Arthritis

Arthritis (3)

  

  

Arthritis Prevention and Chiropractic  

Chiropractic prevents arthritis in accident victims, the elderly and the sedentary

A report on the scientific literature 


By Mark Studin DC, FASBE(C), DAAPM, DAAMLP
 

According to the Arthritis Foundation (2007), "Forty-six million [46,000,000] Americans are currently living with arthritis, the nation's leading cause of disability, and we are all paying a high price for it. The Centers for Disease Control and Prevention (CDC) announced that the annual cost of arthritis to the United States economy was $128 billion in 2003 and increased by $20 billion between 1997 and 2003.

CDC attributes the dramatic increase to the aging of the population, predominantly baby boomers, and increased prevalence of arthritis. CDC also estimates an additional 8 million new cases of arthritis will be diagnosed in the next decade" (
http://www.arthritis.org/cost-arthritis.php
).

Arthritis, A.D.A.M., Inc. (2010, February 5), "...is inflammation of one or more joints, which results in pain, swelling, stiffness, and limited movement. There are over 100 different types of arthritis...

Causes, incidence, and risk factors

Arthritis involves the breakdown of cartilage. Cartilage normally protects the joint, allowing for smooth movement. Cartilage also absorbs shock when pressure is placed on the joint, like when you walk. Without the usual amount of cartilage, the bones rub together, causing pain, swelling (inflammation), and stiffness.

You may have joint inflammation for a variety of reasons, including:

- An autoimmune disease (the body attacks itself because the body immune system believes a body part is foreign)
- Broken bone
- General wear and tear
- Infection (usually cause by bacteria or viruses)... 

With some injuries and diseases, the inflammation does not go away or destruction results in long-term pain and deformity. When this happens, you have chronic arthritis. Osteoarthritis is the most common type and is more likely to occur as you age. You may feel it in any of your joints, but most commonly in your hips, knees or fingers. Risk factors for osteoarthritis include:

- Being overweight
- Previously injuring the affected joint
- Using the affected joint in a repetitive action that puts stress on the joint (baseball players, ballet dancers and construction workers are all at risk)

Arthritis can occur in men and women of all ages. About 37 million people in America have arthritis of some kind, which is almost 1 out of every 7 people" (http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0002223). With hypomobility (less mobility or movement), adhesions occur in a joint (the region where 2 bones connect).

According to A.D.A.M., Inc. (2010, March 30), "Adhesions are bands of scar-like tissue that form between two surfaces inside the body and cause them to stick together. As the body moves, tissues or organs inside are normally able to shift around each other. This is because these tissues have slippery surfaces.

Causes, incidence, and risk factors

Inflammation (swelling), surgery, or injury can cause adhesions to form almost anywhere in the body...Once they form, adhesions can become larger or tighter over time. Symptoms or other problems may occur if the adhesions cause an organ or body part to twist, pull out of position, or be unable to move as well.

Adhesions may form around joints such as the shoulder...or ankles, or in ligaments and tendons. This problem may happen:

- After surgery or trauma
- With certain types of arthritis
- With overuse of a joint or tendon

Symptoms

Adhesions in joints, tendons, or ligaments make it harder to move the joint and may cause pain...Adhesions in the pelvis may cause chronic or long-term pelvic pain.

Signs and tests

Most of the time, the adhesions cannot be seen using x-rays or imaging tests" (http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0002462).

Over time, with a sedentary lifestyle as seen in many portions of the population and increasingly with the elderly, joints become hypomobile. Hypomobility is also seen in trauma-related cases and repetitive use injuries, such as reading while looking down for extended periods, carrying heavy items, holding the phone between one's shoulder and ear, prolonged use of hands, wrists, back and neck, excessive use of computers, etc. As time progresses, internal scar tissue or adhesions continue to develop and further increases the loss of mobility.

Cramer, Henderson, Little, Daley and Grieve (2010), cite previous studies that have shown that adhesions have been found in numerous hypomobile (loss of normal movement) joints and that spinal adjusting separates the articular surfaces of the joint. The researchers inquired as to whether connective tissue adhesion developed in lumbar articular joints as a consequence to intervertebral hypomobility and utilized animal studies.  They concluded that "...hypomobility results in time-dependent [adhesions]..." (Cramer et al., 2010, p. 508). In other words, internal scar tissue (arthritis) developed within the joints over time.

Cramer et al. (2010) sited previous studies that found the spinal adjustment separates the joints which could break up intra-articular adhesions. In other words, in their animal studies, spinal adjustments/manipulation increased the "Z gap" or spacing between the joints/bones and the mobility of the joints. If this applied in humans, the adjustments would then prevent further development of adhesions and degeneration and osteophytes, which is how the arthritic process progresses.

