EVEN DINOSAURS AND cave bears had osteoarthritis. No sooner had skeletons evolved than the joints of animals began to show the signs of wear and tear as they aged.

There are many different factors that will hasten the development of osteoarthritis. Excessive or abnormal wear will increase the likelihood of the condition — and help to determine the age at which it causes symptoms. A patient’s lifestyle is all-important, as is his/her occupation: mining, farm work and any form of heavy manual labour are associated with early osteoarthritis.

Congenital abnormalities of the bones and joints, diseases that cause inflammation in the joints, such as gout and rheumatoid arthritis, and repeated injuries — whether acquired in the pursuit of earning a living or from playing sports — all predispose to early osteoarthritis. Weight is also a factor — perhaps surprisingly, obesity causes more damage to the knees than the hips.

A new hazard to those with dodgy joints has now been discovered. Research published in Arthritis Care and Research and in the journal General Practitioner reports that rheumatologists at the University of California have shown that patients with angina, in particular women, whose condition is treated with nitrates are twice as likely to develop osteoarthritis of the hip as those who have used other drugs to keep their chest pain at bay.

It would be interesting to find out whether anti-impotence pills such as Viagra had any similar effect, as they work on a similar principle to nitrates.

Fortunately Viagra is likely to be taken less regularly than nitrates, and in any case the assumption must be that the average man who relies on Viagra for his sexual prowess would be prepared to risk slight morning stiffness and hip pain as a reasonable price for a return of youthful potency. Elated by his new-found vitality, it wouldn’t even cross his mind that the most common reason for a long- established couple giving up sex is not impotence but arthritic joints.

The journal General Practitioner makes the suggestion that patients taking nitrates could make an attempt to prevent any increase in the rate of the breakdown of the cartilage and therefore an increased risk of developing osteoarthritis by taking more omega-3 in their diet. Fish oil is the easiest means of increasing the amount of omega-3 in the diet. This would have widespread advantages to the ageing patient.

It is already known that fish oil protects against both osteoarthritis and coronary heart disease, so two degenerative diseases would be treated for the price of one if patients had their twice-weekly meals of oily fish. It would be even less trouble for those who have problems with cooking fish if they took daily fish-oil capsules.

Fish oil is also thought to have beneficial effects on intellectual ability during middle age and beyond — it may prevent, or delay, the onset of Alzheimer’s.

A recent study from the Netherlands has shown that a higher intake of fatty fish and fish-derived omega 3 was associated with a reduced risk of losing intellectual sharpness in a middle-aged population.

Additional confirmation of the value of cod liver oil in helping to alleviate the symptoms of osteoarthritis has been provided this week by Professor Bruce Caterson and Professor John Harwood of Cardiff University, and Professor John Dent of the University of Wales. Caterson’s work supplements his research published a couple of years ago, which he summarised by suggesting that “cod liver oil, which contains omega 3 fatty acids, can be beneficial in arthritic diseases. In simple terms, we have been able to show that we can slow down or remove the activities of the enzymes that destroy the cartilage in the joints and cause arthritis, thus reducing inflammation”.

At the time, Caterson suggested that taking cod liver oil would stave off the need for surgical joint replacement, and the latest research reinforces this belief.

With two capsules a day containing 1,000mg of cod liver oil, nearly 90 per cent of the arthritic patients were shown to have a reduced level of the enzymes that produce the changes which affect, to varying degrees, everyone in adult life.

Older patients always have sworn by their cod liver, or fish, oil as a means of easing their arthritic joints and despite the cynicism of some doctors, it seems they were right.