by nate on Friday, November 20th, 2009 | Health, Knowledge, Life, Tips | No Comments

Arthritis is common: One in six adults in the United States has some form of arthritis, and with the aging of our population, that fraction is going up. But the condition is also widely misunderstood. Unfortunately, just about every aspect of arthritis is clouded by uncertainty, misinformation and myth, including how to define it, what causes it, how to treat it and how to predict its course. And misunderstanding about the potential causes of arthritis can lead to bad decisions about treatment.

What Is Arthritis?

Strictly speaking, arthritis means inflammation of a joint, which often leads to some combination of pain, swelling, redness and limited motion. There are more than 100 types of arthritis. In some cases, the type of arthritis needs to be specifically defined, because successful treatment depends upon the correct diagnosis. Gout and rheumatoid arthritis are two such examples. Other types of arthritis can be grouped into categories because the prognoses and treatments are similar.

What Causes Arthritis?

While several types of arthritis have a known cause, the majority does not. Examples of common types of arthritis with no known cause include most cases of osteoarthritis and all cases of rheumatoid arthritis. Even when the cause is known (for example, uric-acid crystals cause gout when they deposit in the joint), it is generally not known why some people develop gout and others with the same risk factors do not. A joint infection may clearly be caused by a particular bacterium (as proven by detection of that bacterium in the joint fluid), but that doesn’t tell you why the bacterial infection developed in the first place. An injury such as a broken bone or torn cartilage may lead to arthritis years later, but not everyone with a similar injury will get arthritis. For most cases, then, arthritis develops for no known reason.

What Does Not Cause Arthritis?

When the cause of an arthritic condition has not yet been discovered, it may be difficult or even impossible to disprove a theory, even one that is improbable. Here are some of the most common, but as yet unproven, theories about the cause of arthritis:

1. Overuse

With usual use, joints hold up well most of the time. Some people who are on their feet all day assume that knee or hip arthritis must be related; yet it clearly doesn’t explain the same type of arthritis occurring in the hands. There are exceptions, of course: Jack-hammer operators and athletes, for instance, may develop degenerative arthritis because of repeated joint injury.

2. The weather or a damp, cold breeze

This notion probably follows from the rather common experience of arthritis sufferers that the weather seems to affect their joint symptoms. At the current time, there is no evidence that identifies any type of weather as a cause of any type of arthritis.

3. Most medications

Although there are occasional exceptions, prescription, over-the-counter and complementary and alternative medications are not a recognized cause of arthritis. Again, there are rare exceptions: Corticosteroids, including ones available in pill form (such as prednisone) may cause interruption of the blood supply to the bones around the hip, causing death of the bone there (called avascular, or aseptic, necrosis)

4. Infections and vaccinations

There are infectious causes of arthritis, but they represent a small fraction of all arthritis. Important examples include bacteria (such as Gonorrhea and Staphylococcus), Lyme disease, some viruses (including occasional cases of hepatitis B, hepatitis C or parvovirus). Fortunately, the vast majority of people receiving the most common vaccinations never develop arthritis.

5. The wrong diet

Theories about which diet is best to prevent or treat arthritis have been around for centuries, but with rare exception and some common sense, diet does not seem to play a crucial role in arthritis. First, the exceptions: Some people find that particular foods (or alcoholic beverages) trigger attacks of gout. Secondly, there is an association between obesity and osteoarthritis, so a diet that promotes weight loss may be helpful. Undoubtedly, future research will provide useful information regarding the importance of diet as a cause or treatment of arthritis.

6. Cracking knuckles

Although you can injure a joint by overenthusiastic knuckle cracking, there is rather convincing evidence that regular knuckle cracking has little effect on joint health.

7. Getting older

Although degenerative joint disease (also called osteoarthritis) becomes more common with age, arthritis is not inevitable. Therefore, age alone cannot be blamed as “the cause” of arthritis.

8. Mental or emotional stress

There is no convincing evidence that psychological stress causes any recognized type of arthritis. On the other hand, stress can make any pain seem worse, and there is controversy regarding the relative importance of psychological stress on the development or perpetuation of joint pain without arthritis (as in fibromyalgia).

9. Poor posture

“Slouching” does not cause arthritis, although certain types of arthritis or bone diseases can affect posture. The idea that poor posture causes arthritis probably follows a misunderstanding of cause and effect: Osteoporosis may cause a stooped posture because vertebrae collapse (called compression fractures). Arthritis in the spine may follow, but the stooped posture is not the cause of the arthritis

10. Inadequate calcium intake

Recommendations to take extra calcium follow the observation that without enough calcium, bones may become thin and so weak that fracture becomes more likely. That’s what osteoporosis is but osteoporosis is not arthritis, and calcium intake has rather little to do with the development of arthritis (unless, as described above, osteoporosis leads to fracture and fracture leads to arthritis).

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