Original publication – January 2020
It seems that more and more, patients are walking in the door diagnosed with arthritis as the cause of their pain. While many of these individuals do have “arthritis” of some type it may or may not be the cause of their actual pain. There are several different types of arthritis. So when a patient arrives at physical therapy and they say that the diagnosis they have been given is arthritis; they appear shocked when we ask, “what type of arthritis”? The type of arthritis is important to know because it may change the direction of physical therapy or the aggressiveness of the treatment.
Osteoarthritis (OA), also referred to as degenerative joint disease (DJD) can be either primary or secondary. Primary osteoarthritis is usually due to the aging process. The reality of life is that we are mechanical in nature and all of our parts are subject to wear and tear. Eventually the parts just wear out. How fast the parts wear out is up to us to a large degree. If you buy a new car and take great care of it, 25 years later you have a classic car. If you take good care of your body in your 60’s, 70’s and beyond you will be a classic.
Secondary osteoarthritis can be from a direct trauma to the area such as a sports related injury or something like a motor vehicle accident. Patients that have had to have complex surgery to repair an athletic injury may experience an acceleration of osteoarthritis later in life. This rate of arthritic development has reduced as the precision of surgical procedures has improved. Look at the difference between Joe Namath having knee surgery in the 1960’s and Adrian Peterson having knee surgery in 2016. There where two very different outcomes and while Joe Namath has already had a total knee replacement we are yet to see the long term outcome of Adrian Peterson. Patients that play collision sports such as ice hockey, football, wrestling, etc. may have an accelerated path to osteoarthritis of the spine. While physical conditioning, helps reduce the onset of osteoarthritis the repeated trauma cannot be reversed only slowed.
Other secondary causes include a variety of disease processes. However the “arthritis” then falls into another category known as inflammatory arthritis. Osteoarthritis is technically not inflammatory in nature. The inflammatory arthritic disorders may be directly related to autoimmune or genetic causes. Conditions such as gout can deposit crystals in the joints and then the cartilage and joint linings react to them resulting in the advanced inflammation. It is the active inflammation that destroys the cartilage and leads to the chronic break down. Rheumatoid arthritis is thought to me more autoimmune. This means that your body is actively attacking or rejecting the cartilage. So the cartilage is inflamed and breaking down without any physical irritant such as gout. Finding out what the trigger to the autoimmune response is an important factor in treating the inflammatory arthritis.
The best way to treat osteoarthritis is not to get it in the first place. That’s easy to say but what if you already have some type of arthritis? There are several simple things that can be done to slow the progress of osteoarthritis. The first two are tied together. Losing as little as 10 pounds and going on what is known as the anti-inflammatory diet. This takes a little research but the information is readily available online and is mainstream today. The next is to stay active with activity that will stabilize the arthritic joints. Speak to your doctor or physical therapist about the type of exercise that will best match up with your particular type of arthritic development. From a vitamin supplement perspective I would recommend taking a glucosamine-chondroitin sulfate supplement together with fish oils. These two supplements have been shown to reduce joint pain related to osteoarthritis.
If you have a genetic or autoimmune type of inflammatory arthritis I would highly recommend you seek consultation with not only a rheumatologist but also an integrative medicine specialist. These two providers can work together to treat your symptoms but also search for the triggers of the autoimmune response. For example you may be eating green peppers thinking they are healthy but may actually be the item stimulating the autoimmune response that flares up your rheumatoid arthritis. There are advanced laboratory studies that can help to pin point these things. Reducing the number of inflammatory attacks is the key to preserving your joint cartilage.
While many patients are diagnosed with arthritis, there are many different types and it is important to ask your doctor what type they think you have. Have a detailed conversation with your doctor about treatment options. There are many legitimate options for patients with arthritis today so don’t just settle for Advil.
Dr. Buchberger is a licensed chiropractor, physical therapist, certified strength and conditioning specialist and Diplomate of the American Chiropractic Board of Sports Physicians with 31 years of clinical sports injury experience. Dr. Buchberger can be contacted at 315-515-3117, www.activeptsolutions.com or www.shouldermadesimple.com