This article gives this elegantly simple answer: “The problem starts when, for reasons no one fully understands, a few misguided T-cells incite other immune system cells called macrophages to attack the joints.”
Those so-called “misguided T-cells” are actually what are known as memory T-cells. In the arthritic process (whether rheumatoid, osteo, or other) these memory T-cells develop an internal program, just like some sort of computer,, which commands macrophage cells to attack and destroy cartilage. This destructive process results in the inflammation of the joints that is so typical in people afflicted with the disease.
The inflammation, in turn, affects the nerves and that’s what usually causes the associated pain. The inflammation may also push some bones out of place resulting in the disfigurement that is so typically found in arthritic joints.
Unfortunately, those memory T-cells never give up. It seems their malfunctioning programs go on forever. Moreover, they clone themselves, generating more and more misprogrammed
T-cells that direct more and more attacks against your cartilage. That’s why, as time passes, arthritis only gets worse, virtually never gets better.
But how does it all start? No one is absolutely certain, but probably it’s because some macrophages discover some particles of diseased or damaged cartilage that needs to be disposed of. Macrophages are like garbage collectors inside your body. Their job is to get rid of any foreign matter and organisms they encounter. They destroy invading organisms like viruses and bacteria, and they clean up waste matter as well. That includes any fragments of unhealthy cartilage damaged by some physical trauma or produced by some invading organism like that which causes rheumatic fever – or maybe even the flu. (Remember those achy feelings in your joints when you had a serious bout with the flu?).
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