ARTHRITIS

What is Arthritis?

Arthritis is a general term used for many conditions that result from the degenerative changes of the joint and its structures. Osteoarthritis (OA) is the most common form of arthritis.  It may affect over 80% of people over the age of 60. 

In OA degeneration, changes describe a slow and progressive loss of the cartilage (a rubbery material between two bones) that acts as a barrier and a shock absorber between two bones, while helping to keep the joints flexible.  Once the cartilage is thinned or lost, the constant grinding of bones against each other causes pain and stiffness around the joint.  Abnormal and excess bone formations called spurs grow from the damaged bone, causing further pain and stiffness.

What are the Symptoms?

• Subtle development of morning stiffness is often an early symptom.
• As OA progresses, there is pain with movement of the involved joint.
• Pain and stiffness become more severe with activity (less than 15 minutes in duration), and improve with a proper amount of rest.
• Decreased range of motion of the joints
• The patient may have difficulty with brushing teeth, combing hair, or opening a jar
• The joints, such as the fingers or knees, may become unstable, causing them to buckle or lock.
• The fingers, spine, hips, knees, or ankles can all be affected, and may be tender to the touch.
• Neck or back stiffness may be present
• There may be swollen or painful joints around the fingers or knees
• Hip or knee pain may cause a limp when walking
• Popping sound or crepitations (cracking sounds) may be heard when moving the joint

What causes Osteoarthritis?

Primary OA is caused by the cumulative effects from years of use that damages the protective coating of the joint known as collagen. As one ages, the ability to restore and repair the collagen matrix decreases.

How is the Diagnosis made?

• Examination by a doctor includes a medical history and a general physical exam.
• The joint involved is then examined for degree and range of motion, stiffness, strength, and presence of fluids or crepitations.
• There may be bony knobs at the end of the fingers
• There may be swollen and tender knee joints.
• If there is swelling and fluid in the joint, the doctor will numb the area with an injection of a local anesthetic such as Xylocaine, then use a second needle to remove the fluid so it can be examined under a microscope.  This is helpful in reducing pain and ruling out other causes of arthritis.
• Radiographs (X-rays) may be normal early in the disease, but later they may show narrowed joint spaces, erosions, small cysts (tiny enclosed sacs), and spurs.

If the doctor needs a detailed view of the joint, or if there is radiculopathy (pressure on nerve roots), a MRI or CAT scan can provide better pictures of the involved joint.

What is the Treatment?

• Protect the joints from overuse by limiting unnecessary and repetitive activities such as driving or lifting heavy pots and pans.
• Be sure to keep good posture with the chin up and a straight back (shoulders pulled back).
• Exercise of all forms has proven beneficial
• A good diet and moderate weight loss is extremely important.
• Chiropractic care and rehabilitation is very helpful in decreasing joint stiffness, pain, and improving mobility and strength.
• Massage of surrounding muscles, acupuncture, or acupressure may help with pain.
• A bad knee or hip can also be replaced with an artificial one.