What is Arthritis?

The other day while reviewing an MRI with a patient, she asked a simple, but thought-provoking question, “What is arthritis?”

I started thinking---as providers of medical care, we throw out a lot of common terms under the assumption that patients have a general understanding of the material discussed. It appears that this is not always the case. So, today I’m going to discuss the basics of arthritis. As there are different forms of this disease, I will focus on, osteoarthritis (OA) in particular. This blog’s intent will be to cover just the general/basic aspects of this topic, as I know them to be---if you are an OA expert, you will likely find the material remedial.

Quite simply OA is a condition involving the articulating joints of the body. The bone ends (epiphysis) are covered/capped with a substance called articulating cartilage. The cartilage is a very slick substance that significantly reduces the friction involved with the mechanical movement of the joint. One of my mentors Dr. Emmett McKeleney, an orthopedic surgeon equated the atmosphere to rubbing 2 pieces of wet ice together---very smooth with minimal friction. With time/birthdays/age, injury, gravity and just basic living; the cartilage will wear down/decrease. When this happens the once slick/smooth atmosphere becomes more friction laden and in doing so causes joint space narrowing, mechanical limitation, pain, and subsequent inflammation, swelling. This is how I define OA---the loss of articulating cartilage.

What we know about this condition is that it is incurable and progressive---what we don’t know is the rate/speed of the progression. While it is incurable, there are some widely-known procedures that can be quite helpful such as life-style changes, joint replacement , and hyaluronic injections (Rooster cone). Some new techniques which are currently flying under the radar are regenerative injections, including PRP and stem cell injections, which my supervising physician (Dr. Sarah Vlach) administers. These have shown great promise for those individuals that want to remain at a high activity level and are not ready for a joint replacement. The take home message here is that, if you don’t understand what your medical provider is presenting you, ask them to clarify.