Friday, November 10, 2017

Fluid in the Joint

  In the soft tissues and cartilage of the joints, very fine ー almost single strand ー nerves have recently been demonstrated. This indicates that a direct connection between the joint and the nervous system does exist. When the cartilage of the joint cannot get its water and food supply from the bone circulation, the arterial circulation to the joint covering and capsule will begin to dilate (see Fig. 29, post under Joint Cartilage and Bone Circulation)  and have fluid available for its pumping and vacuum suction into the joint when the joint begins to move. There is another masterly design of nature in this process, which is commonly labeled as the sterile inflammation of the joints (sterile means non-infectious). Since the circulation of the joint surfaces is sluggish and yet the cartilage calls are living tissue and in need of oxygen, nature has devised an oxygen manufacturing system in some of the inflammatory cells.  This local oxygen manufacturing capability has two purposes. Firstly, it acts as an antiseptic against bacteria and, secondly, it provides oxygen for the cells that are floating about or are lodged within the cartilage pads. This is an emergency oxygen supply system to the isolated area of the joint space. The fluid in the joint should not be removed, unless bleeding is suspected. if the fluid is clear, it should be left alone in the joint.  Joints that have had their fluid removed ( particularly knee joints) do not repair as quickly as joints that are allowed to retain their fluid.

Equally important is the intelligent restriction in the use of anti-inflammatory medications, particularly those that tamper with the local oxygen manufacturing capability of the inflammatory cells. 

  Most initial joint pains disappear after some movement; the natural vacuum created by the movement of the joint may be the mechanism for joint hydration from the vessels in the soft issue joint covering. However, for the act of dilation and shunting of circulation, the agents involved also produce pain. The pain signal indicates three points:
• one,  that the area or the joint is dehydrated and does not get its fluid requirements from its bone route of supple;

• two, that the shunting system to bring water and food to the joint is in operation;

• three, that the joint should not be used until full hydration of the joint has taken place and the joint cartilage, which has a high wear-and-tear rate, can be repaired from its base. This latter cardinal point should be taken seriously. 

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