Degeneration of the tissues
During everyday activity the body is subjected to varying degrees of mechanical stress. Although one of the greatest aspects of the body is its ability to repair itself it does often undergo some mechanical ‘wear and tear’. It is in those parts of the body which move most, such as the joints, tendons and ligaments; or those areas which suffer a lot of local pressure such as the feet, which are most severely affected. This excessive ‘wear and tear’ leads to degeneration of the tissues in the affected areas.
Degenerative processes within the musculo-skeletal tissues of the body are common, and are generally painful. As a result these ‘wear and tear’ conditions are a major cause for suffering and incapacity throughout the world.
While some of the degenerative processes in these tissues are associated with an obvious injury or inflammation, most would seem to arise by themselves with no associated factors, However, close observation will often reveal that they are, in fact, associated with subtle mechanical imbalances which affect the region.
External pressure is exerted on the skeleton through the skin. If excessive, the skin reacts by becoming harder and stiffer and gives rise to a ‘callosity’.. In some instances the underlying bone will also react and become inflammed and swollen, giving rise to what is termed a ‘hyperostosis‘.
The two cartilaginous surfaces of a synovial joint are smooth and slide across each other almost without friction. Degeneration of the cartilage leads to its breakdown and loss. This, in turn, detrimentally affects the ability of the joint to move and, in combination with the inflammatory products produced by the degenerating cartilage, leads to arthritis of the joint.
Tendons transmit the pull of the muscles onto the bone and are responsible for the movement of the joints. They normally move along smooth, synovial lined tunnels which direct their line of action. Excessive, abnormal stress on a tendon results in tendonitis and causes it to swell. The normally smooth lining over both the tendon and its sheath is lost and replaced by a shaggy, fibrous membrane. This markedly hinders the normal gliding of the tendon. Sometimes the blood supply within the substance of the tendon itself becomes compromised. In this instance the tendon can rupture suddenly.
Excessive pull on a tendon can cause a reaction where it enters into a bone. The site then becomes swollen and inflammed. The inflammation at this site is called an ‘enthesitis‘.
Special small sacs are associated with the tendons and ligaments around the joints to assist them sliding and gliding over one another. These ‘bursae’ are normally flat and contain only a very small quantity of lubricating fluid. For various reasons they can become inflamed giving rise to a bursitis. This frequently causes them to secrete excessive amounts of fluid and to become swollen. When this occurs a cyst is formed. This is a relatively frequent occurrence about the wrist and the knee, although they can occur in any area.
Degeneration within the spine begins with degeneration of one or more of the intervertebral discs, which causes them to lose water. Water makes up a large proportion of normal intervertebral discs in the spine. Special large molecules within the substance of the disc absorb and hold the fluid on their surface. As a disc degenerates it fragments and loses the ability to retain the water. As a result the disc shrinks and may lose its attachment to the vertebrae above and below. With the loss of disc pressure the vertebrae can become unstable in their movements which causes a chain reaction of degeneration of the joints and ligaments within the spine. This condition of degeneration of the intervertebral disc is termed ‘spondylitis‘ or, if it is accompanied by hypertrophy of the ligamentum flavum and arthritis of the facet joints it is often termed ‘spondylosis’. Degeneration in the spine can take place at any level, although the most common areas are in the middle of the cervical spine and the lower lumbar spine.