Medical myths: All about arthritis

 Arthritis is a disease characterized by pain and inflammation in the joints. There are two main types: osteoarthritis (OA) and rheumatoid arthritis (RA).

According to the Centers for Disease Control and Prevention (CDC), osteoarthritis is the most common form. The soil for OA is degenerative-dystrophic changes in the cartilaginous structures that are located between the bones in the joint, so osteoarthritis is often called “wear arthritis” or “depreciation disease.”

Rheumatoid arthritis develops when the immune system mistakenly attacks healthy tissues in the body. The result is damage to the joints, but tendons, muscles, and connective tissue can also be involved in the lesson.

Arthritis is quite common. In particular, osteoarthritis is the leading cause of disability in the older age group. The Lancet estimates that this form of joint inflammation affects about 7% of the global population, which is more than 500 million people.

According to the World Health Organization, rheumatoid arthritis is less common but still found in 0.3-1% of the global human population. One of the features of RA is the tendency to manifest at an earlier age compared to OA, usually between 20 and 40 years; also, rheumatoid arthritis often affects daily activities more severely. The WHO notes that “after ten years from the onset of the disease, at least 50% of patients in developed countries can no longer work full-time.”

In addition to osteoarthritis and rheumatoid arthritis, there are several other forms of this disease, including:

– juvenile (juvenile) arthritis, a group of joint inflammatory diseases that begin in childhood or adolescence;

– spondyloarthropathy, the collective name for dystrophic lesions of the joints of controversial etiology;

– systemic lupus erythematosus, one of the autoimmune diseases in which many tissues and structures are affected in the body, including joints;

– gout, accumulation, and deposition in the joints of crystalline salts of uric acid;

– infectious and reactive arthritis, inflammation of the joints as a result of the activity of pathogens;

– psoriatic arthritis, which affects almost a third of patients with psoriasis.

So, about the myths connected with arthritis.

Only older adults have arthritis.

In the older age category, arthritis is more common, but people of any age get sick. Analysis reports from the National Health Interview Survey are available in the PubMed Central database, owned by the US National Institutes of Health.is a nationwide health survey developed by the US National Center for Health Statistics and regularly conducted by the CDC.

According to these data, 49.7% (i.e., less than half) of all cases of arthritis are diagnosed in people aged 65 years and older. 30.3% of cases are in the age category of 45-64 years, 7.3% – in the category of 18-44 years, and in other cases (12.7%), arthritis is primarily diagnosed in people under 18 years of age. As for rheumatoid arthritis (RA), as mentioned above, this form most often manifests itself in the age group from 20 to 40.

If your joints hurt, it’s arthritis.

Not necessarily. Not all joint pain is due to arthritis, and any discomfort in the joints should not be considered a sign of inevitably impending arthritis. There are many other causes of joint and periarticular pain, including tendinitis, bursitis, trauma, etc.

For those with arthritis, exercise is contraindicated.

In general, exercise is not a contraindication for arthritis. On the contrary, an individually designed and thought-out gymnastic system helps maintain joint mobility and strengthen them. At the same time, an absolute necessity is a preliminary consultation with a doctor to agree on the nature, intensity, and frequency of the intended loads.

From the American College of Rheumatology:

“Exercise can and should be practiced for arthritis. Arthritis patients who exercise regularly find less pain, more energy, better sleep quality, and overall better day-to-day functioning.”

Moreover, this organization recommends that exercise be considered “one of the main principles of treatment for osteoarthritis of the elbows and knees.”

Nightshade vegetables aggravate arthritis.

Nightshades, which include tomatoes, eggplant, potatoes, vegetable peppers, and several other agricultural plants, are the subject of one of the most enduring myths about arthritis. Some people claim that meals made from such vegetables worsen the symptoms of arthritis.

For clarification, we turned to Dr. Brian Schultz, sports medicine specialist and surgeon at the Cedars-Sinai Kerlan-Jobe Institute (Los Angeles, California). He told us, “There is no evidence that nightshade vegetables cause inflammation or aggravate the symptoms of arthritis. However, the Arthritis Foundation recommends certain anti-inflammatory foods, including fatty fish rich in omega-3 fatty acids, pigmented fruits and vegetables high in antioxidants, nuts, grains, and legumes.”

For sore joints, warm is better than cold.

This is not true. Both heat and cold can relieve joint pain. From the Guy’s and St Thomas’s National Health Service Foundation (NHS, UK):

“Heat can relieve pain and stiffness in joints and muscles when properly applied. Cold can reduce inflammation and swelling of the joints.”

Foundation experts explain that warming up is best used before physical activity or exercise when the joint is still stiff and movements are painful. But cooling can help if the joint is inflamed and swollen after activity.

There is no cure for arthritis.

Part of this is a myth. Of course, not every case of arthritis can be prevented because some risk factors, such as advanced age, are beyond the control of the individual and cannot be controlled. However, CDC experts insist that people can eliminate or minimize certain risk factors, which will serve as a reliable prevention of arthritis or slow its progression.

In particular, overweight individuals constitute an increased risk group for knee osteoarthritis. Normalization and maintenance of weight in an adequate range can reduce this risk. Another serious factor contributing to the development of rheumatoid arthritis is smoking. Quitting this addiction, dangerous in many ways, reduces the risk of joint damage and provides many other health benefits.

Finally, given the likelihood of developing arthritis after injury, basic joint protection during sports or other physical activity significantly reduces the risk of arthritis in later life.

Once you’ve been diagnosed, you’re already powerless to do anything.

Fortunately, this is a myth. Even though there is often no etiopathogenetic treatment for the disease, its course varies depending on the type of arthritis. Today, medications are available that, in many types of arthritis, effectively reduce clinical manifestations and inhibit the progression of changes.

