Osteoarthritis is not a ‘wear and tear disease’

Osteoarthritis (OA) is an ‘age related low-grade inflammatory disease of the joints’ which causes the protective cartilage cushion between the bones to wear down, allowing the bones to rub together, creating a great deal of pain and discomfort. In the UK, OA affects 8.75 million people contributing to a significant burden on our health and social care systems. Modern medical treatments involve the use of paracetamol, non-steroidal anti-inflammatory drugs (e.g. ibuprofen), opioids, steroid injections, joint replacement/fusing and osteotomies. The use of drugs will provide pain relief, masking the symptoms but will not get to the root cause of the problem. Taken for long periods of time, these drugs can cause significant long-term health issues in themselves.

OA is often described as a ‘wear and tear disease’ that is caused by getting older. There is now very compelling evidence to suggest otherwise. Obesity is the strongest risk factor for OA onset in the knees, but the fact that being overweight/obese also increases the risk of developing OA in non-weight bearing joints, such as the hands/wrists, suggests that physical weight/wear and tear of the joints are not the only factors at play. In 2017 researchers at the University of Surrey identified a significant link between the body’s metabolism (the chemical processes that occur within us to maintain life) and OA – The role of metabolism in the pathogenesis of osteoarthritis – Nature Reviews Rheumatology, 2017.

In this review a comprehensive explanation is made on how poor dietary choices and lack of exercise can trigger the reprogramming of cells in the joints (and indeed the rest of the body) from a balanced resting state to one that is highly active, creating a number of cellular by-products that both inhibit the repair of/and destroy tissue, as well as fuelling inflammation. We know that regular moderate exercise confers significant benefits to overall joint health, as it strengthens muscles, prevents further cartilage breakdown and builds bone.

Lead author, Professor Ali Mobasheri summarises: ‘It is important never to underestimate the significance of a healthy diet and lifestyle as not only does it impact upon our general wellbeing but can alter the metabolic behaviour of our cells, tissues and organs leading to serious illnesses’. The big question of course is what exactly does that ‘healthy diet’ look like for the individual, as healthful foods for one can literally be a slow poison for another.