’Im Doctor Fraser Birrell, I’m a consultant Rheumatologist with Northumbria Healthcare and an Honorary Clinical Senior Lecturer with the musculoskeletal research group at Newcastle University, where we are involved with lots of studies with Arthritis Research UK.
Many people that I see who suffer from joint pain, in their 40s onwards, believe it’s caused by decades of general ‘wear and tear’ on the joints.
This isn’t true. A crucial thing to understand is that if it was ‘wear and tear’ then we would all develop arthritis if we lived long enough, and that’s simply not the case.
Years of research into arthritis and other related musculoskeletal conditions have replaced this outdated, inaccurate and very negative view with fresh scientific evidence and thinking and now we use the terms ‘tear, flare and repair’ to describe what is actually happening.
So, what we need to understand is what are the key factors which are leading to and causing these episodes of inflammation and leading to the episodes of pain.
That includes malalignment of the joints, for example if you’ve got malalignment where your knee throws out to the side and it puts more pressure of the outside, that can lead to pain and pressure.
Obesity increases the load. Specific types of overuse where you’re using your joint more than it’s designed to be used, and sudden movements and particularly those that lead to injury and strain.
Those are all potentially factors.
It’s very common for patients to tell me that they get dull pain the whole time, or some of them will be pain free, and then they’ll get a bad episode of pain, a flare, where the pain goes right up and that has big effects on your function, and your day to day activities as well.
What happens is, it’s the cumulative damage from repeated injuries, and some of them are true injuries which would lay you up, and some of them are subclinical injuries.
The important thing is if they lead to an imbalance in the normal functioning of the joint, the normal alignment, that’s what increases the load, that’s what increases the pressure, that drives the inflammation, that causes the pain and causes the damage to the joint over time.