CARTILAGE DISEASES: TOP REASONS WHY CARTILAGE WEAKENS

Medically Reviewed by Dr. Sony Sherpa (MBBS) - August 28, 2024

The cartilage is an important connective tissue in several parts of the body and bone joints that you cannot live without. It plays a significant role in providing support and facilitating smooth movement. However, certain factors could degenerate or damage the cartilage in your body to become a cartilage disease.

This article will discuss some common cartilage diseases in detail and explain why cartilage weakens.

Brief Overview of Cartilage

Several structures in the body make up a bony joint; the cartilage is one of them. Cartilage is just as important as the bones in joint function. It is also known as the articular cartilage and comprises flexible connective tissue that protects the ends of connected bones. It also serves as a cushion that allows for the smooth movement of bones without friction. However, it is not only found in the skeletal structures.

There are three types of cartilage in the body, namely elastic cartilage, hyaline cartilage and fibrocartilage, found in parts like the nose, spine, trachea and ears. The elastic kind is located in the ears and the nose. The hyaline cartilage is found between the ribs and windpipe, whereas the fibrocartilage is found between the vertebrae and bones of the pelvis and hips. All these cartilage types are prone to various disorders.

Cartilage Diseases

These encompass a range of conditions that affect the health and functionality of the cartilage. Many factors could cause cartilage diseases, ranging from genes to injuries and disease conditions. These result in inflammation, pain and limited joint movement. Some of the common cartilage diseases are discussed below:

Osteoarthritis

It is a common condition characterized by the gradual degradation of the cartilage covering bones in the joints, which exposes the bones, causing swelling, joint pain, stiffness and limiting mobility.

This degenerative condition typically occurs with old age. However, it can also be influenced by genetic factors, joint injury, obesity, and repetitive stress on the joints. While the condition commonly affects weight-bearing joints such as the knees, hips, and spine, osteoarthritis can also affect the hands, wrists, and other joints. Replacing the affected joint entirely is often the only solution to ensure this condition does not progress and cause permanent damage.

Chondromalacia

This condition affects the cartilage in the knee joint by softening it, which results in its deterioration. It is also known as "runner's knee". Overuse, improper alignment of the patella (kneecap), muscle imbalances, or direct trauma to the knee are some known causes of Chondromalacia. It presents with pain, swelling, and difficulty in flexing and extending the knee.

Achondroplasia

When the cartilage's chondrocytes (cells) stop proliferating, the epiphyseal plates of the long bones close to the joints become affected. Due to the kind of bones affected by this disease, it could impact bone growth and development, thereby causing a condition called Dwarfism.

Herniation

It is also known as intervertebral disc prolapse due to the rupturing of the cartilaginous disc between two vertebrae. Disc herniation occurs due to a crack in the cartilage's outer layer, which makes the inner part slip. This slip leads to herniation, making the central portion bulge and press against the nerves and soft tissue. It can occur at any level of the spine and presents with a sharp pain in the affected area which could also radiate to the peripheral regions due to dermatome involvement.

This condition is the leading cause of low back pain in most adults due to the tear. It can occur at any level of the spine and presents with a sharp pain in the affected area which could also radiate to the peripheral regions due to dermatome involvement. Heavy lifting and strenuous physical exercises are the leading causes.

Relapsing Polychondritis

This rare condition[3]  occurs due to inflammation and deterioration of the cartilage, especially in the nose, ears, voice box, windpipe, joints, heart valves, sinuses and rib cages. Its symptoms occur in episodes and include swelling, pain, and redness. It is commonly observed in the ears and is usually seen among people between the ages of 40 to 60.

Medications can treat relapsing Polychondritis; however, there could be life-threatening complications, such as kidney disease, heart murmurs and even blindness. It mostly leads to the individual having floppy ears. There is no known cause, nor is there any known cure.

Chondrosarcoma

These are cancerous or malignant bone tumors that affect the cartilage. The tumors produce a lot of cartilage, growing slowly and then spreading rapidly to other parts of the body to cause pathologies. While rare, it is more common in adults and could be genetic.

Chondroma

These non-cancerous or benign tumors develop in the cartilages of primarily small bones in the hands and feet. In rare situations, they also develop in long bones like the humerus, femur, and sometimes the ribs. Unlike Chondrosarcoma, they do not grow or spread, especially when the developing child’s bones have reached their full length and potential.

Chondroma could form either on the surface of the bone or in the bone marrow cavity. The common symptoms it presents are pain and unexplained bone fractures. There could also be swelling that is sometimes painless or a mass that can be palpated.

Top Reasons Why Cartilage Weakens

As explained above, cartilage is one component of the skeletal system in the body that is prone to weakness and degeneration or loss over time. It allows bones to glide over one another with reduced friction and without wearing out the ends of the bones. Joint swelling and stiffness are prone to occur if you have weakened cartilage.

