Arthritis and Joint Inflammation 

Osteoarthritis (OA) is by far the most common type of arthritic condition with most people over 45 years showing some early signs. OA is associated with ‘wear and tear’ or ‘degeneration’ of the cartilage that form the cushion of joints. This occurs with age or trauma following injury or disease.

OA affects large weight bearing joints like the hips and knees, spine and also hands and feet. Unlike other forms of arthritis, OA does not affects organs.

There are two forms of OA:

PRIMARY OSTEOARTHRITIS

• Not the result of injury or disease
• May have a hereditary link
• Most commonly effects hands

SECONDARY OSTEOARTHRITIS

• Results from injury or disease. Causes include obesity, repeated injury or surgery to joints, diabetes, gout and birth (congenital) abnormalities
• Most commonly effected joints are lower neck, base of spine, hips and knees.

Diagnosis is usually on the basis of X-ray where narrowing of the joint space and bone spurs may be seen. Blood tests for OA will be negative.

OA is not always painful, and some individuals may be surprised when they see significant degenerative changes on X-rays.

An important goal of chiropractic care is to improve muscle and joint function and thereby reduce physical stress that may contribute to advancing OA. To this date there have been no clinical studies that have clearly shown Chiropractic care can reduce the progression of OA.

NATURAL MANAGEMENT

Mild and moderate OA is usually managed well with Chiropractic care, weight loss and exercise to keep joints mobile and well nourished. Supplements such as Glucosamine Sulphate, Chondroitin and Omega 3 fatty acids (such as those found in cold water fish – salmon, sardines, mackerel and trout) may be of benefit. So may supports, such as knee braces.

MEDICAL MANAGEMENT

More advanced cases may require medication. Paracetamol (such as Panadol Osteo) is preferred as this has fewer side effects than Non-Steroidal Anti-Inflammatory drugs (such as Naprosyn and Voltaren) or Cox-2 Inhibitors (such as Celebrex). However, all medication has potential side effects and should be taken with caution.

In advanced cases of hip and knee OA, joint replacement surgery may be required.

Rheumatoid arthritis (RA) is an autoimmune disease that can cause chronic inflammation of the joints and other areas of the body. The immune system of an RA individual is misdirected and attacks the body’s own tissues. It is a chronic disease that most commonly effects middle-aged women and is characterised by periods of flares and remission.

The exact cause of RA is unknown though a hereditary link is suspected. Other triggers may be certain types of virus, bacteria or fungi, though this is yet to be proven. Smoking, exposure to silica and periodontal disease, have all be associated with increase risk of RA.

Typically RA causes symmetrical (both sides of the body) joint pain and swelling. During flare ups individuals may also experience fatigue, lack of appetite and fever. Any joint can be affected, but joints of the hand and wrist are most common.

Organs affected by RA may include:

• Throat – causing dryness known as Sjögren’s syndrome
• Eyes – inflammation in the whites of the eye (scleritis)
• Lungs – inflammation of the pleura causing chest pain (pleuritis)
• Heart – inflammation of the pericardium surrounding the heart (pericarditis)

The diagnosis of RA is based on physical examination, history, X-ray findings and blood tests. A rheumatologist should confirm the presence of RA.

Chiropractic care to effected joints should only be applied during the remission periods. Chiropractic care may help with improving overall wellbeing as well as with advice on nutrition and exercise.

During flare-ups it is best to reduce activity in the effected joints and use ice packs often. During remission stages it is important to be more active with exercises to improve joint function. Using ‘hand putty’ to improve wrist and hand movement is often helpful.

In more advanced cases medication may be required. Aspirin, Celebrex and cortisone are often used as short acting drugs. Methotrexate and hydroxichloroquine used as long acting drugs.

As always, if a natural approach is effective, it is always a better option. Omega 3 fatty acids (such as those in fish oil), Vit D and Quercetin (a flavenoid and antioxidant that is found in many fruits, berries, and vegetables) may be helpful.