For decades, joint disease—particularly osteoarthritis—was viewed as a simple consequence of wear and tear. Emerging research now shows that this explanation is incomplete. Joint health is deeply influenced by metabolic and inflammatory processes occurring within the body.

The human body hosts trillions of microbes that play a critical role in regulating immunity, inflammation, and metabolism. When this microbial balance is disrupted, chronic low-grade inflammation can develop. Evidence suggests that imbalances in the gut and joint microbiomes may contribute to cartilage breakdown, pain, and the progression of joint disease.

Key contributors to joint inflammation include metabolic dysfunction, immune responses to microbial signals, and disturbances in the gut–joint microbial axis. This evolving understanding shifts the focus of joint disease beyond visible structural changes and imaging findings toward the underlying biological processes driving inflammation.

Recognising these pathways enables earlier prevention, more accurate diagnosis, and targeted treatment strategies. Joint disease is no longer seen as merely mechanical degeneration, but as a condition shaped by the body’s internal metabolic and inflammatory ecosystems working together.