Visit Your Chiropractor for Symptoms of Arthritis

Overall, 46 million Americans suffer with either self-reported, or physician-diagnosed arthritis. That number is expected to climb to 67 million by 2030 as the population ages. Arthritis is the most common cause of disability with 19 million adults in the United States reporting that they suffered activity limitation due to arthritis between 2003 and 2005. In those aged 18-64 about one in twenty adults suffered work limitations due to arthritis, and in one-third of those with arthritis. Annual hospitalizations due to arthritis number approximately 750,000, with 35 million outpatient visits, also due to arthritis. Complications from arthritis account for about 9,500 deaths annually. The estimated annual cost to the health care system is $128 billion. Ouch! Tell me those statistics aren’t depressing! However, don’t worry, this article is not all bad news.

Bringing chiropractic into the discussion of arthritis adds a dimension that opens up possibilities for maintaining an active lifestyle. It provides not only a possible resolution of chronic pain, but also the potential for addressing the disease with more flexible methods that focus on long-term health. For most of the twentieth century, many people believed that the diagnosis of arthritis created the expectation that their normal daily activities would be permanently affected. With chiropractic and the benefits it provides, arthritis can become a manageable ailment that, along with exercise and a healthy diet, will no longer be feared.

The basis for chiropractic care is centered in the body’s ability to heal itself. By normalizing the mobility of the joints and muscles, a chiropractor helps increase the range of motion in the body, which assists in better overall movement. Chiropractic and its complementary treatments, which include nutrition, exercise, and better lifestyle choices, can be used as a preventive measure against potentially developing arthritis. If arthritis is already present, chiropractic’s use of gentle manipulation can result in greater ease of movement and decreased fluid build up in the joints that often accompanies arthritic conditions. The use of massage therapy in addition to chiropractic care can also ease stiffness and encourage movement. As well, the application of heat and cold compresses have been shown to ease arthritic pain. And finally, the use of electrical stimulation as part of chiropractic treatment is believed to stimulate pain-inhibiting chemicals in the human body, known as endorphins, and block the nerves that are responsible for pain sensation.

Using chiropractic instead of prescription medicines for pain relief, or over-the-counter medications such as NSAIDs (Non-Steroidal Anti-Inflammatory Drugs), can reduce the chances of experiencing harmful side effects from long-term use. It offers a non-invasive method of maintaining physical health and addresses such conditions as arthritis in a way that will offer freedom of movement without the deteriorating effects that might come with medication. As well, there is the possibility that the pain you are feeling is not just from your arthritis. A chiropractor can help you determine this. To explain, read the article “pain may not be due to arthritis alone”.

 

Your Back Pain May Not Only Be Due to Arthritis

Rarely does a day go by that I don’t hear someone say “my back or neck is sore because I have arthritis”. Yes, arthritis (most commonly in the form of osteoarthritis) can be a very painful and debilitating problem. However, your back pain may not be due to arthritis alone. In fact, a recent study of 500 people (250 of which had low back pain while the other 250 did not) found that there was no significant difference in the severity of osteoarthritis present between the two groups of people. What does this mean? It means that 250 of those 500 people had arthritis but did not have any low back pain.

 

As I explain to patients in my office, just because you have mild to moderate osteoarthritis does not mean that the symptoms you are experiencing are from that alone. However, if you do have some arthritis in your spine, you may be slightly more prone to having acute back or neck problem arise and it may take longer to conservatively treat the recent exacerbation.

 

For most people who enter my office with acute neck or back pain, most of their symptoms have only been present for a relatively short period of time. Even if they had some osteoarthritis in the affected area, it did not suddenly progress and cause the new bout of symptoms. Osteoarthritis generally comes on gradually at a slow rate, not suddenly within a week or so. If your symptoms came on quite quickly, something else is likely contributing to your problem.

 

In regards to neck or back pain, a common problem that many people have is actually what chiropractors call a “chiropractic subluxation”. This can be more likely to occur when osteoarthritis is present and is really just a combination of four problems: stiff and tight joints, irritated or pinched nerves, muscle spasm or tension, and inflammation or swelling around the joint and nerve. A subluxation can occur quickly, as in a heavy lift or a traumatic accident. As well, it can gradually occur over a long period of time with poor posture or a general inactivity. In regards to a subluxation gradually occurring, your joints and muscles may just have some mild stiffness that does not even cause you any real discomfort. However, this mild stiffness would make you more prone to injuring the area. For example, one day you decide to dig up the entire garden while your back does not have its full mobility. By the next day, you can hardly get out of bed because the joints in your spine are even stiffer and inflamed, the inflammation is now irritating the nerves that exit the spine, which causes severe pain and muscle spasms. Again, the important thing to understand is that this scenario can occur whether you have mild to moderate osteoarthritis or not.

 

Once osteoarthritis is present, there is no form of treatment that will reverse these degenerative changes. However, you can treat and prevent the “subluxations” from occurring and the osteoarthritis from starting or progressing by restoring and maintaining the proper mobility in the joints. The more often and better your joints are able to move, the healthier they will remain and the better they will heal when they are injured. In a chiropractic office, receiving chiropractic “adjustments” in conjunction with regular exercise accomplishes this.

 

Ankylosing Spondylitis

Ankylosing spondylitis and specific other types of arthritis are called spondyloarthropathies. They are challenging to diagnose, particularly during the early stages. The main reason for delayed diagnosis is the difficulty in differentiating someone with early AS and someone with mechanical low back pain. This is particularly true because the most common type of back pain seen in clinical practice is by far mechanical low back pain. In Ontario, a third of patients who seek care for low back pain seek chiropractic care, and low back pain is the most common condition seen by chiropractors. Since 3-8% of low back pain patients have ankylosing spondylitis, it is likely that chiropractors see a large number of patients who have ankylosing spondylitis as a cause of their low back pain.

 

The recent discussions on ankylosing spondylitis highlight the importance of early diagnosis so patients can receive appropriate treatments that can significantly impact quality of life and disease progression. To assist in early diagnosis, chiropractors should be aware of current diagnostic criteria and the clinical features that can help distinguish AS from mechanical low back pain. The following is a list of signs that may be present in a patient who has ankylosing spondylitis.

 

a) Low back pain greater than 3 months that improves with exercise but not with rest

b) Limited low back motion

c) Limited chest expansion plus

d) Moderate to severe inflammation/irritation of the sacroiliac joint, noticeable on x-ray

 

Once diagnosed, the best management for ankylosing spondylitis is a combination of both pharmacological and non-pharmacological approaches. While a few effective pharmacological approaches have been identified, the best non-pharmacological form of treatment is still unknown. However, current evidence suggests non-pharmacological strategies should include gentle joint mobilization (as in chiropractic treatment), postural education, and exercises aimed at increasing range of motion and reducing risk of a stooped posture.