Inside About Dr. Theo
Dr. Theo Bio
Dr. Theo on Arthritis
Contact Dr. Theo
Home Page
Q & A
About Dr. Theo

Dr. Theo on Arthritis

Arthritis and related conditions are actually made up of about 100 different diseases.

When the word "arthritis" is used as a general term, it is meant to refer to problems that are specific to or include the joints.

There are over 230 different joints in the human body. A joint is the union of two or more bones, surrounded by various other tissues such as:

  • Joint capsule (fibrous tissue which encloses the joint in a watertight and airtight environment)
  • Muscles (which allow for movement around the joint)
  • Tendons (which connect muscles to bones)
  • Ligaments (which connect bone to other bones)
  • Cartilage (which lines the ends of the bones and acts as both a shock absorbers and a slippery surface that allows the bones to move easily over one another)

Arthritis is a Greek word that translates literally into ?joint inflammation.? The symptoms of arthritis usually include joint pain, stiffness, and sometimes swelling or warmth.

Some people might have advanced arthritis and not have any symptoms of pain. That's because cartilage on the end of the bones does not have the nerve endings. Sometimes, even with significant degeneration of the cartilage, people are unaware of their condition.

In many cases, people might notice stiffness without pain as their predominant symptom of arthritis.

As will see below, it's extremely important to have a physician accurately diagnose the cause of your symptoms. There are many different forms of arthritis that result in the same symptoms. Despite the overlap in symptoms, however, the treatment intervention might vary considerably depending on which form of arthritis is finally diagnosed. Getting the wrong kind of treatment for a particular condition can be detrimental. In some cases, the treatment might make the disease worse, even if there is temporary pain relief at the beginning of the treatment.

How many people are affected?

According to the CDC, arthritis causes symptoms and problems in nearly 70 million Americans, or about one in every three adults. As the population ages, develops more obesity, diabetes, and joint injuries, this number is expected to rise, perhaps even double by 2020.

Despite the fact that most people associate arthritis with the elderly, a full two thirds of the cases are in those younger than age 65.

Arthritis is by far the number one cause of pain and disability in Americans. Fortunately, we know more about treatment and prevention than ever before. The past 10 years have provided us with tremendous breakthroughs in the diagnosis and treatment of many of the forms of arthritis.

Specific diseases categorized as arthritis

It's easy to confuse osteoarthritis and rheumatoid arthritis, two very different rheumatologic diseases with similar names. And it gets even more confusing when you learn that there are about 100 different types of rheumatic diseases, many causing different forms of arthritis. Depending upon the type of arthritis, the associated inflammation may flare up in one joint or many, may limit itself to the joint only, or it might spread to the muscles, tendons, ligaments, internal organs, and even the skin. Different types of arthritis have different causes, courses, and cures.

Naturally, your arthritis cannot be effectively treated until the type has been diagnosed. Your doctor will make the diagnosis, which may very well be one of the common forms listed here.


Half or more of the total cases of arthritis are attributed to osteoarthritis, often abbreviated as OA.

OA is a condition which often starts in those in their teens or 20s and become symptomatic tend to 30 years later.

The hallmark of OA is a slow loss of cartilage on the end of the bones, along with characteristic changes to the bones that include: bone spur formation, tiny fractures called microfractures, and an increase in the pressure inside the bone marrow cavity.

Though osteoarthritis can occur in almost any joint, 55% of the pain and disability is due to osteoarthritis of the knees. The other joints commonly affected include the hips, neck and low back, fingers and thumb joints.

It is believed that there are about 20 different causes of osteoarthritis including: injury or trauma, family history, metabolic disorders such as thyroid problems, diabetes, obesity and an overload of iron; alignment problems in the joints (which may be acquired or have been present since birth), as well as a whole host of other factors.

Risk factors for developing osteoarthritis include: obesity, diabetes, low levels of Vitamin D, decreased muscle strength around the joints, and overuse syndromes through work or sporting activities.

The vast majority of people who have osteoarthritis are unaware of it. In fact, a recent study looking at patients 55 years and older who had no symptoms of joint problems revealed that 96% of them showed signs of osteoarthritis on x-ray.

Unfortunately, the vast majority of those treating osteoarthritis relied on pain relievers and anti-inflammatory medications including over-the-counter and prescription drugs. Tylenol, Advil, Aleve as well as prescription drugs such as Celebrex and Vioxx were often given as the first line therapy for those who have symptomatic osteoarthritis.

We now know that the use of these medications is not without significant chance of harm, and that the medications themselves might lead to worsening of the disease process itself, even in those who experience some pain relief initially.

The hallmark of the book The Arthritis Cure- Revised Edition is to explain all of the causes and interventions of osteoarthritis in an easy-to-read manner. The book details the nine step program for prevention and treatment of this debilitating disease.


