Five common misconceptions about arthritis

The statistics are alarming: if you live in an affluent country, your lifetime risk of suffering from arthritis of the hip or knee may be as high as 25% and 45% respectively^{1 2}. And despite these very high figures, prevention and treatment of arthritis are hampered by the many false assertions circulating about the disease.

Arthritis is the result of normal, age-related wear and tear

Arthritis is a normal, inevitable consequence of ageing, right? Actually no. While many young people might believe this to be the case, they’re wrong. Arthritis is in fact a chronic disease associated with abnormal degeneration of cartilage. Like most other degenerative diseases (diabetes, amyotrophic lateral sclerosis (ALS) – also known as Lou Gehrig's disease, and Alzheimer’s disease), it is, to a certain degree, linked to oxidative stress – the imbalance between levels of reactive by-products of oxygen (commonly referred to as ‘free radicals’) and the body’s ability to protect itself from them. In the case of arthritis, most of these by-products are generated by chondrocytes (the cells that make up cartilage) and are directly involved in the degeneration of cartilage and synovial fluid^3,4. Yet this pathological mechanism has nothing to do with normal ageing. It is the complex result of a combination of factors, some of which are avoidable: repetitive strain injuries and movements, added stress to joints due to excess weight, or a lack of physical activity^5,6.

One thing’s for sure: believing that arthritis is the inevitable result of ageing leads to fatalism and is not conducive to taking preventive measures!

Arthritis is passed from one generation to the next

While it’s true that arthritis does have a genetic element, genes are actually a relatively moderate factor in determining our individual risk, compared with other ‘hereditary’ diseases. Heritability is estimated to account for between 40% and 65% of arthritis cases⁷, as against 60%-80% for Alzheimer’s disease⁸. By way of comparison, heritability of lung cancer, which we know is primarily caused by smoking, is only 8% ⁹. And some forms of arthritis are more ‘hereditary’ than others: 70% in the case of arthritis of the back, 65% for arthritis of the hands and 60% for arthritis of the hip, as against 40% in the case of knee arthritis, making it the most ‘avoidable’ form¹⁰.

In all cases, having a parent who has suffered from arthritis does not mean you in turn will be affected, but it does make you at more at-risk. Having genetic abnormalities (particularly related to collagen composition) increases your risk of developing the disease and you should therefore be especially mindful of lifestyle factors (excess weight, physical activity, diet and stress) in order to reduce your likelihood of developing the disease.

X-rays are an effective way of diagnosing arthritis

For 90% of people affected by arthritis, the first symptom is generally minor and unusual pain - when bending down, climbing stairs, stretching or handling objects¹¹. But it’s only three years later, at the age of 50 on average, that they realise they’re suffering from arthritis.
This delay is partly due to the inability of X-rays to detect the early stages of the disease: by the time there is actual evidence, the arthritis is already at an advanced stage. Bone abnormalities typical of arthritis (osteophytes, deformities, pinching) are apparent, but damage to cartilage, ligaments and synovial fluid is often missed.
Studies^12,13 have shown that X-rays are not a reliable way of diagnosing arthritis and can prevent early treatment of the disease. Unfortunately, MRI and blood tests are equally unable to provide a definitive diagnosis. Pain remains the best indication of early-stage arthritis and we should not wait till it becomes chronic before taking action and seeking advice.

We should protect our joints by abstaining from exercise

Who would risk aggravating joint pain by engaging in physical exercise? Unfortunately, all too many arthritis-sufferers.
Contrary to what you might think, exercise can actually be as effective for arthritis as pain-killing drugs¹⁴, and it produces fewer side-effects. By reducing inflammation, improving joint function and preventing potential problems from excess weight, it represents an effective way of relieving the pain of arthritis. The main problem is actually getting on with it: believing themselves to be too old, too many people lack the confidence to go ahead and start exercising. Yet, apart from activities that require sudden directional changes, arthritis is improved by almost all types of exercise – water-based¹⁵, cycling¹⁶, aerobic¹⁷, strengthening^{18, 19}, as well as high or low impact exercises^{20, 21}.
The most important thing is to keep exercising, because the more you come to enjoy your chosen activity, the more your pain will decrease²².

There’s nothing you can do to relieve arthritis

Arthritis has a reputation for being a complaint that you just have to put up with. However, even though there are no 100% cures, there are a number of ways of relieving it. The mere act of ‘not giving up’, carrying on with everyday activities in spite of the pain, and maintaining a positive attitude, all contribute to effective management of the disease²³.
In addition to physical activity, other forms of treatment include numerous alternatives to the pain-relief drugs which are increasingly viewed as of limited efficacy and potentially risky. Key among these alternatives are the following plant-based therapies and other scientifically-supported treatments:

• Arnica gel, a topical application effective at relieving pain and improving mobility²⁴.
• Cayenne extract (Capsicum frutescens) which, with its high capsaicin content, is internationally recommended for relieving arthritis of the knee²⁵.
• Boswellia serrata extract, currently one of the most popular natural health products²⁶ (available from Supersmart as Super Boswellia).
• Devil’s claw extract (Harpagophytum procumbens), with demonstrated efficacy for reducing inflammation and improving joint mobility²⁵ (available from Supersmart as Super Harpagophytum).
• Glucosamine, which is produced naturally by the body and which relieves pain while slowing the development of arthritis^{27, 28} (available from Supersmart as NAG 500 mg).
• Chondroitin, a key component of cartilage which also eases pain and stems progress of the disease (unlike NSAIDs which tend to accelerate it) ^29-1, available from Supersmart as Chondroitin Sulfate 95% .

We should not forget physiotherapy techniques (cryotherapy⁸, electrotherapy⁹, balneotherapy¹⁰, acupuncture¹¹) as well as other approaches (tai chi¹², yoga13, massage) which have become increasingly popular in recent years.

The truth is that there is no shortage of effective pain relief treatments for arthritis. It’s more a question of ‘making the leap’ and trying them, and accepting that some approaches will suit you better than others. Which have you tried already?

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