ARTHRITIS/JOINT PAIN - MY SOAPBOX

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Arthritis -- joint pain and inflammation-- is a commonly misunderstood and mistreated condition. It is important to know more about it because misinformation keeps many people from getting the relief they need.

There are two types of arthritis: inflammatory arthritis diseases and osteoarthritis. The inflammatory diseases are conditions like rheumatoid arthritis, lupus, and psoriatic arthritis. These are diseases or illnesses. This chapter is not about these diseases.

Osteoarthritis (OA), conversely, is a wearing out of the joints. The joints do not wear out through a cycle of disease but simply through wear and tear (injury). Osteoarthritis is the arthritis most doctors refer to when they say you have arthritis. If you have one of the inflammatory diseases, your doctor would have a lot more specific information to explain to you.

Osteoarthritis has a few names. It is referred to as "wear and tear" arthritis, and it is also correctly called "degenerative joint disease (DJD)." DJD is a name I feel best describes the condition. "Arthritis means "inflamed joint." ("Artho" means joint, and "itis" means inflammation.) Often a person is told they have arthritis from a doctor who is reading their x-rays. While it is true that the doctor sees signs of wear and tear on the x-ray, it may or may not be true that the joint is inflamed. This is why DJD is a better name. DJD states that you have wear and tear which may or may not be painful. (Don't stop reading; we are almost past the technical part!)

If you are told you have arthritis you are being told that your joints are inflamed. Why is this important? Because most often arthritis (inflammation of the joints) is not the culprit. A patient will often have had signs of wear and tear on their x-rays for years, but they may only have been injured for short period of time. If arthritis was the culprit, they would have experienced pain for years. Let me state this another way. At age 60 every single person will show signs of wear and tear (Osteoarthritis) on their x-rays. Does every single 60-year-old hurt? No!

The bottom line is that just because you have signs of wear and tear on your x-rays doesn't mean the worn down joints are inflamed and causing your pain.

My "Soap Box" belief is that doctors erroneously jump to the arthritis diagnosis. This wrong diagnosis keeps people form getting correct treatment.

What is usually the culprit? A sprain/strain complex (which includes muscle spasms and tendonitis.)

So why is this important? Because:

• Musculoskeletal doctors can fix the sprain/stain complex. (We can also help arthritis.)

• It's a problem because doctors tell patients that they just have to live with arthritis.

• It's a problem because patients give up when they are told they have arthritis.

• It's a problem because it keeps people from getting the correct treatment.

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I've seen it over and over again through the years. Patients just accept that they are going to have to live with the pain of arthritis. They simply stop trying. However, when they find out that arthritis isn't the culprit and that we can help them, they are usually very excited. They are even happier a few weeks down the road when they feel much better!

I also don't like the fact that arthritis also gets blamed for extremity pain. With arm and leg pain, tendonitis and muscle spasms are often the cause. Again, musculoskeletal doctors can treat tendonitis and muscle spasms (see the chapter on tendonitis).

Finally, does arthritis cause pain? Yes, if the joint is inflamed. It just isn't nearly as common as it is diagnosed. Either way, get some good health care. Additionally, if you have Osteoarthritis (wear and tear on x-rays) but you are pain free, and then you injure yourself with a sprain/strain complex, you then may not heal as quickly. This is because your joints are worn down and don't work optimally.

So that's my soapbox. Don't give up if you are told you have arthritis. Find a doctor who can help. Of course I think chiropractors are best suited to help you heal. Both with tendonitis and muscle spasm treatment as well as arthritis treatment.