Exactly what is this word “arthritis” that is used so commonly in our culture? It seems that every time you get an ache or pain in a joint, someone says it is probably arthritis. How is it diagnosed, why does it occur and is there anything you can do about it?
Let’s first make an important distinction. There are two types of arthritis. The most commonly talked about, osteoarthritis or degenerative joint disease, is the “wear and tear “of the joints typically caused by injury and over use.
A second type, called rheumatoid arthritis, is a systemic disease process. In rheumatoid arthritis, the joints “flare up” and become extremely hot, red, and swollen. To determine if you have rheumatoid arthritis, your doctor may do a blood test. We will look at the most common type, osteoarthritis, in this article.
Arthritis is typically diagnosed on an x-ray, which can show irregularities in the surfaces of the bones that make up a joint. These irregularities in the contour can cause joint pain and swelling, especially when you use that particular joint. Common areas that develop osteoarthritis are weight-bearing joints such as hips, knees, low back, and big toes. Arthritis appears to be related to trauma (as in sports injuries and accidents), over-use activities and compression of joint surfaces. Osteoarthritis affects an estimated 20.7 million Americans, most after the age of 45. However, in traumatic situations, it can start by the late 20s and 30s. Generally, women are more commonly affected than are men.
Let’s look more closely at why arthritis occurs.
According to the Arthritis Foundation, genetics may play some role in developing osteoarthritis because some people may be born with slight irregularities in their joints. As one ages, these irregularities may hasten early breakdown in the joints.
Interestingly, although age is a factor in arthritis, research shows that osteoarthritis is NOT an inevitable part of aging.
The one constant factor seen clinically in people’s histories and in postural evaluations is that increased joint compression tends to increase the risk of arthritis. That joint compression can come in the form of trauma—as in landing on your tail bone or jamming your knees sliding into a base—or it can come from long-term postural imbalances that place increased weight on one side of the body. Remember, arthritis is generally seen in “weight-bearing” joints. The painful compressed joints, in turn, cause the muscles around them to tighten and protect them, which causes more compression and results in less movement.
Let’s use a metaphor to look more closely at how postural imbalances can cause arthritis.
Say that the two bones making up the knee joint are like two pieces of metal moving in a machine. These pieces aren’t supposed to rub hard together but instead gently glide across each other’s smooth surface with a lubricant (your body’s synovial fluid).
Now, let’s say the floor on which the machine stands settles and the machine is slightly altered. So, those two pieces of metal may rub harder at one point of contact than at another.
If we look at this situation, we can start to see several outcomes. First, the lubricant won’t be has plentiful in the area of most contact. Second, the area that is rubbing too much will probably start to make an audible noise, and third, if you examine the two metal surfaces, you will find the place where the pieces rubbed has more signs of wear.
In this example, which loosely correlates to the body, the noise can be associated with “crepitus” or joint noises and swelling. The floor that the machine stands on is our supporting structure. It is made up of the pelvis and the spine’s postural balance. In other words, if the posture and normal alignment of your body changes, some joints are going to have more stress or compression on them.
Compressive forces can also occur in other situations. Someone who lays carpet, for example, constantly compresses his or her knees. Prolonged sitting with compressive jarring such as driving an older truck without an air seat can increase the likelihood of low back arthritis. Severe pounding like high impact aerobics and running with flat feet and poor shoes can contribute to arthritis.
The good news is there are simple things you can do to minimize your risk of arthritis.
Maintaining your ideal body weight is important. This will ensure you aren’t putting extra stress on your hips, knees, and spine when you do normal activities. Maintaining good postural alignment by standing and sitting up straight is important. If you are unable to stand or sit up straight without a lot of pain or excessive effort, your body is telling you something is out of balance. Seeing a physical therapist, osteopath, or chiropractor who is skilled in both structural and muscular balancing can prove helpful.
Pacing activities by not overdoing (like the weekend warrior syndrome) or by not lifting or doing a job that is too heavy for you is important. Getting help with big jobs, taking frequent breaks, and drinking plenty of water are important, too.
Lastly, keeping the joints mobile and the muscles around them strong without trading off joint compression is a delicate balance to strive for. Sports like swimming, kayaking, Ti Chi, low impact aerobics, Pilates and yoga minimize joint compression, work the whole body, and strengthen it in a balanced way.
Most importantly, listen to your body. It will tell you what activities and exercises make you feel loose, strong and give you more energy. It will also tell you what to avoid. Remember that the old motto “no pain, no gain” has long been dismissed as misinformation. Instead, “train, don’t strain.”