And it is not superfluous to emphasize once again that even after establishing and confirming the diagnosis, it is quite possible (and necessary) to adopt a lifestyle that in itself serves as an obstacle to the further increase in symptoms:

• Eliminate smoking.
• Achieve normal body weight.
• Switch to a healthy diet and ensure you get enough sleep.

Glucosamine and chondroitin can cure arthritis.

As a rule, arthritis is not amenable to etiopathogenetic treatment; this means that, to date, no such therapy would eliminate the causes and restore the affected joints to their original state.

Supplements with a high content of glucosamine and chondroitin can only relieve the symptoms to some extent in some patients with osteoarthritis. Such additives are widely represented on the market and are in a certain demand.

We reached out to Dr. Orrin Traum, a rheumatologist at Providence Saint John’s Health Center in Santa Monica, California, for clarification on the origins of this myth. He says, “The Arthritis Cure, published by Dr. Jason Theodosakis, has become a bestseller. There, in particular, the treatment with glucosamine and chondroitin sulfate is promoted, but to this day, these allegations remain unfounded.

( The referenced book, called glucosamine and chondroitin sulfate therapy “a medical miracle that can stop, reverse and even cure osteoarthritis,” was published in 1997 by a team of authors; the other two, besides Theodosakis, Brenda Adderley, and Barry Fox.).

Many studies have been undertaken, the object of which was the therapeutic efficacy of these substances, both individually and in combination. But there are no clear answers. For example, a major study sponsored by the National Institutes of Health was carried out in 2008; it studied the effectiveness of glucosamine and chondroitin in pain in osteoarthritis of the knee joint. The comparators were celecoxib (a non-steroidal anti-inflammatory drug prescribed by a doctor to relieve pain in OA) and placebo. In this study, only celecoxib was significantly more effective than a placebo dummy.

At the same time, “no significant difference was found with placebo in terms of the efficacy of the other drugs tested.” However, the authors felt it necessary to note that “in a subset of study participants with moderate to severe pain, glucosamine plus chondroitin sulfate provided statistically significant pain relief compared with placebo.” However, this did not affect the general conclusions since the specified subgroup needed to be bigger.

According to the National Center for Complementary and Integrative Health:

“The study results show that chondroitin is ineffective for pain in osteoarthritis of the knee or hip. […]. It remains unclear whether glucosamine helps relieve pain in osteoarthritis of the knee or whether such supplements can reduce pain in other joints.”

Dr. Traum sums it up: “Perhaps for a small percentage of patients suffering from osteoarthritis pain, the combination of glucosamine and chondroitin did help. Since such supplements do not show significant side effects, their clinical trials could clarify the issue for those patients who avoid taking stronger traditional drugs.

Dr. B. Schultz agrees with this question formulation, emphasizing: “Some studies confirm the effectiveness, others disprove it, but in general, these supplements are relatively safe to take, and I usually recommend that my patients try them to evaluate the effectiveness in their particular case.”

Changing weather can exacerbate arthritis symptoms.

There is a strong belief that in rainy and wet weather, the symptoms of arthritis are exacerbated. On this topic, we will end our review.

Even though the claims about the influence of weather on the course of arthritis sound quite mythical, they still find some evidence. However, the available data are of a point, sporadic nature, and more is needed to draw general conclusions.

We asked Dr. John Tybury, a colleague of Brian Schultz at the Cedars-Sinai Kerlan-Jobe Institute, an orthopedic surgeon specializing in prosthetics and joint preservation. Here is what he replied:

“There is no concrete and sufficiently convincing scientific explanation for the influence of weather on the arthritis clinic. There are several theories based on the complaints of individual patients – those who insist on the dependence of symptoms on weather changes.

Dr. O. Traum supports this point of view: “Many of my patients say something similar when it comes to rain or just expecting a change in the weather. Sometimes I even find that these complaints are more reliable than the weather forecast. Patients with inflammatory arthritis or swollen joints can often experience changes in barometric pressure, usually on the day before a change in weather.”

The true mechanisms of the dependence of the symptoms of arthritis on the weather are not understood, but this dependence takes place – to some extent. Dr. Schultz mentions, in particular, the theory that “a decrease in temperature affects the degree of viscosity of the intra-articular fluid, which can lead to greater stiffness of the joint.”

What do we note

The last of the “myths” we have considered is especially eloquent that, despite the prevalence of arthritis, we still have a lot to explore and clarify in this disease.

However, today there is no doubt that a healthy lifestyle, including a balanced diet and regular physical activity, can dramatically reduce the risk of at least some types of arthritis or slow down their development if it is impossible to avoid them.

As scientists advance in research on this disease, so make therapeutic approaches. We may find an answer to the question of how the weather affects the symptoms of arthritis.

In conclusion, arthritis is a common disease characterized by pain and inflammation in the joints. There are several types of arthritis, including osteoarthritis, which is the most common form, and rheumatoid arthritis, which is less common but can be more severe. There are several myths surrounding arthritis, including that only older adults have it, that all joint pain is due to arthritis, that exercise is contraindicated for those with arthritis, that nightshade vegetables aggravate arthritis and that heat is better than cold for sore joints.

However, these myths have been proven to be false. Arthritis can affect people of all ages and not all joint pain is due to arthritis. Exercise can actually be beneficial for those with arthritis, as it helps maintain joint mobility and strengthen them. Nightshade vegetables do not aggravate arthritis, and both heat and cold can relieve joint pain. It is important to consult with a doctor to agree on the nature, intensity, and frequency of exercise and to manage joint pain.