Here are the top reasons why your cartilage could weaken over time:

Age

Based on findings and observations, most older persons have insufficient cartilage due to weakness and wearing out. However, depending on their genetic makeup, some might experience this while others do not. There is not much to do to reverse the body changes that come with old age. However, limiting exposure to toxic chemicals in the environment, sleeping better, and using supplements from an early age can be beneficial for cartilage health.

Adjusting your lifestyle to protect the cartilage is also a viable option to ensure it does not weaken or break down as soon as aging begins.

Overuse

This is most common in individuals who participate actively in sports or physical exercises. Due to the repetitive motions of the involved joints in performing most of these activities, there are chances of damaging the cartilage, tendons or ligaments involved. Overtraining or training the wrong way could also weaken the joint cartilage.

Obesity

Increased weight adds to the force exerted on the joints in the body. This could result in the structure's wear and tear, including cartilage. Being overweight is the leading cause of arthritis as there is an increased load on the weight-bearing joints such as the knee. Besides the mechanical effects of excess body fat, there is also a condition known as metabolic syndrome linked with obesity and diabetes, which affects the chemical structure of the cartilage.

There is also a hormone known as leptin which, when secreted excessively, affects the bones and cartilage. This can be resolved by a change in diet and nutrition, with sugar intake typically kept to the bare minimum and other supplements prescribed.

Joint Instability

Torn or overstretched ligaments could also cause joints to become unstable, which results in connected bones moving around a lot, thereby affecting the cartilage in the long run. The first sign of this is usually swelling and pain which could result in shifting or the bones popping from their sockets. Injections are mainly administered to reduce this instability, and surgery is carried out in cases of irreversible damage or tears.

Degeneration

One condition that mainly affects the joints in the body is osteoarthritis, which, when not managed well, could worsen over time as it wears down the cartilage. It mainly occurs in the hips, knees and hands.

Lack of Exercise

If joints are not moved as often as they should be, it could result in the cartilage becoming unhealthy. Cartilages depend on adequate physical activity to increase blood supply for their normal functioning and to remain healthy. It is recommended to participate in activities such as running and other low-impact exercises regularly.

Direct Trauma

An injury could also cause the cartilage to weaken. Blunt trauma caused by a road accident or bad fall, directly impacting a joint, can damage the cartilage. That said, sporting injuries are the primary cause of direct trauma affecting the cartilage.

In most cases, these impacts are almost insignificant, but over time, the cartilage involved wears out at an increased rate. Antioxidants usually help reverse the adverse effects of cartilage breakdown. Cell-based solutions could also be administered to help speed up the repair process.

Medications

The prolonged use of certain drugs like steroids and anesthetics can cause the cells present in cartilage to die. Over time, NSAIDs taken in excess to manage conditions such as arthritis could speed up the progression of cartilage breakdown.

If advised surgery, it is vital to consider the anesthetic to be administered and the drugs recommended for treatment in consultation with your surgeon.

Nutritional Deficit

Poor dietary habits, as well as lack of adequate or proper nutrition, can also cause weakness in the cartilage. Specific genes need proper nourishment to function well and help strengthen the cartilage. Therefore, optimal dietary intake is vital to supply these genes with the required nutrients. This can be easily corrected by consuming meals rich in vitamins and minerals.

Treatments for Cartilage Diseases

While most cartilage diseases are typically chronic and progressive, various treatment options are available to manage symptoms and slow their progression. These may include lifestyle modifications, such as weight management and exercise programs tailored to strengthen muscles around the affected joints.

Physical therapy, pain management techniques, and assistive devices may also be recommended. Surgical interventions such as joint replacement or cartilage repair procedures may be considered in more severe cases. There are medical treatment plans that have been designed to help restore the cartilage in the joints.

However, most interventions are targeted to help reduce the pain that comes with worn-out cartilage.

• Use of Nonsteroidal anti-inflammatory drugs (NSAIDs)
• Steroid injections
• Physical Therapy
• Exercise

A surgical approach to help treat these diseases is arthroscopy. This involves making tiny incisions close to the joint so that small instruments can be inserted to repair the surrounding tissue and damaged cartilage. It helps improve blood supply and promotes the growth of new cartilage. This procedure is commonly used for knee injuries but could also work for the shoulder and ankle joints. As the new cartilage forms, there will be reduced joint pain and mobility will be restored.

There are advancements in medical research that are leading to new innovative treatment approaches. Some examples include stem cell therapy, platelet-rich plasma (PRP) injections, and cartilage tissue engineering for cartilage regeneration and repair. Hopefully, implementing these will improve outcomes and provide long-term solutions.

Conclusion

In summary, Osteoarthritis, Chondromalacia, relapsing Polychondritis, and cartilaginous tumors can affect cartilage health and growth. They occur due to increased age, obesity, medications and even nutrient deficiency. If not managed properly, they can impact your quality of life.

Thus, it is important to look out for symptoms and seek available treatment options that are safe and effective. Furthermore, it is essential to safeguard your cartilage when exercising or engaging in sports.

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