ARTHRITIS“I have been diagnosed with arthritis.”Arthritis? So? What’s so unusual about that? Everybody eventually gets it, right? It’s like grey hair. This may sound like a crass statement and, yes, it is. It’s a reaction to a very poorly worded diagnosis. It’s about as vague as telling someone they have lumbago. There are hundreds of causes of lumbago, from extremely serious (like cancer), to a little tiny ache periodically. Lumbago is a meaningless term, and really the word arthritis is too. Why? Because there are over 100 types of arthritis and many of them are quite different. Osteoarthritis, gout and Paget’s disease are all forms of arthritis but they have very little in common, except that all three affect the joints. Very often we are faced with a condition that really should be called arthrOSIS, not ITIS. WHY? Because there is no inflammation. That's why anti-inflammatory medication doesn't help. Getting the joint moving again, thus increasing the synovial fluid flow in the joint, and rehabbing the surrounding tissue is what will relieve the pain and disability associated with osteoarthritis in the neck, for example.
Read more about arthritis in the neck …
X-raysIt is widely acknowledged that in early Rheumatoid and Psoriatic arthritis, for example, before there's any bone damage, that X-rays are likely to be insensitive to the soft tissue damage.In these two types of arthritis, blood tests and MRI and ultrasound scans are far more effective in testing for the presence and progress of any disease process. And so it is with Osteoarthritis. The artfully done physical examination yields far more information about the impending disaster, even when X-rays looking for boney changes are quite normal.
Low Back PainThe low back contributes enormously to arthritic sufferers, and much of it can be prevented. How?
The KNEEIn a break-through study in the Netherlands, researchers found that unloading the knee with advanced osteoarthritis using an external fixation device (for two months), increased the synovial fluid flow through the joint resulted in dramatic sustainable improvement after the device was removed. Pain was reduced from 80% to 8% and function improved just as dramatically. Read more …Osteoarthritis in the knee is strongly associated with OBESITY and a LEG LENGTH DEFICIENCY (a short leg):
Two distinct kindsIt’s perhaps useful to think of two distinct kinds of the arthritis. That which affects
The crippling pain that a child might get with Juvenile Rheumatoid Arthritis is light years away from the painful degenerative knees that the obese get in the knee. It’s also from a quite different planetary system to Immobilisation Arthritis, now proved to be the most common form of Osteoarthritis, which mostly responds very well to chiropractic. Where is all this leading us? It’s probably true to say that straight chiropractic can’t do much to help in the treatment of the systemic arthritides, except in a general sense, by keeping the body in harmony with itself through gentle adjustments, stretching and exercises. Fortunately they are relatively uncommon. But if you have an attack of extreme pain in your great toe, and it becomes swollen, red and hot, then for heaven's sake go to your medical doctor first, not your chiropractor. The inflammatory changes of gout are best managed medically.
For more information about the sytemic arthritides take a look at this excellent site written by a medical rheumatologist. "Illness is the doctor to whom we pay most heed; to kindness, to knowledge, we make promises only; pain we obey. " Marcel Proust
But the most common form is called Osteoarthritis, and a major subdivision of it called Immobilisation Arthritis, is what we chiropractors work with day in and day out. It’s our bread and butter, and chiropractic is probably the best form of treatment for localised painful and stiff joints, because mostly it’s not inflamed. It's really an arthrosis, not an arthritis. Anti-inflammatories are not the treatment of choice – getting the joint moving again is, and that’s what chiropractic excels in. Keeping the joints moving, increasing the synovial fluid flow in the joint, and then exercising the joint is what Chiropractic is about. Eating healthily is what ensures the joints are bathed in the the fluids containing the right ingredients. Not smoking is what ensures that the synovial fluid contains enough oxygen. (Smoking reduces blood oxygen by up to 20%)Old age is not something we should dread, and
healthy old age
is what comes to those who make the
