“That person is old. I couldn’t imagine what their bones look like.” One of the biggest misconception categories on this planet involves the elderly. All old people have brittle bones, can’t see, can’t hear, can’t drive, are cranky, etc. These are all false assumptions that millions of people have made assumptions because of their experiences and what they see on the media. Yes, some of these assumptions are true, but not every single elderly patient experiences these issues. Let’s take the brittle bone stereotype for example. Not all people experience arthritis in their lifetime, and they don’t need to be old to get it either. In this week’s blog, we will discuss what arthritis is, the different types of arthritis and how it can be treated.
What is Arthritis?
Before we discuss what arthritis is, let’s first clear up the stereotypes we discussed earlier. Picture two different types of people. The first person is an 80-year-old male who was a straight A student through college, never played sports, married, had two beautiful daughters and eight wonderful grandchildren, and made a great living as a financial advisor. He never played sports, never broke any bones, never had any car accidents, and has lived a full healthy life. The second person is a 35-year-old male who is a retired NFL football player whose career ended due to multiple fractures, concussions, and sacks since his youth football days.
Who do you think has more arthritis? Surprisingly, most people would say the 80-year-old because they believe the older the spine, the more arthritis; however, arthritis occurs mainly because of trauma/wear and tear factors versus age-related circumstances. You would be surprised to hear that a high percentage of our patients who have arthritis are under age 40, and several of our patients who are over age 70 have a perfectly healthy spine. The biggest take home from this is that age is not the biggest factor for developing arthritis, but rather, it is acquired through lifetime wear and tear that may not be noticeable until an advanced age.
So, what is arthritis? Arthritis is when one or more joints acquire inflammation causing stiffness and pain. Wait, aren’t there 360 joints in the human body? Yes, there are, which means any joints other than the spine such as the shoulder, hip, elbow, fingers, etc., can develop arthritis. Another name for arthritis is called Degenerative Joint Disease (DJD). DJD speaks for itself. Just like degenerative disc disease, joints can break down over time and lose overall motion and function. If it progresses, eventually joint space disintegrates causing bone-on-bone circumstances.
What Are the Most Common Types of Arthritis?
Although there are over 100 different types of arthritis, we are going to discuss only the most common ones briefly. In future blogs we can delve into greater detail on each.
Rheumatoid Arthritis (RA)
RA is an autoimmune disorder which means the body attacks itself. The body’s immune system is dysfunctional and attacks the tissues of the body’s own joints and other organs. The immune system normally triggers inflammation that protects a person from viruses, bacteria and other invaders. In people with autoimmune diseases like RA, inflammation becomes overactive and attacks healthy tissue such as the lining of the joints, called the synovium, Persistent inflammation can eventually lead to permanent damage to joints and other organs thus creating worsening pain in the process. RA is typically managed with drugs specifically targeting towards RA.
Psoriatic Arthritis (PsA)
Similar to RA, psoriatic arthritis (PsA) is an autoimmune inflammatory disease in which the immune system attacks the body, especially the skin and joints, causing skin rashes and pain. It typically occurs in people who have psoriasis, an autoimmune disease that creates red or silver scaly skin patches as the production of skin cells accelerates. These patches can be itchy or painful and they can become dry and cracked, causing more pain.
PsA can affect any joint. It may also affect the sites where tendons or ligaments attach to bones, called entheses. The inflammation of these areas, called enthesitis, commonly affects the heel or bottom of the foot and the lower back. Medications used to treat PsA, including DMARDs and biologics, may relieve pain. Additional skin treatments for psoriasis may be needed from a dermatologist.
Gout is a form of inflammatory arthritis caused by high levels of uric acid, but it does not cause body-wide inflammation like RA or PsA. If your body produces too much uric acid or if you are unable to remove the excess fast enough, it can build up in the blood and form crystals in the joints. This results in extremely painful joint inflammation. Untreated, these crystals can form lumps called tophi in affected joints or surrounding tissues. Gout usually strikes suddenly, often in the large joint of the big toe, but sometimes in other joints. With a gout flare, you can go to bed feeling fine and wake up with excruciating pain.
The initial flare is treated with NSAIDs, corticosteroids and an antigout drug called colchicine. To control gout after the flare subsides, uric acid-reducing drugs are used to treat and manage gout. Lifestyle changes, such as drinking more water and avoiding alcohol and purine-rich foods, can also help prevent future gout attacks.
