Is Arthritis a symptom or a disease?

[meshka7]

I keep hearing about Arthritis and I had no idea what it was and never bothered to look into it. I get the impression when some people talk about it, that it's some kind of disease that some people have and some people don't. They treat it with medication and such.

To me, I had joint pain before and eventually overcame it (at least partially) with exercising and strengthening the surrounding muscles.

So, when people talk about Arthritis, is it something I should worry about catching later in life, or is it something that proper exercising and strength will mostly take care of?

Of course going to Wikipedia I found there are some forms of Arthritis that are genetic or caused by auto-immune disease and obviously my question is not about those. But Wikipedia also says "There is no cure for either rheumatoid or osteoarthritis.", which tells me it's something you can't get rid of??

Ok. I'm confused.

[James72090]

This is my non-scientific or medical opinion, but what i have seen with people with arthritis is that it comes in different form likes you mentioned. I think like most diseases there is environmental and genetic aspects as to what could predispose you to having it later in life, both seem to have similar treatment which does not remove it. Think of it like any other major injury, you are never going to un-herniate a disk in your spine, you can only manage the effects and through proper planning could minimize how often pain is felt and your chance to get another one. If i recall correct from high school health is that arthritis caused by environmental aspects is due to repetitive stress injuries that damage cartilage wearing it away and that the pain comes from bone on bone contact, a similar thing would happen if it was genetics or disease except it is due to no fault of your own or a combo of both. The treatment for most forms(again non medical) is to keep the joint moving through a healthy range or motion and that limiting ROM could cause more damage, i think how it would be addressed it moving through what the patient would be comfortable and slowly increasing the ROM to what can be done pain free. Basically if the patient could only flex their finger 70 degrees without pain, but 80 degrees would cause the patient a ton of pain the goal would be to build tolerance and capacity between those ranges in hopes that the upper threshold of pain would be increased to say 85 degrees and working up from there.

[Jonathon Sullivan]

Arthritis is just a word that means "joint inflammation." It may be loosely thought of as a disorder, or as a set of diseases (the arthritides). The symptoms of arthritis include arthralgia (joint pain), edema (swelling), warmth, erythema (redness), crepitance (crunchiness), loss of range of motion, loss of strength and function, deformity, etc, etc, etc.

Osteoarthritis may be thought of loosely (but practically) as "wear and tear" arthritis, due to erosion or damage to cartilage and, to a lesser extent, tendons, ligaments, joint capsules, etc. An unfortunate by-product of Living Life for many people. It sucks.

Autoimmune arthritides include rheumatoid, lupus arthritis, and the like. They can be difficult to manage, and they suck.

Crystal arthropathies include gout and pseudogout. They result from the deposition of urate or calcium pyrophosphate crystals, respectively, int he soft tissues of the joint. They suck.

Septic arthritis is the result of infection of the joint space. Synovial fluid is a most excellent growth medium. Organisms introduced to the joint space either by hematogenous spread (staph and gonococcus are excellent examples) or a traumatic nonsterile invasion of the joint capsule (like, say, an ill-advised or poorly performed medical procedure) can destroy the joint in very short period of time. It sucks.

Exercise, including resistance training, appears to offer benefits in people suffering from osteoarthritis (that is, me and everybody else my age), and in people with autoimmune arthritides. I don't think I've seen any literature on crystal arthropathies and weight training. Septic arthritis is an acute condition, requiring parenteral antibiotics and, often, surgical drainage and debridement of the joint capsule. This scenario presents little opportunity for squatting, although resistance training may certainly be indicated for rehabilitation.

All of these arthritides can, in principle, be definitely "cured" by the "simple" expedient of resecting and replacing the diseased joint. In practice, this often proves to be a less than optimal or even impossible course of action.

Probably more than you wanted to know. Sorry.

[Dastardly]

Thanks for taking your time to answer these questions sully.

[phynnboi]

Exercise, including resistance training, appears to offer benefits in people suffering from osteoarthritis (that is, me and everybody else my age)

I've been wondering for a while now at what point those benefits disappear, or are otherwise overshadowed by the damage caused by the training.

What really kicked this off was reading about Dave Tate, and how he eventually acquired severe shoulder arthritis for which he has said the only cure is "total replacement." I've since read many other such war stories. Recently, I read from a trainer here who claimed his hip (I think?) arthritis was likely exacerbated by his strongman activities, including walking around with 1000 lbs. on his back. He still lifts like a beast, but I get the idea that constant pain is a way of life for him, and that it will only get worse. He's said the condition is hereditary, so I guess he'd have had it anyway. But, had it as bad, as fast? Even he seems to admit, probably not.

The attitude here (and every other strength training forum I've ever seen) seems to be one of continual improvement. People interested in maintaining the gains they've made tend to be shamed. I've got to wonder, though, what the cost of that is, and if these folks really accept that cost, or simply believe "it'll never happen to me," or believe that everyone should be in pain for the sake of not being shamed as "pussies."

This is all rhetorical. I know the real answer is, "I don't know," or more elaborately, "It depends on the person." The real answer is, "Do whatever the fuck you want."

