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What is Arthritis?
Arthritis is a general term that means “inflammation of the joints.” It is used to describe many different joint related conditions which are related to joint pain, stiffness and swelling.
The most common form of arthritis is osteoarthritis which is also called degenerative joint disease (DJD). Osteoarthritis describes various changes that occur to the joints with age including cartilage breakdown, joint space narrowing and bone spurs. It is more common to develop osteoarthritis in older age but can occur in younger individuals if they have had previous injuries or surgery.
Other forms of arthritis include: rheumatoid arthritis, gout, septic arthritis, ankylosing spondylitis (AS), enteropathic spondylitis (ES), psoriatic arthritis and juvenile idiopathic arthritis. These conditions are not caused by the aging process but are typically related to genetics, autoimmune conditions & systemic inflammation in the body.
Within each joint is smooth connective tissue called articular cartilage. Cartilage covers the ends of the bones, which come into contact with one another to form a joint. This cartilage acts as a shock absorber, allows for smooth movement, and produces fluid which lubricates and nourishes the joints.
Osteoarthritis is a degenerative process in which the cartilage in the joint becomes progressively thinner. When the cartilage thins, the space between the two bones may also decrease, leading to joint space narrowing. Bone spurs (osteophytes) may also form along the joint margins and can irritate nearby soft-tissues and nerves.
The capsule, which surrounds and holds the joints together may become thick, inflamed and less elastic over time. All of the above changes can lead to morning stiffness, impaired movement, pain and swelling in the joints. Any joint in the body can be subject to osteoarthritis but the spine (cervical and lumbar) hip and knee joints are the most commonly affected.
Impaired mobility/decreased range of motion.
Reduced muscle strength.
Pain and swelling.
Clicking, catching or grinding in the joints.
Morning stiffness lasting 30 minutes or less.
Joint instability or buckling (later stages).
Prolonged walking or standing.
Transitioning from sit to stand.
High impact activities (running, jumping).
What causes Arthritis?
Osteoarthritis is typically a non-traumatic, slow process that occurs with age. Excessive weight, trauma and surgery will accelerate the process of joint degeneration as well. Osteoarthritis has commonly been thought to occur due to “wear and tear” on the joints over time. X-rays of osteoarthritic joints may demonstrate bone spurs, joint space narrowing and other signs of this “wear and tear” process. A common notion about osteoarthritis is that a person has put too much stress on their joints over time which has lead to development of arthritis. When terms like “degeneration”, “breakdown”, and “destruction” are used to describe the process of osteoarthritis, we immediately attribute it to physical stressors or activities that we have done in our younger years (i.e.: our occupations or sports we have played).
Over time, excessive demand on any joint in the body can cause some degree of degeneration but a joint will see degeneration due to a lack of movement as well. Most people’s jobs, activities, and exercises rarely force them to utilize their joints through their full range of motion. This lack of movement leads to a decrease in joint mobility (stiffness), joint irritation and or muscle tension over time. If proper motion is not restored, the process of irreversible, degenerative change can occur much more quickly. Lack of movement leads to decreased blood flow to our tissues and joints and there and less nourishing synovial fluid around our joints. The joints will be depleted of oxygen and nutrients, which causes the cartilage to break down more quickly. In this sense, movement is medicine since it directly affects the health of the joint.
Unfortunately running, walking or even playing sports will not necessarily improve the health of the joints. They are great activities for our cardiovascular health and will improve blood flow however they do not require movement of the joints through their full range of motion. This is what is required for optimal joint health and must be achieved through specific exercises given to you by your chiropractor.
Osteoarthritis is not considered an inflammatory type of arthritis like rhematoid arhtirtis but there is a level of inflammation that occurs with osteoarhtritis as well. For this reason a goal of arthritis treatment and prvention should be to control inflammation in the body. If we have systemic inflammation due to poor gut health or other autoimmune or inflammatory conditions we may be more likely to develop osteoarthritis. Excessive fat stores in the body can even produce a type of “angry” inflammatory fat which has been shown in recent research to directly attack the joints in the body!
Typically an osteoarthritis diagnosis is made based on x-ray findings combined with clinical symptoms and examination findings. In many cases the extent of arthritic change does not correlate well with pain intensity. It’s important to understand that your symptoms, function & goals are much more important than the image when treating and managing arthritis. At the Mountain Health & Performance North Vancouver Chiropractor clinic we will make a diagnosis based on your clinical history, examination and x-ray findings.
