Understanding the cause, or causes, may give us the key to a cure-if it can be caught in its early stages-or at least to an improvement of the condition. Conventional medicine is unsure of the cause, or causes, but most doctors accept the theory that arthritis can be hereditary, or that some people have a genetic tendency to develop the condition.
Others believe it to be caused by a micro-organism, mycoplasma, while a third school of thought maintains it is a malfunction of the body's metabolic and immune system. All agree, though, that they don't actually have a convincing answer to the question of what causes arthritis.
Chemical sensitivity/environmental factors
Allergy specialist Dr John Mansfield believes there is a connection between osteoarthritis and allergenic or environmental factors, and has witnessed impressive results after ecological treatment, such as a change in diet.
The man who first developed the theory of chemical sensitivity was Dr Theron Randolph of Chicago, Illinois. Dr Randolph had observed enormous improvements occurring in many patients with arthritis of varying types as a result of eliminating foods they'd proved allergic to. However, there were a proportion of people who only partially improved or did not improve at all. As his work developed, Dr Randolph found that the pollutants that could also contribute to arthritis are household gas, formaldehyde and the pesticides found in food supplies.
It is not surprising that some human beings should have problems with chemicals. Living organisms can adapt to many changes in their environment, but this adaptation often takes many generations and even then isn't necessarily universal. Since the Second World War, there has been an enormous explosion in newly discovered chemicals, which have quite revolutionised modern life. In Europe and the US, hundreds of billions of pounds of chemicals are produced annually, and over 25,000 different chemicals are in common use in the UK alone. Many of these chemicals find their way into our bodies.
The cause of ankylosing spondylitis is considered genetic. The disease is thought to be 20 times more likely to occur in the relatives of sufferers, but practitioners still do not rule out allergic factors. Again, X-rays help diagnose the problem, showing changes in the joints. A genetic test, the HLAB27 antigen blood test, shows if the patient has a genetic tendency to the disease, but it is possible to have a positive finding in this test and never develop the condition. A variation of ankylosing spondylitis is Reiter's disease. This is a rare disease occurring in young men. It is most likely genetic, but is usually triggered by an infection such as venereal disease or dysentery.
Doctors have found a strong link between arthritis and the skin disease psoriasis. Psoriatic arthritis occurs in 7 per cent of patients with psoriasis, and 20 per cent of patients with psoriatic arthritis have psoriasis. At times this is only characterized by a change in nails-pitting or discolouration. The condition usually affects only one or two joints.
The usual treatment for this condition is painkillers or gold injections. However, Dr John Mansfield, an allergy specialist, has experienced good results with patients put on an elimination diet.
Further forms of arthritis are caused by micro-organisms and are already well understood and treated. These include viral (caused by a virus such as rubella) and septic arthritis (caused by bacteria such as staphylococci) and rheumatic fever (caused by a throat infection such as streptococci).
Macrobiotic researcher Michio Kushi, in his book Arthritis-A Natural Approach, identifies the nightshade plants, such as potato, tomato, eggplant and peppers, as playing a vital role in the cause of arthritis. He calls these plant foods "yin" foods (as opposed to animal foods which are "yang") and says they contain a toxic molecule called solanine, an alkaloid poison related to nicotine and caffeine, which adversely effects the digestive and nervous systems and can cause the development of arthritis. In his book, Arthritis and the Nightshades, Dr Norman Childers reports that once he removed these vegetables from his diet, he noticed an immediate improvement in his arthritis.
Lectins, the carbohydrate that binds the proteins present in most plants, could be another cause of arthritis, and other chronic conditions. Lectins are known to be toxic and inflammatory and aren't readily destroyed by enzymes or cooking-but they are able to get past the gut wall and deposit themselves in distant organs.
Diet and nutrition
A poor diet is a major contributory factor to developing arthritis. Good nutrition can improve the fluidity of synovial fluid, which helps lubricate the joints, while certain foods and drinks-such as tea, coffee, alcohol and chocolate-can all reduce the body's calcium levels, so affecting the health of the bone.
Eating a lot of fried food, or smoking cigarettes, will release free oxidizing radicals, or free radicals, into the system. While free radicals are a natural by-product of body functions such as breathing and eating, and occur when oxygen reacts with glucose, an excess of them can damage tissue around joints.
One theory has it that arthritis may result from an abnormal glucosamine metabolism. This theory is, in part, supported by the enormously positive effect that glucosamine, as a supplement, can have on the progress of arthritis, and osteoarthritis in particular.
It is certainly true that something goes wrong with the processing of cartilage in someone with osteoarthritis. The body doesn't produce proteoglycans and collagen, the building blocks of cartilage, fast enough to keep the cartilage healthy. Glucosamine, which should occur naturally in the body, is a key substance that determines how many proteoglycan (water-holding) molecules are formed in the cartilage.
It's not clear whether abnormal glucosamine metabolism is, in itself, a primary cause of arthritis or whether it is triggered by another cause, such as a food allergy.
It's a general fact that few of us drink enough water every day. The parts of the body that suffer the most from dehydration are those that don't have direct vascular circulation-the joint cartilages in fingers, knees, and the vertebrae.
Chronic pain in these areas can be a sign of dehydration, and rheumatoid joint pain in particular is a signal of this. Some doctors who believe in the 'water cure' say they have seen arthritis clear once the sufferer increases his or her water intake. It is vital, however, to drink pure and filtered water; water from the tap has too many other ingredients, such as fluoride and chlorine, which may offset any good effects.