When someone mentions gout, we usually think of the hugebellied, gluttonous King Henry VIII swilling port wine and chewing on a leg of mutton, his bandaged foot resting on a stool. Gout was once called the "rich man's disease" because it was associated with being overweight, overeating (especially meat), and overindulging in drink. Today we know that gout is a metabolic disorder, but a poor diet can make the condition worse.

In gout, uric acid, a waste product in the urea (urine) cycle, is either overproduced, under excreted, or both. When a person has too much uric acid in his or her system, some of it forms uric acid crystals. These crystals (think of them as sharp pieces of glass inside your body) can be deposited into the joint space, rather than being cleared by the kidneys. These "glass shards" often find their way to the "bunion joint" of the big toe, although gout is also found in the other joints of the feet, as well as those of the fingers, wrists, elbows, knees, and ankles. The afflicted joint suddenly becomes hot, painfully swollen, and stiff; fever and chills sometimes follow. The skin of the affected area can appear shiny red or purple. The pain from an acute attack of gout can be excruciating. In some cases, the joint is so tender that even the light brush of a bed sheet can cause howls of pain.

Gout affects about two million Americans, most of them male (80 percent). Risk factors for getting the disease include a family history of gout, drinking alcohol, high blood pressure, taking certain medications, being overweight, or gaining weight unchecked. Aside from the severe pain of a gout attack, the disease can be hazardous to your long-term health. The uric acid crystals may eventually be deposited in soft tissue, cartilage, joints, tendons, or elsewhere, forming painful lumps, and the crystals can also damage the kidneys.

The good news is that gout can often be completely controlled with proper treatment, which usually includes the use of non-steroidal anti-inflammatory drugs (NSAIDs) for pain and inflammation, abstinence from alcohol, dietary restrictions (avoiding foods such as organ meats), and possibly -medications to reduce the amount of uric acid production or increase its excretion in the urine.

It is very important to treat gout and prevent gouty attacks because recurrent attacks can lead to joint destruction, deformities, and arthritis in the affected joint. Gout is a common secondary risk factor for osteoarthritis. Treating the gout, and preventing uric acid crystals from getting into the joint are the most important ways to prevent secondary osteoarthritis.


The name makes it sound as if it's a fake, but the pain and other symptoms of pseudogout are real. Often striking the knee joint, then the wrists and ankles, pseudogout attacks suddenly, causing pain and swelling in the joint and possibly destroying cartilage. An attack may go on for days or even weeks, with the acute phase lasting 12 to 36 hours. Sometimes the pain may flare up in several joints at a time, though when that happens pseudogout is usually less severe and more chronic. Sometimes the pain increases after activity; sometimes it doesn't. These symptoms often disappear without treatment.

Also known as calcium pyrophosphate crystal deposition disease, pseudogout is a form of inflammatory arthritis. As is the case with gout, the pain is caused by crystals deposited in the joint spaces, but in pseudogout the crystals are formed from calcium pyrophosphate rather than uric acid. The calcium crystals can also be deposited into the cartilage, causing a condition called chondrocalcinosis (Latin for "calcium in the cartilage").

Pseudogout is uncommon before the age of 65 and it seems to affect men and women equally. The disease can be brought on by surgery, trauma, or stress (because stress causes excessive parathyroid hormone production, which affects the calcium balance in your body). Unlike gout, it's not caused or affected by diet. Even though the crystals contain calcium, drinking milk or eating high calcium foods doesn't seem to make a difference.

Treatment includes joint aspiration to remove the fluid containing the crystals and NSAIDs to manage pain and inflammation. Exercise helps to build muscle strength and restore full motion of the joints after an acute attack. In rare instances, surgery may be used to replace a joint that has been badly damaged, is extremely painful, or is unstable.

Perhaps the most dramatic responses to glucosamine, chondroitin and ASU I have ever seen occurred in people suffering from pseudogout. Some cases were patients who had little response to NSAIDs or even cortisone injections and who were contemplating radical surgeries to scrape down the cartilage and calcium deposits. After a few weeks on the supplements, their recovery was dramatic. Some were completely cured of their pain and swelling, even years later, and even after they took up running again.

Glucosamine has an "antireactive" effect that helps keep the calcium crystals from irritating the cartilage. This is why I believe that the research on the supplements, which generally just includes people with primary osteoarthritis, underestimates the real-world value of treating people with joint pain from other types of arthritis.

Continuing reading Dr. Theo on arthritis...


Learn about and purchase the book

90% of people who follow The Arthritis Cure treatment program don't need anti-inflammatories (like Aleve, Celebrex or Advil).
Dr. Theo warned people that these drugs, used first... read more


Glucosamine/Chondroitin vs. Celebrex- What's Best for You?



Copyright ?1997-2005 Jason Theodosakis, M.D.
Privacy Policy
Please read this site's disclaimer.