Osteoarthritis (OA) and Degenerative Joint Disease (DJD)
Arthritis is a massive subject, when some one says “I have arthritis” there is a huge variation as to which type they could have, each one differing in severity, characteristics and location. The word arthritis when broken down essentially means Arthr- meaning ‘joint’ and -itis meaning ‘inflammation’, this therefore encompasses a large variety of conditions that cause primary inflammation at the joints. The most common of all arthritis is Osteoarthritis (OA) Osteo- meaning ‘bone’, it is also known as degenerative joint disease (DJD) or “wear and tear” by the general public. Everybody at some point will get Osteoarthritis as they enter the latter years of life. Osteoarthritis can also come about as a result of a previous injury, where a joint has been affected and does not function correctly the joint can degrade faster and lead to recurring inflammation at the joint. The term used to describe the mechanism that explains how Osteoarthritis can occur at a joint is “a stable load on an unstable joint or an unstable load on a stable joint”.
So, Osteoarthritis is essentially a wearing out of a joint due to forces not being distributed through the joint evenly. The onset leading to this poor distribution of force varies with each cause, with obvious changes occurring with problems such as trauma, with fractures etc. This is in comparison to the onset of Osteoarthritis as a result of aging, in which case the mechanism is due to a change in the turnover of cartilage cells, which normally act as buffers to protect the bone which is pain sensitive. The body reacts to this by trying to stabilise the joint, this is where the complications begin to occur.
Treatment options Generally the options for Osteoarthritis depend on how severely the joint has been affected. The most common scenario is a patient presenting with joint pain which a manual practitioner will examine and determine if it is indeed arthritis causing the problem and following testing the clinician will refer for an x-ray to confirm the diagnosis. The patient’s joint is then managed so that mobility is increased or maintained and so that the joint and surrounding structures are strengthened to become more stable and slow down or prevent further degeneration. If the arthritis is too severe and begins affecting general daily activities then a manual therapist will refer their patient to their GP or directly to an Orthopaedic consultant as it is possible that the patient will need a replacement joint or other treatment such as an artificial synovial fluid injection.
Conservative treatment If you suspect having Osteoarthritis in a joint or in your joints I would always recommend seeking conservative treatment before choosing surgery. A manual therapist will do as much as possible to prevent or delay surgery though will make you aware if it definitely is the time to consult your GP or consultant. The reason for this is that surgery is not always succesful (as with any surgery) and there is also a chance that the replacement joint will need replacing again after a certain period of time which means more time off work and another spell of time spent in hospital. Conservative treatment would involve advice on how to look after the joint/joints at home with Ice, exercises and stretches and some physical therapy in the clinic to maintain or increase the range of movement at the joint and to make sure exercises and stretches are being performed with correct technique. A Chiropractor can manage your Osteoarthritis for you as well as Physiotherapists and Osteopaths. However to receive the best treatment I would always recommend researching the practitioner you visit prior to consulting by asking friends and family or others in the local area to the clinic as this is the best way to find out how good they are.
I hope this has helped you understand a bit more about your body and Chiropractic, If you have any questions on this topic send me an e-mail at danny@longlevenschiro.com