‘Creaky Joints’? The aches and pains of ageing joints.

It has been predicted that approximately 10 million people in the UK alone now have Osteoarthritis one of the most common forms of Joint disease. As we age the health of our joints decline.

Through wear and tear and general ageing the structures within the joint begin to break down which can lead to damage, pain and what can only be described as ‘creaking joints’.

What is the structure of a Joint?

Synovial Joints are a type of joint found in the body, such as the knee hip and shoulder. There are 6 kinds of a synovial joint. These are:

• Hinge, found in the elbow.
• Ball and Socket, found in the hip.
• Pivot, found in the neck.
• Condyloid/Gliding, found in the wrist.
• Saddle, found in the thumb.
• Planar, found in the ankle.

Synovial joints are made up of a number of complex structures that relieve pressure and friction within the joint, maintaining its flexibility and mobility. As we age or come into contact with damage the structures are made less efficiently and breakdown. The important structures are as follows:

Articular Cartilage- This covers the epiphysis (end of bone), it is distinctive as it is shiny with a bluish hue. A large proportion of this articular cartilage is collagen. Its role is to cover the entirety of the ends of the bones, reducing friction and absorbing shock.

Synovial Membrane and Synovial Fluid- The synovial membrane encapsulates the synovial fluid. Its role is to secrete the synovial fluid. The role of the synovial fluid is to lubricate the joint, and supply the joint with nutrients. The nature of bone is very active, it is constantly breaking down and building back up. Osteoclasts are cells that break down bone and Osteoblasts reform cell to replace old and damaged bone. To do this it requires a constant supply of nutrients, a prominent role of the synovial fluid.

Meniscus- This is a ‘pad’ made up of fibrocartilage. The primary role of the Meniscus is to absorb shock from movement conducted in the joint.

Bursa- This is only found in some synovial joints such as the Knee. It reduces friction caused by mechanical movement, such as between two ligaments, a muscle and bone, or a tendon and bone.

There are other structures in the joint, but the 4 listed above are the most important. The other structures include the Ligaments, Periosteum and Fibrous capsule.

What disorders can effect the Joint?

Disorders that can effect the joint include:

• Arthritis
• Osteoarthritis
• Rheumatoid Arthritis
• Bursitis
• Gout

As previously mentioned in this article Arthritis is a common disease that is now believed to effect over 10 million people. Despite there being many rare forms of Arthritis, Rheumatoid and Osteoarthritis are the most common. Osteoarthritis affects 8 million people in the UK and is a condition associated with ageing. The pathophysiology of the disease effects the articular cartilage that coats the end of the bone. As we age more friction occurs within the joint and less shock is absorbed. This makes mechanical movements of the joints less efficient and incredibly painful. To increase efficiency, our body compensates by increasing workload of the tendons and ligaments, this increases swelling and causes bone to rub against other structures encouraging ectopic growth of bone, called ‘bony spurs’. The joints that are most often affected are those found in the fingers, ankles, knee, hip and spine. Rheumatroid arthiritis is less common and is caused by a genetic hyperactive immune disorder. This causes widespread inflammation of the joints, which can be debilitating, and causes loss of function and extreme pain.

Symptoms of Arthritis include:

• Pain
• Stiffness
• Inflammation
• Loss of flexibility
• Alterations in posture
• Bones pushed out of place
• Frequent Fractures

Bursitis can only occur in joints that contain a Bursa, such as the knee, elbow and shoulder. This again causes inflamamtion that can lead to loss of function and pain, however this is thought to be caused by overuse and repetitive movement. Gout is a disease caused by the build up of pyridine crystals around the joint which causes swelling and pain. This was a common disease ion history thought to be linked with a rich fatty diet full of meat.

How can you prolong Joint Health?

Much like any disorder, joint pain, inflammation and disease can be aided by improvements in Diet. Maintaining a healthy weight can be hugely beneficial as it reduces pressure on the joints and increases mobility. There are nutrients to be eaten in abundance if inflammation is the cause of pain. Particularly Omega 3 fatty acids which are anti-inflammatory. Additionally, the contribute to the production of synovial fluids that reduce friction and inflammation. A diet rich in red meats, alcohol and sugar is thought to aggravate such diseases as they promote inflammation, and promotion of gout/rheumatoid arthritis symptoms. A diet rich in plant oils, fish, fruits, vegetables and lean meat is thought to benefit symptoms of poor joint health.

Supplementation of the diet is also beneficial to better joint health. Natural herbs/spices such as Ginger, Turmeric and Garlic have been shown to have anti-inflammatory properties by inhibiting the action of inflammatory factors within the body. In addition, the active ingredients Epigallocatechin-3-gallate found in Green tea have potent anti-inflammatory mechanisms and have been found to be hugely beneficial to people suffering with arthritis and other inflammatory disorders. Vitamin C is responsible for the production of Collagen according to the European Food Standards Agency (EFSA). Collagen is required for numerous structures within the joint including the articular cartilage, synovial membrane, tendons and ligaments. MSM (Methyl-sulphonyl-methane) and Chrondriotin Sulfate are abundant sources of sulphur and are vital components used when making synovial fluid. Lastly, you are advised to take Glucosamine which is used as a basis for damage repair in the joints.

Exercise is always beneficial to joint health. It’s recommended that you do not regularly participate in heavy weight bearing activities such as sprinting or weight lifting as this can cause further damage. However, you are recommended to do less forceful activities such as swimming as this takes the pressure off the joints. Moreover, mix up your daily exercise routine, repetitive actions can also cause unnecessary wear and tear.