The term “arthritis” means inflammation of a joint, and there are as ways that people can experience arthritis as there are types of arthritis. There are literally dozens of kinds of arthritis: osteoarthritis, rheumatoid arthritis, gout, systemic lupus, bursitis–to name just a few. The good news is that arthritis will rarely kill you, although the pain can well and truly drive you up around the bend. The bad news is that the stiffness that you experience can make you feel like real old age has set in far too early.Who gets osteoarthritis? : Occupational arthritis : Common Osteoarthritis Risk Factors : Signs and symptoms of osteoarthritis : Stiffness : Typical signs and symptoms : What about a hip or knee replacement?
Osteoarthritis (OA) is the most common form of arthritis. It is a degenerative disease affecting the whole joint, and any joint can be affected but OA most commonly affects the knees, hips, hands, neck and low back. Diet changes, vitamins, minerals, and herbal medicines can all help significantly. OA can be isolated to one joint, generally a weight bearing joint such as the hip or knee, but it often affects multiple joints. OA can lead to significant problems with mobility with middle aged and elderly people and is probably the most common cause of disability in elderly people in the developed world. OA affects so many people, and I have often been asked to write about it by patients, and offer some of the best natural medicine solutions I know. Let’s explore this condition and see what we can offer, there are many options and I’ll try to give you plenty.
Sir William Osler, known as the “Father of Modern Medicine,” once said, “When an arthritis patient walks in the front door, I feel like leaving by the back door.” After seeing many arthritic patients over the years, I can sympathise with Dr. Osler and understand that many other conventional medical doctors since him have difficulties facing arthritic patients, because there is little that conventional medicine offers them apart from drugs and surgery. I trust that the following points do not come across as being too cynical, it is just my experience in dealing with patients with arthritis who rely primarily on conventional medicine for arthritis treatments:
- The lucky patients get temporary relief along with the anti-inflammatory drug side effects.
- The unlucky patients only get the drug side effects and little to no relief from drugs.
- The unfortunate patients end up with surgery which may or may not be effective or even necessary, they may have steroid injections unfortunately. All too many unfortunate patients end up with wrecked digestive systems from a continual reliance on NSAIDS (non steroidal anti-inflammatory drugs, more about them later)
Who gets osteoarthritis?
Anybody who is alive and active will probably develop a wear and tear syndrome affecting the mechanical parts of their body like their joints sooner or later.
Do you own a motor vehicle? Then it is realistic to understand that if you owned your vehicle for 50 or 60 years or so (the time when osteoarthritis generally will present itself) that if will show signs of significsnt wear and tear in those shock absorbers (your knees), the chassis (your spine) or perhaps your hips (or shoulders (axels, wheel bearings, etc). The fact is, the older we get, the more likely it will be that something just plain wears out. But this is certainly not true for all motor vehicles! Perhaps your vehicle was the type that was just driven to church on a Sunday? Or maybe your car was washed and polished every week, had an oil change and service twice yearly and was carefully driven and parked? Then maybe you belong to that group that never has a problem all through their life with the human frame. There are many reasons why people don’t develop osteoarthritis, and my guess would be that there are just as many reasons why they do.
For many years I have seen certain patients hobble around with sore knees and hips. They could be the kind of people who were very active in their younger years or they could be people who just plain wore out their joints from excessive exercise, or had an accident, a fall, etc. Either way, there is often a history of unusual activity surrounding the affected joint/s in those with osteoarthritis. You may also find that those with OA are the perfectionist people, or like to take control and do things their way. They may do too much and feel happier for having done things “their way”, and this kind of behaviour will ensure that they simply do too much and wear their bodies out prematurely.
Occupational arthritis
Typically, if a guy tells me that he was a truck driver for years (getting in and out of the cab) or a bricklayer (very hard on the joints) or even a mechanic (bending down on knees and looking/working under vehicles) these are all cases for osteoarthritis later in life. A football player, a person who works as a gardener, or even a dressmaker can develop arthritis. You will typically find the “weekend warriors” or the sporting enthusiasts will often develop arthritis.
Just like stress and anxiety are often a cause of muscular pain and tension, excessive use of a limb can result in wear and tear causing osteoarthritis. You get the picture – those who simply do too much or expect too much from their bodies are more likely to end up with arthritis than those who take it easy and slow down when they feel their body needs a rest. That is not to say that all cases of arthritis are caused this way, there are many potential causes of osteoarthritis. Osteoarthritis is also known as a “degenerative” arthritis or the “wear and tear” arthritis. If you’ve been told by your doctor that you have this type of arthritis, there’s a good chance you can substantially reduce or even eliminate your symptoms, while tapering down or even eliminating drugs you may be taking.
