Arthritis

Arthritis is an umbrella term for painful joints. It covers degenerative and inflammatory conditions. Inflammatory arthritis includes Rheumatoid arthritis, seronegative arthritis, psoriatic arthritis, reactive arthritis ankylosing spondylitis and juvenile arthritis.

In this article we are going to look at osteoarthritis - a degenerative arthritis of normal wear and tear.

Osteoarthritis

Symptoms

Symptoms of osteoarthritis include:

•Joint pain and swelling after activity or in response to a change of weather
•Limited flexibility, especially after not moving for a while
•Bony lumps at the end of fingers, called Heberden’s nodes, or on the middle joints of fingers, called Bouchard's nodes
•A grinding sensation when the joint is moved
•Numbness or tingling in an arm or leg, which can happen if the arthritis has caused bone changes that are putting pressure on a nerve, for example in the neck or lower back.

People who have osteoarthritis often complain of a deep ache, centred in the joint. Typically, the pain is aggravated by using the joint and relieved by rest. However, as the disease worsens, the pain becomes more constant. Often, when the pain is significant during the night, it interferes with sleep.

Osteoarthritis only shows up on X-rays in the later stages of the disease.

The diagnosis can usually be made based on the history of the condition, and the presence of the signs and symptoms listed above. If there is any doubt, or if the pain does not resolve with treatment, it may be necessary to have an x-ray of the joint. A CT scan or MRI scan may also show the problem. Your G.P. or osteopath may also ask for blood tests to look for evidence of other arthritic conditions.

About Osteoarthritis

Inside a joint, a tissue called cartilage cushions the joint and prevents the bones from rubbing against each other. Osteoarthritis occurs when the cartilage of a joint erodes (breaks down). Bones begin to rub against each other, causing pain and difficulty moving the joint. Osteoarthritis also can affect nearby bones, which can become enlarged in places. These enlargements are called bone spurs or osteophytes.

Although the term arthritis means joint inflammation, there is relatively little inflammation in the joints of most people with osteoarthritis. For this reason, and because this type of arthritis seems to be caused by age-related wear and tear of the joints. many experts and health care professionals prefer to call it degenerative joint disease.

Osteoarthritis probably does not have a single cause, and, for most people, no cause can be identified.

Age is a leading risk factor, because osteoarthritis usually occurs as people get older. However, research suggests that joints do not always deteriorate as people age. Other factors seem to contribute to osteoarthritis. Sports-related injuries or repeated small injuries caused by repeated movements on the job may increase the risk of developing osteoarthritis. Genetics also plays a role. Obesity seems to increase the risk of developing osteoarthritis of the knees. One theory is that some people are born with defective cartilage or slight defects in the way joints ﬁt, and as these people age, they are more likely to have cartilage in the joint break down.

Medicinal Treatment

Treatment focuses on managing pain and maintaining the ability to use the joint.

Your GP will usually suggest a suitable painkiller or non-steroidal anti-inﬂammatory such as paracetamol, ibuprofen or arthrotec. However, NSAIDs may be unsafe for people at high risk of developing ulcers, including people who have had ulcers in the past and the elderly.

In rare instances, when inflammation is significant, it may be possible to remove fluid from the joint and inject the joint with a corticosteroid drug.

This is recommended for acute problems with weight-bearing joints, usually the knee. However, these drugs can damage the joint if they are used too much, so your health care professional will use them only when absolutely necessary.

In severe cases, where deterioration is significant, surgery may be recommended to correct deformity in a joint or to reconstruct or replace a hip or knee joint.

Professor Anthony Hollander and his team at Southmead Hospital have successfully grown human cartilage from a patient’s own stem cells for the first time ever. This means that people suffering from osteoarthritis could in the future have cartilage transplant operations.

Osteopathic Treatment for Osteoarthritis

Osteopaths spend a large amount of their time dealing with the pain and suffering caused by arthritis. Many people mistakenly assume that arthritis is untreatable and that they must learn to live with their symptoms. In many cases, osteopaths are able to help considerably. Pain relief and lifestyle management improve the quality of life for arthritis sufferers.

Treatment is aimed at improving mobility and reducing inflammation by using gentle, manual osteopathic techniques on joints, muscles and ligaments. Arthritic joints often lack stability so treatment focusses on strengthening the muscles that support the joint.

Sometimes additional support is required either temporarily, whilst you are strengthening the muscles, or in the longer term. This support may consist of taping with soft strapping or joint braces or bandages.

Age is no barrier to osteopathy since each patient is considered individually and treatment is gentle. You may also be given advice about your diet, which in some people may be a factor in their arthritis. Exercises to do at home may also be prescribed to improve joint function and to reduce muscle spasm. Exercise in warm water or salt baths may also be recommended.

Naturopathic medicine can help the body heal itself from the inside by looking at diet, nutrition and lifestyle. There are a huge amount of different supplements and gadgets on the market that claim to Newsletter June 09 Allergy & Pain low.pdf. A naturopath can help identify ones that may be useful for you.

Osteopathy is not a cure-all and there are situations when surgery may be necessary – such as a hip replacement when you will be referred to a specialist via your GP. However, osteopathy can also help with rehabilitation after surgery.

Exercise Recommendations

Take regular exercise

•build up gradually over several days or weeks to keep discomfort to a minimum
•walking is excellent for back, hips and knees
•use good walking shoes or boots
•for very inflamed and painful joints, hydrotherapy exercise e.g. gentle swimming may be more comfortable
•for arthritic shoulders, wrists or hands: avoid very painful movements or activities but continue to use the joint as normally as possible.

Guidelines released by the National Institute for Clinical Excellence (NICE) to GPs recommend that patients suffering from osteoarthritis take regular exercise that helps to strengthen muscles.

Arthritis accelerates normal wear and tear of joint surfaces (cartilage). This disrupts the normal position of the joint and leads to muscle imbalance. The pain associated with arthritis tends to lead to over-protection of the joint - you avoid using the joint e.g. walking less, stopping sport activities. Unfortunately this means the muscles around the joint get weaker and this actually puts more strain on the joint itself. Not only that, but you are more likely to put on weight which increases the strain on your back and legs.

A recent study into the benefits of exercise for osteoarthritis sufferers found that there was a long-term reduction in pain levels, although in the short-term they may experience an increase in pain associated with the exercise. The study at East Carolina University found that although patients on supervised exercise programmes experienced increased pain in the initial weeks after starting the exercise programme, the pain tended to abate in the evenings and so long as they worked through this “pain hump”, the increased pain experience was likely to be short-lived.

Osteopathic treatment helps in managing the pain associated with arthritis by releasing strains and stresses that have accumulated in the body over many years, thus improving mobility and the circulation to all parts of the body as well as improving circulation, strength and mobility of the painful joint.

This should make it easier for you to exercise.