“Doc, I was told I have arthritis,” the face drops, eyes look down…. I look at the patient sitting in front of me in the examination room and I more often then not say something like: “Ok, that’s cool. So you know you have some explanation for the pain and swelling you are experiencing, and what are you doing about it?”
Here is where the perplexed look comes at me along with the head tilt, like a little puppy: “I didn’t think there was anything to do about it, I was told I just have to live with it, take these medications, and wait for surgery. ”
What is the Truth About Arthritis?
Let’s begin with a definition. Arthritis is defined as inflammation (which is swelling) in a joint or series of joints in the body, often accompanied by pain and can lead to degenerative changes.
Arthritis shows up most commonly in one of two ways. One form of arthritis is a metabolic form such as rheumatoid. Although this condition is more challenging to manage, a comprehensive treatment regimen can slow and even prevent the effects of rheumatoid for most people. The other form of arthritis is called osteoarthritis. Osteo means bone. Osteoarthritis is the most common form of arthritis and typically has a genetic link. In other words, there is typically a family history associated with osteoarthritis. But just because you have it in your family, does not mean the genetic “switch” needs to be turned on in you.
Osteoarthritis typically forms as a direct response to abnormal physical stress (also known as abnormal loading) of the joints. What is abnormal loading of the joints? Well, if you have flat feet for example, you create abnormal physical stress in the joints of the feet and knees. If you have one flat foot or if one of your legs is just a little longer than the other, you will wear down one side of your ankles, knees, and hips. This “wear down” is osteoarthritis.
Osteoarthritis is usually found in the knees, back and neck. Why there? Think about it, the knees, back and neck are all weight bearing joints and carry much of the physical load of our daily lives as we walk, sit, stand, run and work. Over time, and like a car or a truck, these parts can wear down as a direct result of the load being placed on them. Unlike a car or a truck, it’s not so easy to replace these parts. A knee replacement is a painful and difficult procedure and some research suggests that physical therapy alone without the knee replacement surgery has as good of an outcome as the knee replacement surgery with physical therapy.
Since these body parts are not so very easily replaceable, prevention becomes the key.
How to Prevent Osteoarthritis in Weight-bearing Joints
Alignment, Alignment, Alignment
There are several forms of analysis to determine whether a person is alignment properly. Posture analysis, gait analysis (examining how you walk,) and full spine X-rays in the upright weight-bearing position are just a few of the ways to determine alignment. Analysis of alignment for the prevention (and may I say) correction of osteoarthritis can be most commonly performed by a well trained physical therapist, osteopathic physician, or chiropractor.
Once your alignment has been successfully analyzed, a treatment plan can be devised to either put you back into alignment (or at least improve your alignment) and prevent it from getting worse.
Treatments can include orthotics and/or heel lifts in your shoes, postural retraining and stabilization exercises, spinal traction if the alignment issue is in the spine, viscosupplementation injection therapy to the knees, nutritional supplementation such as fish oils, and the list goes on.
Demystifying arthritis by understanding it is the first step. The next step is up to you!
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