Osteoarthritis

Stiffness and pain in the joints was for centuries seen as a mark of mortality, one of the natural shocks of old age: just look at Leonardo da Vinci or Thomas Rowlandson’s caricatures of old people, with their crooked digits and knobbly joints. Since the 16th century, anatomists have been familiar with the basic structure of joints—bones capped with cartilage, connected by ligaments, and lubricated by synovial fluid—and the name they gave to the principal disorder of these joints is a classic example of plain English put into learned Greek: arthritis, literally joint inflammation. This simple term reflects a fairly straightforward clinical history, but it also evokes one of the hardest questions in medicine: how to deal with the intractable, quotidian misery of chronic pain?