Osteoarthritis: Joint degeneration

From the March 2005 edition of Dr. Fuhrman's Healthy Times:

Currently, the pathogenesis of OA is explained by various contributing factors that adversely affect cartilage cells. In simple terms, the chondrocytes (cells that produce cartilage) become stressed, overworked, injured, and eventually die. This destruction of the chondrocytes makes it impossible for your body to keep up with the production of high-quality collagen needed for normal wear and tear. As the cartilage erodes, the joint becomes inflamed, and lytic (caustic) enzymes can further degrade the cartilage matrix. As cartilage wears away on the ends of the bones and cushioning is lost, the intensity of pain may increase. Pain may become quite severe if the cartilage has completely deteriorated.

Surprisingly, physical inactivity can be more harmful to the joints than overuse. Joint activity signals for the delivery of nutrients to the joints. A lack of exercise or varied movement can weaken the muscles that support the joints, and an underused joint may become stiff, painful, dysfunctional, and prone to injury and osteoarthritis.

Joints, because of their somewhat unusual blood supply, are extremely sensitive to negative nutritional influences compared with other parts of the body. When we abuse our body with poor nutrition, we not only raise our blood pres sure and increase our risk of heart attack and stroke, but we also damage our joints. In fact, OA and degenerative bone disease of the spine could be early warning signs of heart disease in years to come.

The reason why joints have an increased susceptibility to damage from dietary folly is because of their indirect blood supply. Instead of direct oxygenation and nourishment from being bathed in blood (such as with muscles and organs), cartilage is nourished from the fluid in the joint capsule. Oxygen comes from tiny capillaries that surround the joint capsule and diffuses across the joint capsule membrane and into the joint fluid. With normal microcirculation and good nutrition, plenty of oxygen and nutrients bathe the cartilaginous surface of the joints.

This intricate and fragile system can be vulnerable to nutritional stresses. The nourishment to the cartilaginous surface of the joint can be curtailed even by the smallest impediment to normal blood flow. When atherosclerosis is present, the delivery system can be easily disrupted by as simple a thing as eating a high-fat meal. Even the earlier stages of atherosclerosis can impede oxygen delivery to the joint, revealing itself in joint problems that occur decades before the heart problem is diagnosed.

When you eat a piece of high-fat food—such as cheese pizza, bacon, or steak—the saturated fats thicken the blood and make the red blood cells sticky. This clumping together of red blood cells makes them too large to enter the small capillaries that surround and nourish the joint capsules. Atherosclerotic deposits thicken the walls and narrow the vascular bed, further impeding delivery of oxygen and nutrients to the joint area where most cartilage and bone remodeling takes place. Defective remodeling then occurs, with gradual destruction of the joint.

Here’s more on osteoarthritis:
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