Joint Pain and Inflammation with Mast Cell Activation Disease (MCAD)

Everyone deals with joint inflammation at some point and most certainly it is fairly common knowledge that heat causes it to increase and cold can cause it to decrease, or stabilize.

So many times it just happens. All of a sudden a joint doesn’t work as it should. Yesterday it was my left hip. Sudden pain, can’t really move my leg while trying to pick up sour cherries off the ground. Usually this behaviour is equivalent to a deadlift or squat one would perform in the gym and it was very likely directly and indirectly related to “leg day” the previous Saturday. Third day following is usually the day when the muscles are sore and tight. Inflammation in the joint is the cause, but it is not because I have injured myself in this case.

It is just what happens to me and something I have to be careful of. It can spring up in any joint any time. Last time it was my right knee. But I am careful to monitor my body and especially my joints as I follow my post workout rest routine. And although this can occur to anyone; it is much more common in my body and those like me with Mast Cell Activation Disease (MCAD).

Irritation of some sort; heat alone or in concert with irritation or injury cause inflammation. Exercise causes inflammation and is one reason why we need recovery.  Cardio work with repetitive motion is an obvious cause we deal with. The building of muscle through strength training intentionally injures muscle so it is rebuilt stronger. Joints involved in every case do experience overheating and irritation during exercise and daily life.

Mostly it is unnoticeable until there is an injury or soreness, pain. For me it can just spring up anywhere. What is fine one day can suddenly be painful, with or without getting swollen, then be gone again shortly afterwards. There is no doubt that the running of my dogs and the exercise I do in the gym pushes this on me. But there are other significant factors in my case.

My understanding of the uniqueness that is me has enabled me to become fit through regular physical exercise now despite the fact that it has disabled me repeatedly in my past. Unlike most people, my mast cells are anything but normal. Mast cells are the cells throughout the body that detect injury and respond to repair it; referred to as the innate immune system.

If you bang your knee, the bruise is triggered by mast cells. If you cut yourself, the pink that begins to show is from mast cells responding, they gather at the site of the injury and dump granules filled with chemicals that signal the immune system to repair the damage. This is the inflammatory process. In my case those mast cells over react to everything that stimulates this process.

Normal activities, even non strenuous activity can and does stimulate them to respond. They over react in my body and degranulation is excessive causing many things to occur. Some part of this reaction impact systems throughout my body through Histamine receptors of a variety of types. H1 receptors in skin and cardiovascular systems, H2 receptors in the GI tract, H3 receptors in the Central Nervous System and H4 receptors in Mast Cells, which unfortunately act to stimulate and amplify the over reaction.

In addition to Histamine there are a number of other chemicals involved in the degranulation that impact a variety of structures and functions. This is not well understood for the most part, but it does lead to what has been referred to as food sensitivities.  However; they are not sensitivities! They are allergic reactions stimulating degranulation and the immune system inflammatory response, without the mediator, Immunoglobulin E, which most Doctors consider necessary. They are wrong!

Things I am allergic to; both IgE allergies like grass that is currently the culprit, and non-IgE allergies like cherries and nightshades plants, cause a spike in the reaction of my mast cells which results in a highly amplified level of degranulation and a cascade of responses to occur throughout my body through all types of Histamine receptors. This has meant many unusual and unexplained symptoms I have mentioned to my doctor previously, but have generally been ignored until this past year.

Now that these allergies are under some control thanks to my newfound awareness; it has enabled me to see the result of combining them with the excess body heat I create during exercise. Not that I have intentionally done so, but the grass grows and I cannot stop breathing the pollen as of yet; although I do have masks and can filter some of it as it is creating a massive one-two punch in the effects of my mast cell over activation and degranulation.

Histamine release and mast cell degranulation occur with increases in body heat in everyone. But once again this is massively amplified in my body. Exercise causes it and I have to be careful to manage it. I control how much I exercise, how long, how much weight I push, how long I run, even how big the muscles are that are doing the work all influence how much heat I produce and the degree to which my mast cells degranulate. I have begun to understand this process and how it impacts me.

Now the combination of the two, excess heat and an allergic reaction, produces even more spectacular changes that most do not have the pleasure of experiencing.  In my case it causes sudden and unexpected joint pain for one. I can’t work through it at all. This will, and certainly has in the past, result in injury and permanent failure. No, I don’t push through it. I manage it; I stop working and often utilize one of the many ice packs at my disposal.

And if I do manage it and wait and rest, it will disappear as quick as it came about and I will be back in action once again. If I push through it; the problem gets worse and I break!

But it is the combination of my over active mast cells, my allergic response of those cells to something I have breathed in or eaten (or absorbed) and the increased degranulation and inflammation that results from exercise that combine to throw my body over the edge without what would seem to be any corresponding event to cause the sudden pain and mobility issue I might experience in one of my joints, when there were no signs previously.

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