Common Osteoarthritis Risk Factors
A number of predisposing factors can hasten this degenerative process, even in young people. They include:
- Increasing age
- Sports (for knee arthritis)
- Family history (several gene variations have been identified as putting someone at increased risk for OA.
- Previous joint or cartilage injury including accidents, infection, fractures and ligament tear causing joint instability,
- Certain types of inflammatory arthritis (like rheumatoid arthritis or gout)
- Repetitive occupational or exercise-related joint movements.
- Diabetes melitus. (Type 2 diabetes)
- Joint mal-alignment problems such as Perthes’ disease of the hip.
- Obesity (more weight stress on weight- bearing joints, especially the knees and lower back).
- Occupational arthritis (knee arthritis in athletes e.g rugby, elbow arthritis in those working with pneumatic drills, etc).
- Ethnic origin (more common in white Europeans).
Signs and Symptoms of Osteoarthritis
The most commonly affected joint is the knee joint, and the second most commonly affected is the hip joint. As mentioned earlier, it is the hips, knees, ankles, neck, low back and hands in general which are the most commonly affected joints. Hip pain can be especially severe, even making walking extremely painful and difficult. Some people’s fingers may develop a knobby and gnarled appearance (Heberden’s nodes). Osteoarthritis of the spine is a common cause of chronic pain and decreased neck and back mobility. In some cases, large bone spurs may compress the spinal cord or pinch its nerve.
Stiffness
Osteoarthritis is usually experienced as aching joints and stiffness. The pain is aggravated by movement and weight-bearing on the involved joint. The osteoarthritis sufferer may feel worse when they are cold or with little movement. As they warm up, the joint may not feel quite as bad and even improve a little with mild exertion. This is not always the case however, as it may aggravate significantly and may even feel much worse for continued motion. With rheumatoid arthritis however (the inflammatory type of arthritis) this will not be the case. Although swelling may occur with OA, warmth and redness and heat of the affected joint usually imply an inflammatory-type of arthritis like rheumatoid arthritis (RA) or gout.
Typical signs and symptoms of osteoarthritis may include:
- Joint pain that is exacerbated by exercise and relieved by rest.
- Rest and night pain can occur in advanced arthritis.
- Knee pain can be felt in one or in both knees and is felt in and around the knee.
- Hip pain is felt in the groin and the front or side of the thigh.
- Hip pain can also be referred to the knee and, in males, the testicle on the affected side can even be tender.
- Joint stiffness in the morning or after rest.
- Reduced function and participation restriction.
- Reduced range of joint movement.
- Pain on movement of the joint or at extremes of joint movement.
- Joint swelling.
- Pain and tenderness in and around the joint.
- Crepitus. (“creaking”, clicking or clunking noises felt when the joint is moved).
- An absence of systemic features such as fever, heat, and rash means osteoarthritis, not rheumatoid arthritis, which is the arthritis of heat, inflammation and infection. Rheumatoid arthritis can cause fever and pain throughout the whole body.
- Bony swelling and deformity in the fingers which presents as swelling of the joints more near your finger nails (known as “distal” joints), which are called Heberden’s nodes, or swelling of the joints closer to your hand (known as the proximal joints) which are called Bouchard’s nodes.
- Joint instability – the knee may feel unstable. There may be times when you get up off a chair and the knee feels like it is going to temporarily “give way”.
- Muscle weakness/wasting around the affected joint.
What about a hip or knee replacement?
Did you know that almost 85% of all knee and hip replacements are carried out because of osteoarthritis? You replace your car, your toothbrush, and other items commonly used on a regular basis. Some folk even change their partners on a regular basis, but you don’t replace your joints, they just keep on going day after day, year in and year out. Some of us may get a knee or a hip replacement, and for some, it is the only way to improve the quality of their lives when the pain is just too much to bear.
In my experience, I have found that some patients ended up replacing the opposing joint down the track. The problem is that the corresponding joint to the one replaced (the healthier one on the other side of the body) may take more strain and may need attention in due course. Your mechanic would rather replace both brake shoes and shock absorbers on your car when only one needs replacement, or both tyres are replaced simultaneously as a set rather than one at a time. Why? Because your mechanic can see the need for balance, a brand new tyre on one side of your vehicle may act and respond differently (more favourably) in various driving conditions. Replacing both tyres at the same time ensures that you don’t place unnecessary strain on your shock absorbers and other parts of the car’s driving train. Similarly, if only one hip is replaced, or one knee joint, you may end up with lower back or knee problems, I’ve see this happen on many occasions. If you do have a knee or hip replaced, take it easy for at least 3 to 6 months and I’d highly recommend a course of Feldenkrais or Tai Chi to bring about more balance and harmony to your body’s scaffolding. Common sense? I think so, and it is often lacking in medicine. I’m certainly NOT advocating that you get both hips or knee joints replaced at the same time, this is simply not feasible or even possible in most situations.
