What is Arthritis?
The word arthritis means inflammation of a joint. There are many different types of arthritis of which the most common are Osteoarthritis (OA) and Rheumatoid Arthritis (Rh.A or RA).
It is important that the distinction between these two conditions is fully understood, as the treatment and prognosis for each are very different.
This page will discuss the condition of Osteoarthritis. Other forms of arthritis are discussed on the page Rheumatoid Arthritis and Gout.
Osteoarthritis is a degenerative condition in which the smooth cartilage covering of the joint surfaces flakes or cracks and wears away. This allows the bone surfaces to rub together and can lead to an inflammation of the whole joint.
How can I tell if I have Osteoarthritis?
OA usually affects the larger weight bearing joints like the spine, hips, knees etc., but can be found in smaller joints such as the ends of the fingers, wrists, toes, or even the jaw. The problem is usually noticed in just one or two joints initially.
Movement of the affected joint becomes increasingly painful, especially when under load, such as the knee after walking, or the shoulder after carrying a heavy bag. Where the spinal joints are affected, bending backwards will worsen the pain and it may ache after a long period of standing still.
The mobility of the affected joint becomes restricted and this leads to a weakening or even wasting of the muscles around it. You may find that the problem is not painful whilst at rest but is stiff afterwards, especially in the mornings (but this morning stiffness tends to wear off quickly).
In severe cases X Rays may show the extent of any degeneration and a blood test may be necessary to rule out other forms of arthritis.
What are the causes of OA?
OA is caused by "wear & tear", so most people wrongly attribute it to old age.
(It's often found in just one knee or hip - so ask yourself - how old is the other leg?)
The truth is that with considerate, normal use a joint can last a lifetime without problems, but abnormal use or an injury, can cause accelerated wear. OA is not inherited directly but you could have inherited an abnormality, like a short leg or twisted spine, which can lead to the problem developing.
Sufferers of other forms of arthritis such as Rheumatoid Arthritis are often left with the condition of osteoarthritis after their other symptoms subside.
How does OA affect the spine?
Age, abuse and disuse all lead to a reduction in the fluid content, and therefore of the thickness of the discs, which separate the vertebrae in your back. As this happens it allows the vertebral bones to come closer together (facet approximation). This leads to greater 'rubbing' pressure on the joints of the spine and so to arthritic degeneration (people with hollow backs are particularly prone to this).
Eventually the thinning of these discs will cause them to spread outwards. This stretches the ligaments which lie alongside the spine and, as well as pain, can cause a bony ridge or spur (an osteophyte) to form. These osteophytes can intrude into the spaces where the nerves come out from the spine and cause pain, numbness, or tingling in the arms or legs, depending on where they occur.
So can my OA be cured?
Not really. To cure means to restore to 'perfect' or a pre-disease condition and I am afraid this is not possible.
Does treatment help my OA?
Osteopathic treatment for an OA sufferer is aimed at improving the range of pain free movement, so that the problem will be less noticeable and life more normal. In many cases tight muscles surrounding the affected joint exacerbate the pain. Easing this tightness can substantially relieve the discomfort. The pain caused by local inflammation is often helped by massage and electrotherapy such as Ultrasound.
Another aim of treatment is to strengthen the muscles around the joint so as to afford better support for the future and, with other exercises to maintain the mobility levels, reduce the rate of further degeneration.
Obviously the condition can sometimes be so far advanced that you may require surgery and, if so, your Osteopath will suggest that you talk to your G.P.
Should I see my Doctor?
Your doctor may prescribe anti-inflammatory drugs, which will help the symptoms, but you should also consider other forms of help for this, such as acupuncture or homoeopathic treatment, which have very few, if any, side effects. He may also refer you to an appropriate specialist or for physiotherapy but will also usually be happy for you to be treated by an Osteopath, as long as he is assured that we are aware of the problem and that the treatment will be suitable.
How can I help myself?
Don't ignore your pain! Slow down or rest, especially if the pain persists for more than an hour after activity or if an affected joint swells up. Remember - if you try to do too much at once you'll end up having to rest for longer! (Fatigue is one of the symptoms of chronic arthritis).
Severe pain after activity may be helped by the application of an ice pack (try frozen peas), wrap in a damp cloth and apply several times for a few minutes each time. On the other hand, mild stiffness after rest is best relieved with a hot water bottle.
Gentle non-weight-bearing exercise is helpful and might include hydrotherapy. The exact nature of exercise required depends on your age and condition and which area is affected - ask for advice.
AVOID BECOMING OVERWEIGHT
Ensure that your family, friends, and workmates understand your problems, as the pain and stiffness can make you frustrated and irritable. You may need more help sometimes than others.
Is swimming the best exercise?
Not necessarily, whilst being a good way to strengthen muscles to support the knee or hip, the arching of the back involved whilst swimming can cause problems if you suffer with OA in the lower back and especially the neck.