A lot of people have mentioned to me they have arthritis – whether or not that’s why they’re coming to see me is a different story. How much that arthritis bugs them varies drastically. Often, it’s something my patients mention in passing – their family doctor mentioned they have arthritis and now they just deal with the pain that comes with the diagnosis. Sometimes I have patients that try and do something about it – they take supplements, medications, or are otherwise looking around for different solutions to try and get rid of their pesky aches. But, to get to the root cause of how to help arthritis, it helps to understand arthritis. So – what exactly is OA, or osteoarthritis?
If you ask the best researchers in the world about this area, they might say a few different things. What we were taught in chiropractic school is that it’s a combination of a few different things – some things we can assess in clinic and some things we can’t necessarily know on the spot. Osteoarthritis typically involves loss of cartilage – a strong tissue that’s found throughout your body and covers the ends of your bones to help protect your joints. This loss of cartilage makes your joints narrower. When your joints get narrower like this, your bones grow more, to provide stability, and make what are called osteophytes. These are things we can’t see directly in clinic. What we can see in clinic is stiffness – which is the result of the combination of bone growth and joint narrowing. We can ask you about any pain you have associated with the area, and we can try and figure out if you have inflammation in your joint – another finding of osteoarthritis.
The reason I said different researchers might have different opinions on osteoarthritis is because some people care more about the X-ray findings – the things we can’t directly see. These doctors will take a look at an X-ray of your knee, your hip, or any other joint in your body and be able to see joint narrowing and the formation of osteophytes. With this information they will confidently diagnose you with OA. More recently, some researchers have been interested in whether or not this joint narrowing actually bothers people. Does EVERY person with a decreased joint space have pain? For these studies, they took X-rays of a lot of people at all sorts of different ages young and older. They measured the degree of how much joint narrowing there was and how much osteophyte formation people had – then they asked those people how much pain they had and how much it affected their lives.
What they found was that A LOT of people have findings of OA when you take X-rays of their joints, especially as they get older. However, not everyone had pain. Not everyone felt stiff, and for a significant number of people – it didn’t bug them at all in their daily lives. So, some doctors now are saying – if people are fully mobile and pain free should they really be diagnosed with OA?
For me, I usually discuss the diagnose of OA with a patient if they’ve already been given the diagnosis by another doctor or healthcare practitioner. It matters most to me if they have the findings that actually affect their daily lives. That’s when we can really do something about it. We know from reading research that just because you have bony changes in your knee, your elbow, or wherever – it doesn’t mean you’re bound to be stiff or have pain. There’s a lot of different options for how to manage OA, and a lot of them are surprisingly simple. Sometimes it’s as simple as walking a little more throughout your day or doing a few daily exercises. Osteoarthritis can involve some complex changes in the cartilage and bone but it certainly doesn’t mean feeling better will be complicated.