The winter season is supposed to be the time when we feel the aches and pains in our joints more and we start to get arthritis.

That's probably not strictly true. In fact, doctors see roughly similar numbers of people with both main types of arthritis - osteo and rheumatoid - all the year round. There isn't a true "arthritis season". Maybe we just feel our joint troubles more in winter because cold muscles get stiff, and that makes us less confident moving around if we can't trust our joints.

Thankfully, arthritis research has come a long way in recent years. We know that osteoarthritis, for example, isn't just a matter of "wear and tear". It does affect the weight-bearing joints, the spine, hips, knees and ankles, and it is worse if you are overweight.

But there's now evidence that it is inherited, and that the fault lies in the cartilage that normally acts as a shock absorber between the bones inside a joint. If the cartilage isn't strong enough and pliable enough, it can tear and disintegrate - and that leaves the bones to rub against each other. They can't take the strain, and begin to wear away. That leads to the well known pain and stiffness.

In the past, all we could do to ease osteoarthritis was to give painkillers, advise rest for the affected joint, and help sufferers to lose any excess weight. It wasn't good enough.

Now we can replace most osteoarthritic joints - and that has been a huge advance. But surgery has its price. Joint replacement is very expensive and far more people need new joints than surgical teams can possibly cope with.

What are needed are new ways to tackle early osteoarthritis so that it never comes to the stage of needing surgery.

That's where the new research comes in. Scientists are perfecting ways of growing sheets of new cartilage that will be put into arthritic joints to replace worn out or damaged cartilage.

Like replacing a shock absorber in a car, it should give the "owner" a better and smoother "ride". And much less pain, as the bones no longer grind against each other.

New cartilage technology is still in its infancy, but it's one we will surely see early in the next century. That's because the substances needed to grow cartilage in the laboratory are already known. It's a relatively short step from that knowledge to making it work in practice.

There's similar good news on the rheumatoid arthritis front. In this crippling disease, the whole of the lining of the inside of the joint is inflamed. The joints are hot and swollen and very painful. Osteoarthritis is generally an older person's disease, but rheumatoid strikes at any age - even in children.

Until the last year or so, all we have had to help this type of arthritis have been anti-inflammatory drugs such as aspirin or its cousins the "non-steroidal anti-inflammatory drugs" (NSAIDs), like ibuprofen or naproxen. More severe cases are treated with so-called "disease modifiers" such as gold injections, antimalarials, and drugs normally used to ward off transplant rejection.

We didn't really know how the disease modifiers worked, but most people with rheumatoid arthritis react well to them. They ease the pain, reduce the swelling, and help people to move again. Now, they can look forward to even better drugs to come.

The first are likely to be "TNF-alpha blockers". TNF-alpha (the letters stand for tumour necrosis factor) has been identified as the substance released into the joints that causes the inflammation and destruction. If you can stop its release you stop the inflammation and ease the symptoms.

The first trials of a TNF-alpha blocker in people led to three-quarters of them reporting dramatic improvement. There's one snag. TNF-alpha is also part of our natural fighting response to cancer and infection, so the researchers must be very certain that we do not swap one disease for another by blocking it. Preliminary results suggest that it is safe so far, but it may take several years before we are sure enough to prescribe TNF-alpha blockers generally.

My bet is that it won't be long before a safe drug, similar in chemistry to a TNF-alpha blocker, but that won't interfere with the natural protection against cancer and infection, will be made. And that will be a huge advance, on a par with the invention of penicillin.

Converted for the new archive on 30 June 2000. Some images and formatting may have been lost in the conversion.