Arthritis is not a single disease, but an informal way of referring to joint pain or joint disease. There are in, fact more than 100 different types of arthritis. Common symptoms include swelling, pain, stiffness, and decreased range of movement (1).
There are various types of arthritis but the main types we see clinically are;
- Osteoarthritis; Disease of cartilage in the joint and underlying bone
- Rheumatoid; An autoimmune disease initially affecting the synovial membrane
- Trauma arthritis; A disorder of the joint capsule and synovial membrane
Degeneration involves a decrease in the specialised function of a tissue accompanied by some structual changes. Degeneration results when the means of health are insufficient; for example a reduced blood flow, excessive mechanical demands or both. Poorly resolved inflammation in the joints from trauma often results in some degeneration.
The joints (osteophytosis, spondylosis), invetebral discs, bursa, ligaments, tendons, and tendon sheath can all be affected. The process of degeneration will be different in different tissues, and under different conditions but often involves;
- Reduced blood supply
- Increase in fibrous connective tiers and a decrease in functional tissue
Osteoarthritis as described above is a degenerative process beginning in the articular cartridge of a joint. The irritation caused by the degeneration eventually leads to inflammation. Degenerative changes appear long before the start of symptoms such as pain or swelling. Osteoarthritis manifests in middle age, and not ‘just a normal ageing process’. However can be a result of excessive mechanical demands on a joint. In osteoarthritis we normally see;
- Pain after rest and sustained use
- Tenderness around a joint
- Stiffness of the joint
- Giving away of the joint for example; knee when standing
- X-Ray may show a decreased joint space, presence of osteophytes (bone spurs/projections), or sclerosis (an abnormal increase in density and hardening of bone) of pressure area and subchondral bone
Acupuncture for Osteoarthritis
In multiple studies, Acupuncture has been found an effective treatment for pain and physical dysfunction with osteoarthritis of the knee (2). As well as improving gait in patients with osteoarthritis (3).
Rheumatoid Arthritis (R.A)
Rheumatoid arthritis is a chronic inflammatory disease that begins in the synovial fluid membrane and is sustain by an auto-immune process. The cause has not yet been established, however sometimes their are familial and dietary factors identified. Most (75%) of sufferers are positive for a protein called rheumatoid factor in their blood, but 25% are actually seronegative, the prognosis for the later are better. Symtoms associated with R.A are;
- The initial onset is systemic (entire body symptoms) which could include; fatigue, weight loss, generalised muscle pains. This is then followed by joint pain and swelling, especially after rest. Then swelling and deformity of the joint.
- Symmetric joint swelling
- Starts in small joints
- More common in women
- Started between ages of 25-55 years old
- X-Ray in early stages there is diffuse rarefaction of the bone
- X-Ray in later stages show decreased joint space and sclerosis and secondary degenerative changes
Treatment of R.A needs to address the auto-immune process as well as the joint pain and swelling.
Acupuncture for Inflammaotry Arthritis
More coming soon