Ankylosing Spondylitis (AS)
AS is an inflammatory disease that mainly affects the spine and pelvic girdle that creates pain and stiffness as a result of bones fusing together. There is no cure for AS, but like RA, there are management therapies and medications used for RA that help with AS symptoms.
OA is perhaps the most common type of arthritis that patients experience. This condition is what we see most frequently in our office. It is a degenerative disease that affects the whole joint. Over time, the protective cartilage and fluid break down, making joint movement difficult and painful. OA typically affects the hands, knees, hips, and spine. When you look at an x-ray and see all the degenerative changes at each vertebral level, that’s OA. OA typically occurs from wear and tear over a lifetime.
OA cannot be reversed, meaning the degeneration that is found on an x-ray is there to stay. Although it won’t get any better, it can be managed from getting progressively worse with proper care. Most doctors will recommend anti-inflammatory drugs such as Tylenol and regular physical activity. More severe cases of debilitating pain and minimal mobility may necessitate a bone replacement.
We highly recommend regular physical activity because it will continue to keep bone strong and healthy. Instead of taking NSAIDs, take supplements such as Vitamin C, D, and calcium to help keep bones and soft tissue structures strong and stable. For more severe cases, sometimes, a replacement is necessary, and we are not afraid to admit that. We realize that we can only go so far and buy the patient some time, but eventually, the replacement will need done. We have said this in the first few blogs and will bring it up again. We tell all patients upon meeting them that our goal is to serve and to give them the health they want and deserve. After the first visit, we will be able to give you the answer to whether we can do that or not. If we can help, we will be happy to serve them, but if we cannot, we will get them to someone who can.
How is Arthritis Treated?
Let us reiterate that arthritis cannot be reversed. The damage that is present is there to stay, but it can be managed from progressing further. The question is, How? Drugs and steroids only help numb the pain. That’s what many MDs will do to help patients with arthritis. They’re not actually fixing the problem, and that’s why we have researched and found some different remedies and alternative therapies that patients can use.
First, patients should have a regular physical activity routine whether it’s walking, slow-paced running, light weightlifting, simple house chores, etc. The worst thing for a patient with arthritis or any patient for that matter is to sit or lay down and do nothing every day. Movement keeps the muscles loose and the body limber and maintains sufficient blood flow to keep inflammation levels low.
Second, increase Vitamin and supplement intake. Finding the right FDA approved company is key. Don’t just grab any product off the store shelf. It’s always best to talk to us so that we can give you the best recommendations. For arthritic conditions, increasing supplementation of Vitamins C, D, calcium, and magnesium is crucial. Vitamin D and calcium will help maintain the structure and integrity of the bones, magnesium will aid in muscle support and prevent spasms and Vitamin C will assist in collagen and soft structure support.
There are two other supplements that we would like to briefly discuss that are sold exclusively in our office. The first supplement is called Formula 419. It contains protease, calcium and magnesium and its focus is directly removing inflammation. This is great for patients who have more inflammatory arthritic conditions such as rheumatoid arthritis, psoriatic arthritis, gout, and ankylosing spondylitis.
The second supplement is called Baxyl. Baxyl contains a component called Hyaluronic Acid (HA). HA is found in the body naturally until mid-30s early-40s. HAs jobs include keeping skin and hair smooth, aiding vision and most importantly helps bones glide through their designated joint space. When HA is depleted from the body, skin begins to wrinkle, hair becomes brittle, vision diminishes, and arthritis increases. Baxyl is great for patients with osteoarthritis and helps with stiffness and pains in the shoulders, elbows, hands, hips, knees, feet, and spine.
The final step to help manage arthritis is to go see a chiropractor. We see patients with arthritis every single day. It is the most common condition we help manage and help manage successfully. With an appropriate treatment plan, any chiropractor should be able to help any patient live a healthy, normal, pain-free life with arthritis. We see miracles happen like this in our office every day.
Arthritis is an extremely common condition that almost every patient will encounter in their lifetime. It’s just a matter of how much stress or strain the body experienced in its lifetime. Realize that there are easier, cheaper and more successful solutions than opioids and injections. If you or someone you know has arthritis or are experiencing arthritic pain, please call us at (724) 547-3377 and checkout our website at www.drlarrywilkinsspinalcare.com for more content on similar conditions and treatment options.
Yours In Health,
Larry E. Wilkins, DC
Brian M. Steinert, DC