People of any age can develop arthritis but the symptoms almost always include pain, stiffness, achiness, loss of movement, and decreased function that get progressively worse over time. The statistics on arthritis are staggering in their impact on individuals as well as the cost to society. Data from a 2007-2009 National Health Interview Survey (NHIS) estimated 50 million (22%) of adults have self-reported doctor-diagnosed arthritis and 21 million (9% of all adults) have arthritis and arthritis-attributable activity limitation. The annual cost of arthritis and related conditions, such as osteoarthritis, cost nearly $128 billion per year in medical and indirect expenses, including lost wages and productivity while the annual cost per person with osteoarthritis is $5700. Arthritis can prevent a person from doing normal activities such as opening a jar, writing, playing sports, typing, exercising and even enjoying their family. So what is osteoarthritis and what are the causes, and treatment options? Even more important, how do we change the crippling effects of osteoarthritis on both individuals and society?
First, Osteoarthritis (OA), or degenerative joint disease, is one of the oldest and most common types of Arthritis. It is characterized by the breakdown of the joint’s cartilage. Cartilage is the part of the joint that cushions the ends of bones. When cartilage breaks down, it causes bones to rub against each other causing pain, stiffness, and loss of movement. OA most commonly affects middle-aged and older people, but can occur in younger adults or even teenagers at times. The severity of OA may range from very mild to extremely severe and it most commonly affects weight-bearing joints such as the spine, knees, hips and feet, although the hands are also a common target.
While age is a significant risk factor to OA, research has shown that OA is not an inevitable part of aging. Obesity is a predisposing factor to OA of the knees, hips and spine but injuries from sports, work, and accidents are the most common cause. In particular, car accidents predispose injured parties to developing OA of the neck, especially if they don’t receive comprehensive examination and treatment. Genetics can also play a role in the development of OA, particularly in the hands. Some people may be born with defective cartilage, slight defects in the way that joints fit together or other abnormalities that cause altered biomechanics. As a person ages, these problems lead to early cartilage breakdown which gets progressively worse over time.
The symptoms of OA vary based upon the severity of the condition as well as the age, activity level, and overall health of each individual. The most common symptoms are pain, stiffness and achiness around a joint especially after periods of inactivity or excessive use. In the spine, the most common symptom is stiffness and achiness upon awakening that improves and usually goes away with activity, but often recurs, sometimes everyday. The problem is that the frequency and severity of the symptoms, or lack thereof, do not correlate with the progressive degeneration and tissue damage. This results in delayed diagnosis and treatment that ultimately limits treatment options. Waking up with back or neck pain from “sleeping wrong” or “no reason” is highly suggestive of OA. Sensations of grinding, grating or even popping with normal movements known as crepitus also suggest poor cartilage health and possible OA. Loss of motion can occur gradually over a long period of time, like difficulty looking over your shoulder when driving. Ultimately, bony growths develop at the affected margins of the joints and may cause deformity, particularly in the hands and feet. In severe cases, calcification of the joint may get so severe that motion is almost totally lost.
In the past, treatment focused on rest, pain medications including non-steroidal anti-inflammatory drugs (known as over-the-counter pain relievers) and ultimately joint replacement surgery, especially for the hips and knees in severe cases. Today, emphasis is placed on moderate exercise, proper nutrition, and prevention. We now know that smokers with OA have more severe joint pain and greater degradation of cartilage. Some studies support the value of chondroitin sulfate and glucosamine supplementation to support cartilage health. Proper hydration is also critical to maintaining healthy cartilage. Medical treatments typically include drugs to reduce pain and improve function although joint replacement surgery of the hips and knees is common if the pain and deterioration are severe. A commonly overlooked option is physical medicine treatments that maintain joint function, range of motion, flexibility and physical conditioning. In the spine, decompression traction is particularly effective for both relieving symptoms of pain and stiffness while simultaneously improving function and movement. Chiropractic manipulation is also beneficial because it helps restore joint and nerve function, promotes flexibility, and maintains the health of spinal joints and discs.
For osteoarthritis, chiropractic medicine services that provide relief and reduce the progression of the condition include:
- Traction (the gentle stretching or elongation of a joint by a machine) to open the joint space, enhance tissue health and improve function.
- Joint mobilization (the movement of a joint in a prescribed manner) to increase joint function and restore pain-free movement.
- Prescription of specific stretches and exercises to be performed at home.
- Specific nutritional supplements to promote healthy cartilage.
Benefits of Chiropractic Treatment for Arthritis
Patients should experience a progressive reduction in pain as well as a steady increase in strength, mobility, range of motion, and the ability to perform many tasks that were difficult or impossible before treatment. Since certain types of arthritis can compromise other functions of the body relating to the heart, lungs, blood flow, nervous system and the immune function, chiropractic evaluation and treatment in conjunction with concurrent medical management can serve as an excellent way to reduce the possibility that arthritis will cause deformity of one’s joints or compromise these other important body functions.
Many people deny their pain and accept it as a condition of life. They simply put up with it and “hope” it will go away. Even worse, excessive amounts of over-the-counter pain relievers or prescription arthritis medications are taken. These products can damage the liver, kidney, stomach or other vital organs and may even result in death. Chiropractic medicine provides a drug-free treatment that can not only reduce the pain and suffering from arthritis but often even slows down the progression of the condition! This results in better mobility, improved function, and a substantial elevation in the quality of life for patients with arthritis.