_Arthritis

Arthritis is a general term that means inflammation of one or more joints. There are several types of arthritis, including Osteoarthritis, Psoriatic, Rheumatoid, and Gout. This article is going to address Osteoarthritis.

Osteoarthritis is a progressive, non-inflammatory disease affecting a joint's cartilage, bone, and surrounding tissues. Osteoarthritis is the most common form of arthritis and is the leading cause of disability in the U.S. Osteoarthritis first appears asymptomatically in your 20s & 30s and everyone over the age of 70 has a certain degree of Osteoarthritis. It occurs in almost all vertebrates even those that live supported by water such as whales, dolphins and porpoises. The only 2 mammals that don't get Osteoarthritis are bats and sloths.

How does Osteoarthritis Develop?

Before that question can be answered you need to understand the basic anatomy and function of a weight bearing joint. In a basic sense, a joint is made up of two bones, whose ends are covered with cartilage that are surrounded by a capsule and filled with fluid. The surface of cartilage is so smooth that it could be considered friction free. This is very important, because when a joint moves the cartilage surfaces compress and rub against each other. Thus, the less friction a joint has the healthier it will be. In addition, cartilage doesn't have a blood, nerve, or lymphatic supply; therefore, it requires weight-bearing and use to remain healthy. When a person uses and puts weight on a joint, they compress cartilage causing it to discard used fluid and material, and when they take the weight off the joint it allows it to re-expand, hyperhydrate, and absorb the nutrients that are necessary for its health and function. In summary, cartilage acts like a sponge.

Osteoarthritis develops when there is damage to the cartilage altering its normal structure and function.

Causes of Cartilage Damage

• Acute Trauma

• Chronic Trauma

• Infection

• Metabolic

• Etc.

When the smooth surface of cartilage is damaged it becomes pitted and irregular, resulting in friction. The surrounding tissues (tendons, ligaments, and muscles) that hold the joint together become weak and the joint itself eventually will deform. Initially, osteoarthritis is asymptomatic and as the disease becomes progressively worse, symptoms develop.

Symptoms of Osteoarthritis

Pain: Usually occurs with exercise

Stiffness: Especially in the morning and after periods of inactivity

Crepitus: A grating sensation that sounds like gravel in the joint

Muscle Spasm

Joint Tenderness

Decreased Joint Motion

Joint Deformity

Treatment Options of Osteoarthritis

The two goals of osteoarthritis treatment should be to decrease the symptoms and control of progression the the disease.

Chiropractic: Chiropractors adjust the joints of the body removing stress and restoring normal joint function. A Chiropractic Adjustment is an involuntary controlled motion. Involuntary controlled motion means that the chiropractor, not the patient, moves a dysfunctional joint in a specific direction to improve function. Once joint function is restored, the progression of osteoarthritis is decreased and symptoms are reduced. Patients can use voluntary (patient performed) controlled motion to help their joint function (See exercise below.)

Exercise: Exercise is a voluntary controlled motion of the joints that helps maintain healthy cartilage, range of motion, and develops the supporting tendons, ligaments and muscles.

Examples of voluntary controlled motion

• Range of Motion Exercise

• Stretches

• Free Weights

• Nautilus

Natural Supplements:

Glucosamine: Glucosamine is a major building block of cartilage. It makes up the proteins that bind water in cartilage and it stimulates the chondrocytes (cartilage producing cells) to produce more cartilage.

Chondroitin: Chondroitin also helps attract fluid into the cartilage. This is important because water acts as a spongy shock absorber and "sweeps" nutrients into the cartilage. Chondroitin also inhibits enzymes that destroy cartilage.

Sulfur: Sulfur is very important in the binding of cartilage molecules to aid with cushioning and lubrication.

Drugs: Pharmaceutical approaches consist of the following:

• Acetaminophen (Tylenol, Datril & Liquiprin)

• Nonsteroidal anti-infiammatories (Aspirin, Ibuprofen, Advil,
Motrin, Aleve, Nuprin, Excedrin IB, etc.)

• Corticosteroids (Cortisone & Prednisone)

These approaches address symptoms of Osteoarthritis, but not its progression. These drugs also have some serious side effects especially when taken for long periods of time.

Surgery: Surgeries including laminectomy, osteotomy, and total joint replacement should only be considered after all conservative therapy has proven unsuccessful.