Arthritis

We have all heard of arthritis, some of us may have even been told we have arthritis. But what is “Arthritis”. The word is derived is derived from the Greek words “arthron” for joint and “itis” for inflammation. Common symptoms include: tenderness, pain, swelling, and joint stiffness.  Most forms of arthritis can occur in any joint, including spine joints. There are many different forms of arthritis, in each one the inflammation is due to a different cause. Sometimes it is due to an auto-immune problems (where the body attacks itself) and not only affects the joints but other parts or tissues of the body. However, Osteoarthritis is the commonest form.

In osteoarthritis  the cartilage around the joint wears out, causing the bones in the joint to rub together, creating inflammation and pain. It occurs commonly in joints  under excessive load or stress. Hence knees and hips and certain parts of the spine that are under extra stress. Sometimes, there has been an injury to the joint many years prior to the symptoms developing, such as a sporting injury or car accident with whiplash injury. More commonly, the joint damage is the result of accumulative loading and stress due to work or sporting activities.

When Osteoarthritis occurs in the spine it is referred to as spondylosis.

If you suffer any of the following  Symptoms you may have Osteoarthritis:

  • Back and/or neck stiffness and pain tends to be worse in the morning (particularly for about 30 minutes after waking up), often called “first movement pain.”
  • The pain will usually subside to a more tolerable level over the course of the day as you become more active.
  • Pain and stiffness tends to get worse again in the evening.
  • Pain that disrupts sleep is often an indicator of osteoarthritis.
  • Swelling and warmth in one or more joints, particularly during weather changes (which may be related to barometric pressure changes and cooling of the air).
  • Localized tenderness when the joint or affected area of the spine is pressed on.
  • Steady or intermittent pain in a joint, which is often described as an aching type of pain. The pain may be aggravated by motion.
  • Loss of flexibility of a joint, such as inability to bend and pick something off the floor.
  • A crunching feeling or sound of bone rubbing on bone when the joint is moved (called crepitus), particularly notable in the neck.

Treatment

Your GP may have prescribed NSAIDs for the management of osteoarthritis. However, recent concerns regarding the use of NSAIDs, due to possible side-effects on joints, the gastrointestinal tract, kidneys and liver have lead to a preference for a more conservative natural treatment approach. The use of NSAIDs should be limited to the treatment of gross inflammation and analgesics should only be used in the short-term when absolutely necessary for pain palliation. Treatment options that have shown beneficial in offering relief (Arthritis can not be cured) without the side-effects of NSAIDs include (1,2,3)

  • Chiropractic manipulation in spinal OA
  • Low-level (cold) laser therapy (LLLT) (via an analgesic effect as well as a biomodulatory effect on microcirculation) in knee OA
  • Glucosamine sulfate supplementation
  • Specific stretches and exercises to maintain joint function.
  • Yoga
  • Chiropractic manual flexion/distraction therapy
  • Heat therapy when combined with Chiropractic is more effective than heat alone for treating OA-based lower back pain.
  • Use of nutritional supplements and diet modification to reduce the level of general inflammation in the body
  • Weight loss to reduce the loading on joints
  • Lifestyle modifications including ergonomic improvements at home and in the workplace, and reviewing the types and frequency of physical activity

 

 References

  1. Gottlieb, M.S., 1997. Conservative management of spinal osteoarthritis with glucosamine sulfate and chiropractic treatment. Journal of manipulative and physiological therapeutics20(6), pp.400-414.
  2. Beyerman, K.L., Palmerino, M.B., Zohn, L.E., Kane, G.M. and Foster, K.A., 2006. Efficacy of treating low back pain and dysfunction secondary to osteoarthritis: chiropractic care compared with moist heat alone. Journal of manipulative and physiological therapeutics29(2), pp.107-114.
  3. Hegedűs, B., Viharos, L., Gervain, M. and Gálfi, M., 2009. The effect of low-level laser in knee osteoarthritis: a double-blind, randomized, placebo-controlled trial. Photomedicine and laser surgery27(4), pp.577-584.