Framingham Strikes Again: No Association between Inflammation and Arthritis
Wow, this is a medical stunner that went largely unnoticed by the media this week. The Framingham study group published another game changer awhile back showing that meniscus tears in middle aged and elderly patients were simply a fact of aging and not a hallmark of something that produces knee pain. Now this week they dropped another bomb-serum markers for inflammation aren’t at all correlated with osteoarthritis in the joints! This is a bit like saying that despite there being a forest fire, it doesn’t damage the individual trees in the forest. Measuring body wide inflammation has been a real focus of heart risk of late and this group is primarily focused on cardiac issues, so it’s not surprising they had extensive blood work on lots of patients. The most common of these blood tests for inflammation is CRP or C-reactive protein, which is elevated when there’s inflammation or swelling in the body. Because chronic inflammation has been linked to clogged arteries, measuring CRP and it’s serum marker cousins is all the rage right now.
Now that this bomb has been dropped, the folks who study how we get arthritis will have to go back to their drawing boards. We do know that blood sugar control issues like those found in Metabolic Syndrome (obesity, high blood pressure, and pre-diabetes) have a direct correlation with poor cartilage health. We also know that small biomechanical changes like a short leg over time can be correlated with knee arthritis. The local chemical environment in the joint is very important-meaning that there are some joints with bad chemicals that can help break down cartilage. Finally, we think we know that long standing spinal nerve issues (like a disc bulge pressing on a nerve aka “sciatica”) may be linked with knee arthritis. The upshot? When your doctor tells you to get your inflammation down because your C-reactive protein (CRP) is too high, it may be good for your heart, but getting it under control is unlikely to help your arthritis!