Arthritis: The Misunderstood Diagnosis
By Kelley Lindstrom, DPT | Therapydia Beaverton
Arthritis is a diagnosis that almost everyone has heard of, yet few people have an understanding of what it really is. So what is arthritis? How do I know if I have it? If I have it, can anything be done to help the pain that it causes?
The What-
There are different types of arthritis, with osteoarthritis (OA) and rheumatoid arthritis (RA) being the most prevalent. RA is an autoimmune disorder causing the body to attack its own soft lining around a joint while OA, also known as degenerative joint disease, is the most common type of arthritis and therefore the most common form treated by physical therapists. OA is a slow developing condition that occurs when the flexible tissue at the end of a bone, known as articular cartilage, wears down. Articular cartilage is what allows two bones that make up a joint to glide smoothly on each other without friction. When articular cartilage starts to wear down this can cause abnormal rubbing of the bones leading to inflammation within the joint. Hence the name osteoarthritis – “osteo” means ‘relating to bone’, “arthro” means ‘relating to joints’, and “itis” means inflammation.
Arthritis is:
- an inflammatory condition in one or more joints
- a treatable condition
- a common cause of joint pain and stiffness that can worsen with age
- a misunderstood diagnosis
Arthritis is not:
- a “death sentence”
- unavoidable or inevitable pain
- an untreatable condition
- a reason to stop moving. Movement is medicine!
Symptoms of OA-
Arthritis simply refers to the inflammation of one or more joints in the body. The most common symptoms of OA are pain, swelling, stiffness (especially in the morning or after periods of prolonged inactivity), joint tenderness, weakness, and altered movement (i.e. limping). Another common symptom is a crackling or grating sound, known as crepitus, in a joint during movement. Often described as a “creaky joint”, crepitus is caused by that wear and tear discussed earlier that leads to friction during movement. With that said, people can have a noisy joint with sensations of clicking and crackling and have no evidence of osteoarthritis.
The How-
How is OA diagnosed? Although clinical tests can be very accurate in diagnosing OA, the gold standard is diagnostic imaging. An x-ray, ultrasound, or MRI can determine the degree of tissue degeneration; OA is graded on a scale of 0 (normal) to 4 (severe, or “bone on bone”). Although some individuals can get by with grade 4 OA, typically this is when someone becomes a candidate for a total joint replacement.
Treatment for OA-
Many people believe – unfortunately because they have been told – that there is no treatment for OA. This couldn’t be further from the truth! The symptoms of OA are often due to abnormal joint mechanics, inefficient movement patterns, and muscle weakness…and those things can be treated by a physical therapist! Think of abnormal joint mechanics as a car wheel that is out of alignment. That tire will show abnormal wear and tear of the tread just like the articular cartilage within a joint would show degenerative changes on an x-ray. Manual therapy and exercise prescribed by a physical therapist is like taking your car to the shop for a tire alignment. Treatment can restore normal movement in a joint that then leads to reduced inflammation, less pain, and improved function!
Regular physical activity is the best “medicine” for OA. In other words, the worst thing someone could do with OA is stop moving! Our joints need motion in order to produce the fluid that helps provide smooth and pain free joint mobility. Think of this joint fluid (called synovial fluid) like our bodys’ WD-40; it lubricates joints to make movement easier. Depending on the grade of OA, low-impact activities such as walking, swimming, biking, yoga, and body weight strengthening are the most recommended forms of regular exercise. A physical therapist can help you determine what type of exercise is best for you!
Anti-inflammatory diets, over-the-counter medications, injections, and surgery are other forms of treatment for OA. The best treatment depends on one’s severity and symptoms, age, lifestyle, and even one’s financial situation. For example, in recent years research is showing positive results from regenerative medicine treatments such as stem cell injections. However, this treatment is not yet covered by health insurance companies and comes at a high cost to the patient. Regardless of the treatment approach taken, physical therapy is almost always appropriate and beneficial to help people reach their goals.
Arthritis Q&A:
Q: My parents both have/had arthritis, so does that mean I will to?
A: While there can be a hereditary component that could put an individual at higher risk for
developing some forms of arthritis, environmental factors can “override” and help prevent
this from occurring. Making the healthy lifestyle choices discussed above can significantly
reduce one’s chances of developing OA later in life.
Q: I’ve heard that taking supplements can help arthritis. Is that true?
A: Although there are lots of supplements available that are beneficial for joint health such as
glucosamine, chondroitin, turmeric, and fish oils, these are best taken over a long period of
time and are most effective if coupled with other healthy lifestyle choices. These
supplements are not intended to “cure” arthritis. However, they can help with pain
management and some provide other health benefits. It is best to talk with your doctor
about which supplements may be best for your specific situation.
Q: How does physical therapy help?
A: Ultimately, due to the degenerative nature of OA, the main goal of rehabilitation is to
prevent and prolong a total joint replacement. A physical therapist may perform manual
therapy (hands on treatment) to restore normal joint mechanics to reduce the abnormal
stresses to the joint(s) that are contributing to the degeneration of tissues. Physical therapy
can also help to strengthen the muscles that support your joints, as well as improve your
efficiency of movement; these strategies also help to reduce inflammation and pain.
Q: When should I seek help?
A: The sooner the better! Research shows that the sooner someone seeks out treatment and
guidance by a physical therapist, the quicker they will experience pain relief, improved
mobility, and reduced healthcare costs!
Arthritis does not need to define who you are and what activities you are able to enjoy as you age! The physical therapists at Therapydia can perform a thorough assessment of your body to determine what you can do to reduce pain and increase function so you can get back to the activities that you love, regardless of your age! Give us a call or email us today to set up a complimentary consultation or an initial evaluation to help you regain control over your body and life!