Article #3: Well! You Wanted to Know! by V. V. Vetrano, B.S., D.C., M.D.

How does rheumatoid arthritis differ from other arthritis and what can be done about it?

Arthritis is a general term referring to any inflammatory disease involving a joint. There are many different types of arthritis, their names being based upon different things, such as whether or not it is acute or chronic, its cause, or etiology, the specific joints involved, etc.

Suppurative arthritis is a condition where the inflammation is associated with the formation of pus. It is thought that this type of arthritis is due to direct bacterial invasion, sometimes causing the white blood cell count to reach 200,000 mm3. It is usually limited to one joint. As the process advances, this type of arthritis can destroy the structures of the joint just as badly as does rheumatoid arthritis. The only difference is that in rheumatoid arthritis multiple joints are involved and pus does not form.

Tuberculous arthritis sometimes develops as a complication of pulmonary tuberculosis. This type of arthritis is even more destructive than suppurative arthritis and frequently normal tissues of the joint are replaced with scar (fibrous) tissue. Calcification (ankylosis) of the joint also takes place.

Rheumatic fever is always associated with a type of migratory arthritis. This type of arthritis usually subsides without injury to the joint. It is well known, however, that the heart is often damaged. It is the belief of Hygienists, however, that the heart damage is probably due to the drugs used to treat the problem rather than bacteria or the disease.

In arthritis associated with gout, which is a systemic disorder of uric acid metabolism, urates will be deposited in and about the joints. This kind of arthritis leads to extensive destruction of the articular surfaces. It is very chronic and extremely painful. It is so severe in some people that the least movement or just the touch, of a sheet will send the sick one into agonizing pains.

Rheumatoid arthritis is a systemic inflammatory disease of unknown etiology according to physicians. However, the etiology is not unknown to Hygienists. Being systemic, all the organs of the body are affected, but the outstanding feature is the progressive deformity of the involved joints. Usually more than one joint is diseased and it is symmetrical; that is, if one hip is involved, the other usually is also. It usually begins in the small joints of the hands and feet, but it commonly affects the wrists, elbows, ankles, hips, knees and spine. The synovial membrane (the membrane which secretes the joint fluid) becomes inflamed and develops into a mass of swollen and inflamed tissue with tags protruding out into the joint itself. It becomes what is known as a pannus and it is thought that this is what eventually destroys the articular cartilage. It also extends to the joint capsule which surrounds the joint and the supporting ligaments and weakens the entire joint. It eventually destroys the articular cartilage, then the bone. In the latter stages of the disease, the articular surface is eroded and the joint space is obliterated. In the final stages of rheumatoid arthritis, adhesions of fibrous tissue or bony ankylosis prevent the joint from moving. Complete confinement to the wheel chair is the final outcome of those who do not learn about Hygiene before this destruction takes place.

Osteoporosis is different in that it occurs principally in weight bearing joints, and is very slowly progressive. The current thought is that the condition is essentially a "wear and tear" or aging phenomenon and should not be called arthritis because it is not basically an inflammation. Pathologists who desire to be technically correct call the problem degenerative joint disease. Degenerative joint disease may appear in younger people when the joint has been injured.

All types of arthritis develop from chronic toxemia. Even with an arthritic tendency one does not necessarily have to develop the disease. A correct mode of living will prevent the development of the disease even in those predisposed to it. Physicians are still ignorant of the cause as is stressed in the following quotation: "It is depressing to relate again, as with so many diseases, that the cause of osteoarthritis is unknown." It is thought that laxity or instability of the supporting tissues of a joint, whether because of previous injury or aging, predisposes one to osteoarthritis. Trauma, slowing of the body's ability to repair as one ages, and anatomical and biochemical changes are all given as possible causes when the real cause is a biochemical perversion from wrong ways of living. As long as the tissues of the joint are normal and all the metabolic wastes are carried away as fast as they are formed, the joint will repair itself even of gross and microtraumas of long years standing.

The primary difference between the two great types of arthritis, rheumatoid and osteo, is that the joints most commonly affected in osteoarthritis are those most active, such as the articulations of the vertebrae, hips, knees, and the distal interphalangeal joints of the fingers. The wrists, elbows, and shoulders and the proximal interphalangeal joints are seldom involved.

Actually, osteoarthritis differs greatly from rheumatoid arthritis in almost every way. It is equally common in both sexes, however, and it develops most often later in life. In osteoarthritis, "there is no evidence of a toxic factor; the large joints are commonly involved, often only one joint; there is no true ankylosis." In osteoarthritis, movement is limited by bony outgrowths, but the two bones never become joined together (ankylosis) as in rheumatoid arthritis. Women especially are prone to the development of Heberden's nodes. I'm sure you have all seen the knobby hands of some older women, especially the bumps on the last joint of the fingers. These are known as Heberden's nodes and they arise because of degeneration of the tissues around the joint after which they are subsequently ossified.