Arthritis Pain Treatment and Management:
At Mountain Health and Performance North Vancouver chiropractor clinic we utilize various therapies along with education & nutrition to help our patients manage arthritis pain and improve function. Various studies have found that manual therapy has a beneficial effect on arthritis pain and joint function in the short and long term. Studies have also shown that manual therapy in addition to exercise produces better improvements in pain and function vs. exercise alone. At Mountain Health and Performance we recognize the importance of hands-on therapies, modalities, exercise and nutrition when treating all musculoskeletal conditions, including arthritis. Therapies may include:
Joint Manipulation and Mobilization for Arthritis Pain:
At Mountain Health & Performance North Vancouver chiropractor clinic we use joint manipulation to improve joint mobility, decrease pain and decreases muscle tension for the treatment of osteoarthritis.
Myofascial Release Therapy for Arthritis Pain:
At Mountain Health & Performance North Vancouver chiropractor clinic we use Active Release Technique (ART), Functional Release (FR), & massage. These soft-tissue techniques will help to decrease soft-tissue tension around the joints that may be preventing full range of movement. When we decrease the tension around our joints we can move our joints through a greater range of motion and maintain better joint health with the proper exercises.
Laser Therapy for Arthritis Pain:
At Mountain Health & Performance North Vancouver chiropractor clinic we use laser therapy in the treatment of arthritis. Laser therapy is a non-invasive modality, which has few associated risks or contraindications. Research in humans & rodents has found that laser may have a positive effect on pain and function for osteoarthritis. Some studies have found that patient’s experienced an increase in local blood flow, decreased swelling, and an overall self-reported decrease in pain following a trial of laser therapy.
Weight Loss for Arthritis Pain:
If your BMI puts you in the overweight or obese category, loosing weight can have a positive impact on your overall pain and disability. Decreasing fat stores can also decrease inflammation in the body which may be contributing to arthritis pain.
Resistance & weight training, cycling, swimming and aqua size are all great forms of exercise that will help improve cardiovascular health & aid in weight loss. High impact activities such as: running, jumping and certain sports may need to be modified or avoided in later stages of arthritis.
The most important exercises for athritis are exercises that are targeted specifically to moving your joints through full, controlled ranges of motion. The chiropractors at the Mountain Health & Performance North Vancouver chiropractic clinic are trained in Functional Range Conditioning (FRC) which is a mobility training method that specifically targets joints to improve health and function. These exercises will improve mobility, strength and control around the joints which can help with pain, inflammation and prevention further degenerative change.
Anti-inflammatory and joint supporting supplements such as curcumin, omega 3 fats and glucosamine are great options for helping to keep your joints healthy. If you are taking prescription or over the counter medications it’s important to speak with your naturopath or medical doctor prior to starting a course of supplements to ensure there are no adverse interactions between the drugs and supplements. A diet that is low in grains, sugar and processed foots and high in fresh fruits, vegetables, grass fed meat and healthy fats and oils can also help with arthritis pain and inflammation.
Treatment Outcomes & Expectations:
It’s important to understand that there are no hands-on treatment, exercise or prescription drug that can reverse the degenerative changes associated with arthritis. Treatment can help to decrease and manage pain, improve function and slow down the process of further degeneration – this is key to preventing long-term disability and poor quality of life. For example, if you are currently suffering from arthritis pain that is preventing you from walking or participating in physical activity you may increase you risk for other health problems including: diabetes, stroke, heart disease, & depression.
In order to maximize the benefits of care, the frequency and duration of treatment is critical. A painful, arthritic joint does not occur within a day, week or even a year. It’s a long process that occurs over many years and and will therefore require a longer period of time to respond to treatment. Many conditions that we treat at Mountain Health & Performance may only require a short course of therapy however arthritis management is a longer process that requires patience and commitment. At Mountain Health and Performance we will provide the treatment and guidance with the long- term goal of maintaining optimal movement, decreasing pain and limiting future joint degeneration and disability.
Mountain Health & Performance is back open for non-urgent care as of May 19th 2020! We will be following COVID-19 guidelines in our clinic to ensure the safety of our therapists and patients. Please call 604-984-0014 to book or click on the "book an appointment" button to book online.