I just wonder after some of these people. I wonder if having 300/400/500 1RMs with no pain (or reduced pain, if they had pre-existing conditions) is really so much worse than having 400+/500+/600+ 1RMs with a lot of pain (due to the training itself).

In a way, this reminds me of the cliche about the depressed billionaire who owns so much, but doesn't see it because there's still more of this world he doesn't own. He's "always poor." These people are "always weak." Sometimes I wonder if it's really just the gimmick for self-motivation that it appears to be on the surface, or if these people really believe, deep in their hearts, that something transcendent will happen once they can finally squat N + 5 pounds. Then they get to N + 5 and nothing magical happens, so it must be the next N + 5 pounds that's going to do it. On and on it goes.

[Jonathon Sullivan]

Several points here:

People who train for cometitive weightlifting/powerlifting/strongman etc are training at the elite level, where every additional kg of weight comes at a high price in time, work, and to some extent, injury. People who make the choice to pursue that level of training should understand that.

People in the general population who train are training in the novice and intermediate levels, with a few at "advanced" levels. While they are able to progress, they should. They will accumulate wear-and-tear, and an occasional injury....like everybody else who moves around and does stuff in the physical-temporal plane. I for one don't believe there's anything transcendent about an extra five pounds. I just believe it's better to hit my 8th decade with x sarcomeres rather than x-1 sarcomeres. And my default practical assumption is that if I'm not adding muscle or strength with progressive overload, I'm losing it. Keeping it exactly the same is a knife-edge balancing act that, in my opinion, just doesn't work over the long term.

It's not about how much weight you lift, or not wanting to be a pussy, or any of that. My self-worth does no comport with how much weight I can lift (if it did, I'd be in trouble; I started late and I'm not strong). It's not about getting another 5 lbs so you can finally reach nirvana.

It's about this: As you get older, you inevitably lose strength, function, and tissue. Inevitably. The idea is to bank as much of those things as you can when you're young, and to hang on to them as long as you can when you're old...because life sucks without them. And whether you're young and banking or old and saving, the way to go is progressive overload, because it's progressive overload that challenges the organism and forces it to mount an adaptation. It's really that simple. If you're 68 and you can deadlift 345, why wouldn't you shoot for 350? Really? Because, just as it's true that nothing magical happens when you add 5 lbs to a lift in a safe and rational progression, it's also true that nothing catastrophic happens, either.

Adaptation, dude. It's about adaptation.

[Karl Schudt]

Autoimmune arthritides include rheumatoid, lupus arthritis, and the like. They can be difficult to manage, and they suck.

My brother has some sort of autoimmune arthritis, perhaps brought on by childhood salmonella poisoning, and it does indeed suck. His wife is one of my trainees, and is doing splendidly. Big brother tried to go in the gym with her, and ended up hurting for three months, he says. I wish I could say he was just a big baby, but apparently he isn't.

[meshka7]

Dr. Sullivan, thank you for your informative reply. Thanks everyone else for raising some good points.

I think the points phynnboi has raised are all good points. I have been asking myself similar questions especially being very early in training (but unfortunately not very early in life).

It's really that simple. If you're 68 and you can deadlift 345, why wouldn't you shoot for 350? Really? Because, just as it's true that nothing magical happens when you add 5 lbs to a lift in a safe and rational progression, it's also true that nothing catastrophic happens, either.

Adaptation, dude. It's about adaptation.

But I think his original point is rather : can I reach 68 deadlifting 345 (or more) without being injured allover my body and having constant pain from all the heavy lifting I have done earlier in life?

If I understood you correctly, I think the answer is YES for most of the general population.

[MattJ.D.]

My father had Gout and Rheumatoid arthritis, that shit did not look like fun. When he would flare up he'd be in bed for days at a time unable to walk and barely sleep from the pain, he only in his 40s too at the time. I just thought I'd share that.

[Jonathon Sullivan]

But I think his original point is rather : can I reach 68 deadlifting 345 (or more) without being injured allover my body and having constant pain from all the heavy lifting I have done earlier in life?

If I understood you correctly, I think the answer is YES for most of the general population.

If you are talking about crippling, incapacitating pain, that is correct. If you are talking about pain and injury in general, then NO, the answer is not YES.

If you train, even for general fitness, even using barbells, which are incredibly safe, you will have pain. You will suffer minor injuries. If you are careless, stupid and/or unlukcy, you may suffer more serious injuries. If you train, you will have fascial strains and occasional muscle belly tears and facet tweaks and joint pain. You will be sore after volume workouts. And so on.

When you hit 68, you will be, to some extent, beat up.

Because you're 68. Who lives to be 68, and doesn't arrive a little beat up? Nobody I've ever met. The goal is to be 68, beat up, hurting, and strong.

I'm afraid my writings on this board may have given some the impression that I think barbell medicine is a panacea. It is not. It is a powerful physical tonic, to be sure, but not an existential one. Pain and death are our lot, guys. The only question is whether you face them standing up, with a sword in one hand and a wet pussy in the other, or flat on your back waiting for somebody to come wipe your ass for you.

Sorry. I'm in a mood today. But really.