There are over one hundred different types of arthritis, and every type falls into one of two distinct categories: degenerative or inflammatory. The most prevalent type of degenerative arthritis by far is osteoarthritis, which accounts for about 80 per cent of all arthritis and affects tens of millions of people around the world. The most prevalent type of inflammatory arthritis is rheumatoid arthritis, which afflicts roughly one or two in one hundred people. If you have ever seen pictures of an active volcano, then you know how lava keeps spewing forth, spreading out beyond itself and forming land that was not there before. Think of the production of cartilage as you would a very slow lava flow. A layer of specialized cells called chondrocytes slowly secrete a particular cartilage gel. The cartilage gel is made up of two different types of materials. One is collagen, which is akin to strong "ropes" and provides the cartilage with its scaffolding. The other type of material in cartilage goes under the heading proteoglycans. These are little elasticized "springs" that connect the "ropes". They are crucial because they dam up water between them, providing the joint with elasticity and its ability to slide easily. Water also provides foolproof cushioning.
It can not be compressed, but it can easily be squeezed from place to place, which means it can even out the pressure in cartilage by flowing from an area of high pressure to an area of lower pressure. The process of distributing pressure throughout a joint works as follows: When you put a load on a joint, say, by walking or gripping something with your hand, muscles in the area move the bones, which in turn compress the cartilage. Specifically, it is the springs inside the cartilage that are compressing. This squeezes the water out from between the springs from the middle of the joint to the edges, which, in turn, allows the pressure of the movement to be evenly applied across the joint. After the movement is completed, the water flows back between the springs, ready for the next step or grip and with age, you lose some of the springs-and, therefore, some of the elasticity. The springs that remain, eventually become more brittle and less springy. In some people, the joint wear and tear of a lifetime leads to osteoarthritis; in others, it does not. It can not be predicted with certainty who will end up with osteoarthritis and who will not. But there are some risk factors that make a lot of people far more prone to developing the disease.
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