Arthritis

Written by Dr. Jason Ngan, DC

What is Arthritis?

Arthritis is a painful condition when joints become inflamed. The term “arthron” means joint in Greek and “itis” means inflammation. There are over 100 types of arthritides. They are separated into four main categories. Some common types include:

  • Degenerative include osteoarthritis (OA), diffuse idiopathic skeletal hyperostosis (DISH), neuropathic arthropathy (aka Charcot’s joint), synoviochondrometaplasia

  • Inflammatory include rheumatoid arthritis, systemic lupus erythematous, scleroderma, psoriatic, enteropathic, anklylosing spondylitis, and Reiter’s (aka reactive arthritis)

  • Metabolic include gout, calcium pyrophosphate deposition (CPPD aka pseudogout)

  • Infectious include septic arthritis

Osteoarthritis is the most common type of arthritis and we will be focusing on OA in this article. OA (aka degenerative joint disease (DJD) or degenerative disc disease (DDD) if in the spine) is a non-inflammatory type of arthritis that most commonly involves weight bearing joints (spine, hips, knees).

What Causes Osteoarthritis?

OA occurs when the cartilage and surrounding tissues in the joints break down over time. Cartilage are soft tissue that cushion joints and protect bones. When cartilage wears down, the bones will rub against each other and cause pain. Eventually, the body tries to repair the damaged area by creating additional bone to stabilize the joint. These extra bones are known as bone spurs and can cause discomfort by impinging on nerves. Some common causes of OA include:

  • Old age (wear-and-tear on joints)

  • Overweight/obesity puts additional stress on joints

  • Genetics

  • Secondary osteoarthritis can be caused by injury, infection, deformity, and even another disease

    • These conditions can wear the joints down quicker and cause OA

What are the Signs and Symptoms?

  • Pain and tenderness in the joints

  • Pain, numbness, or tingling going down the arms or legs when OA impinges on nerves

  • Stiffness especially after long periods of rest (such as sleep)

  • Decreased range of motion

How is Osteoarthritis Diagnosed?

OA is diagnosed with a thorough medical history, physical examination, orthopedic testing, x-ray diagnostic imaging, CT scan, and MRI.

  • X-rays and CT can visualize decreased joint space and any bony changes

  • MRI can visualize damage to the cartilage and other soft tissue changes

  • Muscle weakness

  • Abnormal sensation (pain, numbness, tingling)

  • Decreased range of motion

What are the Treatment Options?

Although damage and changes to joints and bones cannot be reversed, OA pain can be managed by chiropractic care. Regular treatments and a healthy lifestyle can slow the progression of OA and improve joint health. The main goal is to maintain an appropriate weight and stay active.

  • Chiropractic manipulation and mobilization

  • Flexion-distraction

  • Spinal traction

  • Soft tissue therapies

  • Gua-sha

  • Cupping

  • E-stim

  • Ultrasound

  • Ergonomic/postural/nutritional counseling

  • Rehabilitative exercises and stretches

Other treatments that patients may seek (not provided at Ngan Chiropractic) include acupuncture, epidural steroid injections, and surgery if severe.  

References

  1. Chen D, Shen J, Zhao W, Wang T, Han L, Hamilton JL, Im HJ. Osteoarthritis: toward a comprehensive understanding of pathological mechanism. Bone Res. 2017 Jan 17;5:16044. doi: 10.1038/boneres.2016.44. PMID: 28149655; PMCID: PMC5240031.

  2. Haq I, Murphy E, Dacre J. Osteoarthritis. Postgraduate Medical Journal 2003;79:377-383.

  3. Kai Fu, Sarah R Robbins, Jason J McDougall, Osteoarthritis: the genesis of pain, Rheumatology, Volume 57, Issue suppl_4, May 2018, Pages iv43–iv50, https://doi.org/10.1093/rheumatology/kex419

  4. Senthelal S, Li J, Ardeshirzadeh S, et al. Arthritis. [Updated 2022 Jun 19]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK518992/