RIGHT CHOICES. "You're never too old to become younger." Mae West To be honest though, much of health remains a mystery. Why do people who obviously try to make the right choices still get sick? We just don't know yet. Genetics, environmental toxins that we don't know about, side effects of drugs and many others. None of us choose to be rammed in a car accident either - something that can ruin an otherwise healthy life. Whilst much remains mystery, much is also clearly understood. Exercise the body, consider new ideas to stretch your mind, feed the spirit, an apple a day ... it does keep the doctor away! CartilageWhat do all forms of this large group of disease have in common? They affect the cartilage that covers the ends of bones. This cartilage makes it easy for bones to articulate easily with a neighbour. It is white, hard and very smooth, with a polished look about it. Interested? Next time you have leg of lamb (if you’re not a vegetarian!), then before you throw the bones into a pot to make a broth for your next soup, cut open the hip joint and take a good look. Fascinating! It’s like highly polished marble. Believe it or not, its slip index is lower than ice on ice. But when the joints become arthritic, this cartilage becomes rough and pitted. The symptoms? Stiffness first usually, and then pain as the disease progresses.Professor WJ Bijlsma, feted Netherlands academic, admits that in the early stages of osteoarthritis there is a marked discrepancy between
In clinical terms, this translates into pain and stiffness as the fixated joint, for example in the neck after a whiplash injury, starved of nutrients begins to complain, BUT NOTHING IS SEEN ON THE X-RAY. Or, as we say, "X-rays are likely to be insensitive in patients with early whiplash osteo-arthritis." Diagnosis: So, of course, your doctor tells you there is nothing wrong, all you need is some painkillers and perhaps a massage. WRONG! YOU ARE DEVELOPING ARTHRITIS! As the famous Eliza Doolittle said: "Just you wait Henry Higgins, just you wait!" Only then, if the fixation is not released, does it turn into the advanced osteoarthritis we so often see on X-ray 10 years later after an accident. Prof Bijlsma went further to admit that "the placebo has been the most effective medical treatment we have found for osteoarthritis in many studies". Chiropractic can do better than that! There is plenty of strong research proving that an adjustment of the joint is what will reduce the pain and stiffness, together with some good rehab exercises so that you don't need to run off to your chiropractor twice a week for ten years!
Exercise benefits arthritis
Many studies involving thousands of sufferers have concluded that exercise benfits those who suffer from both Osteoarthritis and Rheumatoid Arthritis, improving function and lessening pain. Whilst most of these studies have been done on the knee, the principles apply to all joints. OLEOCANTHALThe well known scientific journal Nature reports that olive oil contains a compound called oleocanthal which acts as a natural anti-inflammatory that has a potency strikingly similar to that of ibuprofen. Both these oleocanthal and ibuprofen inhibit the same cyclooxygenase enzymes that cause arthritic inflammation.For more information about the benefits of olive oil, (and a fun short story)
click here.
Joint fluidsWhat you can’t see in Mary’s little lamb’s hip (sorry, that’s in poor taste!), is that the joint is bathed in a fluid. It is this liquid that feeds the cartilage, and the most common form of OA is called Immobilisation Arthritis (IA), when this fluid is not adequately replaced by the body. We are now discovering that IA is not the same as OA, which is really a wear-and-tear disease, though the end result is the same when seen on an x-ray. But under a microscope, at a cellular level, the changes are quite different. A huge amount of research has been done on IA, but little of it finds its way into the popular literature. It’s just dumped in with OA, and assumed to be as inevitable as grey hair. Not so! Read more about Immobilisation A, the most common form of arthritis, click here.Shoulder painOddly, one of the premier arthritic joints is not a weight-bearing joint (like the hip) but in the shoulder. A little hinge joint, called the ACROMIO-CLAVICULAR JOINT is a primary cause of shoulder pain. For more about the AC-joint and shoulder pain, click here.The AC-joint is very important factor in Knee Arthritis and ExerciseInteresting research from Melbourne, Australia confirms that walking actually increases the volume of cartilage in the knee. What this 14 year study confirms is that we should not fear exercise, but rather should grasp it whole heartedly. It actually reduces arthritis.The real enemies of joints are a sedentary existence and a poor diet. Are you a couch potato? Read more about Knee arthritis and exercise … USEFUL LINKS.
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