with proteoglycans provides elasticity and high tensile strength to the cartilage which enables the weight-bearing joints in our body to distribute weight in such a manner that the underlying bone can easily absorb the shock and weight. These weight-bearing joints include knee hips and lower lumbar spine. Over time these chondrocytes start making collagen type I instead of type II which results in less elasticity, over-exhaustion of chondrocyte can also result in apoptosis and eventually aiding in the development of arthritis.
Normally, chondrocytes maintain a delicate balance between breakdown of old cartilage and making of new cartilage but as we age this balance tips towards breaking down of the old cartilage resulting in degeneration. Age is a very important factor in the pathogenesis of arthritis.
Gender also has a very important role in the development of arthritis. Female gender is more prone to develop arthritis after their menopause and the reason is that women in their reproductive age secrete estrogen hormone which has a protective effect on bones as women age and they hit menopause estrogen secretion drops making them more vulnerable to develop osteoporosis (weak bones) and osteoarthritis.
In recent studies, it has also been established that obesity is also one of the main culprits behind the development of arthritis but the connection has not been made yet.
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Joint injury and trauma can also manifest as arthritis. Due to injury to the joint local inflammatory mediators like IL-1, IL-6 and TNF are released into the joint space causing degeneration of cartilage.
Other causes of arthritis include neurologic disease, genetics, and certain medications.
In short, there are many culprits involved in the development of arthritis we cannot point in only one direction and the research is still being conducted on this to understand it more clearly...