What are the Causes of Osteoarthritis
I was so often asked in practice what are the causes of osteoarthritis. Why have I got osteoarthritis in one hip or knee only?
Medicine claims that osteoarthritis can be primary or secondary. Primary means it is an inevitable part of the aging process while secondary means there are known causes of osteoarthritis.
What I am going to say here is very much my opinion and many medics will disagree with me. But the one thing I am very sure about is that all 360* joints in your body are the same age, yet joint degeneration has not affected every one of them. So I say there there are definite causes of osteoarthritis and there is not one global reason why you have osteoarthritis.
* (We can’t even agree on how many joints there are in the body! I believe there are 360; 86 skull joints, six throat joints, 66 thorax joints and 76 in your spine and pelvis. Also there are 32 in each upper limb and 31 in each lower limb.)
There are many causes of osteoarthritis which have been proven including:
♦ Genetics– one study of classic twins concluded that you have a 60% susceptibilty of getting hip osteoarthritis if a close relative has osteoarthritis. That makes it one of the most common causes of osteoarthritis.
However I have issue with this a one of the causes of osteoarthritis. The twins in this study were bought up together and so probably played the same childhood sports, had the same level of care when they hurt themselves etc. If they did a study on twin separated at birth and found had the same results I would be more convinced that genetics are one of the causes of osteoarthritis. I believe genetic makes you more susceptible to OA but is not really the reason.
♦ Obesity– this has been shown to be one of the major causes of osteoarthritis when BOTH hips or knees are affected. For some reason this is especially common in women. I am not sure if this is because a higher percentage of women are obese or it is the shape of our pelvis compared to men. It is important to decrease the weight in childhood and young adulthood to reduce the chance of our weight being one of the causes of osteoarthritis in later life.
♦ Trauma– this is another of the common causes of osteoarthritis. A study published in the Medical Journal of Epidemiology looked at the causes of osteoarthritis and concluded that major trauma was a factor for men but not women. This could be because men tend to be greater risk takers, especially as teenagers, or due to the type of sports they play making injury more likely.
‘Old Age’ is NOT one of the causes of osteoarthritis!
I believe the most common cause of osteoarthritis is previously injured joints that never healed properly. These injuries do not have to be major trauma but could be small repetitive traumas or overuse injuries. Obesity is trauma as there is too high a pressure is repeatedly put through the joint.
When a joint is injured the muscles, tendons and ligaments are injured. (Please see what is osteoarthritis for an brief anatomy lesson if needed). This may be a sprain (the ligaments) or a strain (the tendons and muscles) or a sprain/strain (everything!). The tissues is repaired with scar tissue and this is not laid along the existing fibres but laid down hazardously in a sort of web. If the scar tissue is left like this it forms bridges in between the fibres stopping the fibres sliding past one another. This stops the soft tissue stretching and so it is effectively made shorter. Because the tissue is shorter it will alter the pressure through the joint leading to dysfunction. Leave the joint like that for years and the joint wears quicker and you get osteoarthritis.
The problem is we repeatedly traumatize ourselves, especially as children. Consider a child learning to walk. How many times a day does it fall ? How many times do kids sprain their ankles and well meaning but untrained parents decide a bandage for a few days and it will all be better. Healing a badly sprained ankle takes 3 to 6 weeks and for a good part of that the ankle will be symptom free so according to mum and dad they are fine to return to sport. Later in life that will become a ‘weak’ ankle and so another one of those common causes of osteoarthritis.
That is why I believe all osteoarthritis is secondary and the causes of osteoarthritis are untreated previous major trauma, untreated repeated trauma and that’s about it! If you genetically have weaker cartilage then your untreated joints will wear even quicker and so the statisticians then say genetics is the cause of your osteoarthritis.