What is Arthritis?

The term arthritis refers to the inflammation of joints.

This inflammation can happen for many reasons including wear-and-tear, infections, and autoimmune disorders. While it is common in the general population it is especially prevalent in older adults. According to the Center for Disease Control (CDC), from 2013 to 2015 approximately 54.4 million adults were diagnosed with some type of arthritis by their doctors in the US, annually (1).

Osteoarthritis (OA) and rheumatoid arthritis (RA) are the most common types of arthritis. The pain from these conditions can negatively affect routine tasks like getting out of bed, bending or kneeling to pick up objects, and even sitting for too long. Luckily, there is much one can do to help alleviate the pain from arthritis, slow its progression and maybe even treat it.

Osteoarthritis (OA):

Osteoarthritis, also known as degenerative joint disease, is joint inflammation caused by gradual wear-and-tear and incomplete healing of articular cartilage. Articular cartilage surrounds the end of bones at the joint, it helps reduce friction between the gliding bones during movement.

The inflammation and incomplete healing of articular cartilage over time leads to its degradation, increasing the friction between bones. This bone-to-bone rubbing then leads to joint stiffness, pain, altered mechanics, and muscle weakness. As OA – the degeneration of cartilage- progresses, injured bones damaged by friction by building more bone. This formation of bone on top of bone leads to joint abnormalities that interfere with movement and cause pain.

Rheumatoid Arthritis (RA):

Rheumatoid arthritis is joint inflammation caused by an autoimmune response. In this scenario, the immune system is attacking the joint which then leads to swelling and pain. Rheumatoid arthritis results in inflammation of the synovium (synovitis), which is a capsule-like membrane that surrounds the joint. The synovium is in charge of making synovial fluid, which lubricates the joint.

Inflammation of the synovium also leads to the erosion of bone and cartilage, and over time, to the formation of a pannus. The pannus is a layer of granulation tissue that forms around the joint and whose growth damages both bone and cartilage.

The degradation of cartilage and narrowing of joint space can lead to the fusing (ankylosing) of bones. This is the case of ankylosing spondylitis, in which spine vertebrae fuse together due to the narrowing in space between them. Joint deformities, such as the twisting and bending of bones, are also common for rheumatoid arthritis.

What Can Be Done?

Anti-inflammatories:

There are many anti-inflammatories a physician may prescribe for arthritis. Anti-inflammatory prescribed may include steroids and NSAIDs (nonsteroidal anti-inflammatory drugs) like ibuprofen. However, more specific treatments will depend on arthritis type and stage of the disease.

Analgesics:

Medications may be taken/prescribed to help alleviate and cope with the pain like acetaminophen and oxycodone. In extreme cases where the pain has become unbearable or unaffected by medication, joint-replacement surgery may then appear as the only option.

General Health:

Maintaining good general health benefits patients with arthritis. A healthy weight, for example, helps control the stress put on joints. Therapeutic exercise and physical therapy help control body weight, pain, stiff joints, and weakening muscles. Nutrition therapy helps reduce inflammation of joints and throughout the body.

Manipulation Techniques:

Chiropractic and osteopathic manipulations alleviate many mechanical stresses presented by arthritis. Osteopathic manipulative treatment (OMT), for example, can help reduce swelling and pain associated with arthritis. On the other hand, chiropractic adjustments of the spine improve both nerve and mechanical function. Both osteopathic and chiropractic manipulation techniques will help free the body of structural restrictions and improve overall mobility.

Alternative Treatments:

Alternative treatments to help with the pain from arthritis include massage and acupuncture. Massage therapy techniques help reduce swelling by increasing local blood flow and lymphatic drainage of the joint. Acupuncture techniques also reduce pain by balancing nerve activity and meridian flow.

Regenerative Treatments:

Prolotherapy techniques including Hackett-Hemwall dextrose, PRP, and stem cell injections can help alleviate pain and dysfunction associated with osteoarthritis. These techniques involve injecting regenerative substances to the affected joint thus eliciting its recovery.

Prolotherapy injections tighten the loose and injured ligaments/tendons that support the joint. In fact, the combination of prolotherapy injections and OMT is so effective in treating dysfunction that it represents an alternative to surgery in 80% of cases (2).

If you have a form of arthritis or degenerative condition, visit Santa Cruz CORE. We have many services that can help alleviate and even eliminate pain including massage therapy, acupuncture, osteopathic manipulative treatment, and prolotherapy.

References:

“Arthritis.” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, 18 July 2018, www.cdc.gov/arthritis/data_statistics/arthritis-related-stats.htm.

Hauser, Ross A, et al. “Prolotherapy as an Alternative to Surgery: A Prospective Pilot Study of 34 Patients from a Private Medical Practice.” Journal of Prolotherapy, 19 Sept. 2017, journalofprolotherapy.com/prolotherapy-as-an-alternative-to-surgery-a-prospective-pilot-study-of-34-patients-from-a-private-medical-practice/.