By Carl Green 

 

In this 8th edition of my musculoskeletal series, I will be summarising and simplifying a number of commonly used terms associated with ageing and inflammatory issues (please note that many other commonly used terms have been covered in my other posts). 

In healthcare and medicine there are lots of terms, and many can sound more serious than they are. Terminology can be useful in clarifying and differentiating types of problems for clinicians, but unfortunately can also lead to confusion, misinterpretations, and anxiety in those less familiar or not considering the bigger picture. This is one of the main reasons I started this series on types of musculoskeletal pathology, as myself and the team at Colchester Physio and Sports Injury Clinic want you to feel more knowledgeable and confident. 

 

Degenerative changes or diseases refers to ageing and restructuring processes that lead to bodily tissue changes. In the vast majority of cases degenerative conditions are a normal part of the ageing process and can often cause no significant symptoms despite tissue changes. However, people can experience flare ups in pain, stiffness, tightness or weakness due to genetics, injuries, suboptimal lifestyles with either over or under loading, reduced fitness, or an interaction with other diseases. 

People often ask us about ageing and its effect on muscle strength. The ability to use our muscles to move and lift relies on the strength of the muscle tissue itself, and also the ability of the nervous system to recruit and contract that muscle tissue effectively. 

 

As we age, there are gradual changes to the nervous system that make it less efficient at transmitting signals. This affects our ability to sense changes in our environment or body position, hearing and eyesight function is often reduced, muscle fibre activation or recruitment is slowed down. Such changes can cause difficulties with coordination, balance, learning, energy levels, and completing both physical and mental tasks. 

 

Our muscles also change in structure over time (and), muscle fibres slowly decrease in size, (and) connective and fatty tissue increases, making muscles less capable of producing or withstanding higher forces. 

 

The good news is that these normal age related changes often happen gradually over decades, and can be minimised or at least slowed down through maintaining a routine of regular progressive and challenging exercise (particularly “proper” strength training through moving heavy things, several times to fatigue, with appropriate recovery time). 

 

Inflammatory conditions (not associated with ageing) that directly affect muscles and nerves are uncommon and often caused by various neurological conditions or infections. 

Please see my last post on tendinopathies and bursitis if you have not already, as this provides lots of information including degenerative changes. In short, “bursitis” is inflammation of the bursa (fluid filled sack between soft tissues), and “Tendinitis” is inflammation of the tendon. Other inflammatory terms include “enthesitis” which related to the attachment sites of both tendons and ligaments into the outer casing of bone (periosteum), and “discitis” of vertebral discs (connective tissue between spinal vertebrae). Inflammation of all of these structures is often caused through overloading the structures via too much compressive/pressure or elongation/stretching stresses. 

 

In regard to joint cartilage, two of the most common terms are “osteoarthritis” and “rheumatoid arthritis”, and they are often confused with one another despite being quite different. 

 

In medical language “osteo” refers to bone, “arthro” refers to joints, and “itis” refers to inflammation. So, when we put these words together “osteoarthritis” could be crudely translated to bone and joint inflammation. The main anatomical change in those with osteoarthritis is thinning and degeneration of the articular cartilage, the smooth connective tissues found within our joints that line the ends of our bones (you may also be interested in my previous post on cartilage tears). Spondylitis is inflammation of the spinal facet joint (at the back of the spine that joins one vertebrae to another) and can sometimes be used to describe a feature of osteoarthritis or spinal rheumatic conditions such as “ankylosing spondylitis”. 

 

Rheumatoid arthritis or “Rheumatism” are commonly used terms by the general public and health professionals. However these terms should not be confused with osteoarthritis or age related degenerative changes, but instead are umbrella terms for various auto-immune conditions. In most rheumatoid conditions the body incorrectly targets its own tissues with antibodies that try to break them down, causing inflammation and potentially tissue damage and deformity, if not well controlled. 

If you have any questions or are interested in our support, please get in touch with us at Colchester Physiotherapy and Sports Injuries Clinic, and myself (Carl Green) or my physiotherapist colleagues Craig Fowlie or Jane Marr will do all we can to help you. 

 

Also, please get in touch if you have seen this and would like us to cover other topics or questions in future posts. 

 

The next instalment in this musculoskeletal conditions series will be on “deconditioning and obesity”, check back in for that or follow us on social media to see when it is published.