The most common chronic health condition in Canada – Arthritis
More than six million Canadians experience the daily impact of arthritis. It is estimated that this number will grow 40% by 2040. People often come into see an Osteopathic Practitioner with their MRI or X-ray results showing ‘degenerative changes’ in one or more of their joints or after being told that they have arthritis. It is important to understand what arthritis is, how it is affecting you as a person and what you can do to manage your symptoms in order to improve your quality of life.
What is arthritis
Arthritis is an umbrella term used to describe more than 100 conditions affecting the joints of the body, with pain and stiffness being the main symptoms. Arthritis can affect any joint in the body ranging from weight bearing joints (eg. Hips) to smaller joints (eg. Thumb).
There are many different types of arthritis, including: Osteoarthritis, Rheumatoid Arthritis, Gout, Lupus, Psoriatic Arthritis and Ankylosing Spondylitis to name a few. Depending on the type of arthritis, the cause can range from a previous injury, general ‘wear and tear’, autoimmune disease, genetics and sometimes can be idiopathic (meaning there is no cause). Osteoarthritis is the most common form of arthritis and known as degenerative arthritis and will be explored below.
Although more common as we age, arthritis can affect people of any age, with three in 1,000 Canadian children being diagnosed with childhood arthritis.
Arthritis is a chronic condition with no cure; however, life style changes and treatment to maintain joint mobility and reduce pain can have enormous effects on a person’s ability to deal with the symptoms and in turn their quality of life.
Symptoms
Symptoms vary dramatically between people and depending on the type of arthritis they have. Due to the chronic, ongoing nature it can be debilitating and prevent people from achieving simple tasks and activities of daily living. Although pain and stiffness are the most common symptoms this can evidently lead to fatigue, sleep disturbances and mood changes which when combined severely reduce one’s quality of life.
Osteoarthritis
In Osteoarthritis the cartilage, which provides lubrication and prevents bone rubbing on bone, is progressively worn away due to abnormal load bearing and repetitive movements. As the cartilage is slowly worn away the bodies’ protective mechanism kicks in shortening the surrounding muscles and ligaments, making the joint stiffer and decreasing the range of movement.
Eventually the joint starts to enlarge as chemicals accumulate in the joint to try and repair the tissue damage; this can stimulate new bone, cartilage and other tissue growth. The new bone formations can overgrow the edges of the joint (osteophytes) – which can be seen and felt. This decreases the space you joint has to move, it causes pain and restriction of movement over time. This creates a vicious cycle: as yours joint becomes stiff and painful → minimalised movement occurs → which leads to uneven joint position to avoid pain → uneven loading on the joint → and overall increased wear on joint.
The reduction of movement to an osteoarthritic joint reduces its blood and nutrient supply as well as its drainage capabilities which both are needed for optimal tissue healing. Meaning – the swelling that may be associated with the joint degeneration takes longer to subside and the cartilage does not have enough nutrients in order to heal properly.
In conditions such as arthritis where pain may have been present for a long time, our body can undergo abnormal pain processing mechanisms (central sensitisation). This causes our nervous system to become hypersensitive meaning that we may feel more pain, more often. Central sensitisation can even lead to pain responses from areas of the body distant to the irritated joint.
Clinical presentation
The first sign a patient usually notices is pain which may start intermittently and then become constant. Stiffness is usually worse after long periods of rest i.e sleeping and then subsides after some movement. The joint may slowly become less mobile so that you are unable to perform a certain movement and will start to grind or crackle with movement. The surrounding muscles become weaker as they are not being activated and many compensation patterns can happen.
Example with hip osteoarthritis
You come into an Osteopathic clinic with an MRI showing you have osteoarthritis of your left hip. You have noticed over the last year that your left hip has gradually become less mobile and you have pain in your left groin that may refer down into your thigh, bottom or knee. You have started to develop a limp as you are now weight bearing more on your right leg. The movements that usually beomes limited first are: being able to turn your foot inwards (internal rotation, bring your hip backwards (extension) and bringing your hip to the side (abduction). Your left gluteal muscles have become noticeably weaker compared to your right side and your left hip flexors have become tighter.
Due to favouring your right side you may have now stared to feel some pain through your right knee and hip, as this side has been doing most of the weight bearing. The left leg (in a position of lying down) your foot may point outward (external rotation) and adduction, making it appear shorter – meaning your left sacro-iliac joint may be tilted forward in comparison to your right. This causes torsion through your lower back which travels all the way up to your neck – and you’ve been wondering why your neck and upper back have been stiff and tender lately.
Lifestyle
Early diagnosis and management are key to preventing further joint damage and improving your quality of life. Diet, maintaining a healthy weight, exercise, stretching and relieving stress are all lifestyle changes that you can make in order to manage your arthritis symptoms and prevent more joint damage.
Help for arthritic pain when you’ve tried everything else – How Osteopathy can help
An Osteopathic Practitioner will take a detailed history to understand how your arthritis is affecting you and what your goals are for the future. Your Osteopathic Practitioner will do a full body assessment to test the mobility of your joints, any muscle tension or weakness, your circulation, and your nervous system. He/she will work out all the possible factors that may have contributed to your arthritis in the beginning (eg. an ankle sprain from 5 years ago) which has affected your gait and what lifestyle factors may be maintaining the affect it is having on you as a whole.
Due to the stiffness and the lack of flexibility in your joints, and Osteopathic Practitioner will work with you to help mobilize your joints and reduce stiffness, through gentle articulation and mobilization of your joints, soft tissue and indirect techniques. An Osteopathic Practitioner can also address the muscle weakness which may be associated with the joint pain; he/she can go through gentle stretches and exercises to help keep your joints flexible and help with any compensation patterns that may have arisen.
Your Osteopathic Practitioner can also work on your circulation, improving blood flow and encourage tissue healing as well as lymphatic drainage to help with any inflammation that may have happened.
Due to the heightened pain response that may be associated with your arthritis an Osteopathic Practitioner can work on your nervous system to allow effective cerebral spinal fluid circulation and allow your nervous system to quieten down letting you heal.
The holistic nature of Osteopathy makes it the ideal treatment for reducing the pain, stiffness and anxiety that may be associated with all types of arthritis.
Help heal your arthritis with Osteopathy today, if you want to know more about arthritis and the benefits Osteopathy can have, please don’t hesitate to contact us.