While arthritis affects approximately 1 in 7 Americans, the prevention of and/or correction of arthritis would relieve a great strain on our economy. While not all arthritis is a result of hypomobility, much of it is. If every person was under chiropractic care, we could not only positively affect the lives of every American, we could potentially rescue the economy of the United States and every other country and insurer in the world that assumes risk for an aging and hypomobile society.
 

 

References:

1. Arthritis Foundation. (2007, January 17). Cost of arthritis increases to $128 billion annually. Retrieved from http://www.arthritis.org/cost-arthritis.php

2. A.D.A.M., Inc. (2010, February 5). Arthritis. Retrieved from http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0002223

3. A.D.A.M., Inc. (2010, March 30). Adhesion. Retrieved from http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0002462

4. Cramer, G. D., Henderson, C. N. R., Little, J. W., Daley, C., & Grieve, T. J. (2010). Zygapophyseal joint adhesions after induced hypomobility. Journal of Manipulative and Physiological Therapeutics, 33(7), 508-518.

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Low Back Pain, Arthritis and Chiropractic, A Clinical Correlation

A report on the scientific literature 


By

Mark Studin DC, FASBE (C), DAAPM, DAAMLP

William J. Owens DC, DAAMLP

 

The American Chiropractic Association (2010) reported that 31 million Americans experience low back pain. This is an epidemic at a staggering rate because what most of the public and doctors alike do not understand is what that sets the patient up for later in life that can be prevented. Stupar, Pierre, French and Hawker (2010) found that 49% of the general population reported a 6 month prevalence of low back pain, with11% reporting the back pain to be so significant that it seriously limited their activities.

Low back pain and arthritis have now been linked. According to Dawson and Shaffrey (2009), the most common form of arthritis is called osteoarthritis. It is also known as degenerative joint disease. It affects more than 20 million American adults. The cause of osteoarthritis is a breakdown of cartilage, the connective tissue that provides a cushion between the bones of the joints. Healthy cartilage is what permits bones to move over one another and acts as a shock absorber during physical activity. Those afflicted with this disease experience a breakdown of cartilage in which the cartilage wears away. As a result, the bones under the cartilage rub together, resulting in pain, swelling, and a loss of motion in the joints.

Osteoarthritis often begins at a slow rate. Early on, joints may be sore after physical work or exercise. The pain of early osteoarthritis dissipates and then returns over time, particularly as a result of overuse of the affected joint. Other symptoms may include:

1. Swelling or sensitivity in one or more joints, especially when related to a change in the weather

2. Loss of joint flexibility

3. Stiffness in the joint(s) after getting out of bed

4. Either a crunching feeling or a sound that results from bone rubbing on bone

5. Bony lumps on the finger joints or at the base of the thumb

6. Intermittent or regular pain in a joint


As Stupar et al. (2010) reported, osteoarthritis or OA has long been associated with back pain and reported comorbidity (they exist together). 40% of hip or knee osteoarthritis patients have had low back pain. That is a significant number and associated with hip arthritis. The 2010 study concluded having hip osteoarthritis and low back pain is a conclusive predictor for future leg pain and disability and suggested that alleviating low back pain may impact future hip pain and function.

Clinically, the authors have seen in patients with low back instabilities and persistent pain the degeneration of the spine and hips over a lifetime. This has been termed "subluxation degeneration." The Association of Chiropractic Colleges has defined subluxation as "...a complex of functional and/or structural and/or pathological articular changes that compromise neural integrity and may influence organ system function and general health" (The Association of Chiropractic Colleges, 2010, http://www.chirocolleges.org/paradigm_scope_practice.html). Simply put, subluxation is a diagnostic entity that denotes the vertebrate is out of position, is fixed or stuck in the wrong position to some degree and has a negative neurological effect. Once the vertebrate is out of position, the body automatically tries to stabilize the spine and mobilizes calcium to use as cement or glue to prevent further malpositions. This is one of the causes of the degeneration or osteoarthritis as a sequella to malpositions of the vertebrate.

A 2009 study by Aspegren, Enebo, Miller, White, Akuthota, Hyde, & Cox concluded that 81.5% of workers with an acute injury causing low back or neck pain reported immediate post-treatment relief. That doesn’t take into account those patients who got better over time.

In 2009, Painter reported that Consumer Reports conducted an independent survey of 14,000 subscribers who rated hands-on therapy as the #1 treatment of choice for low back pain. The report went on to say that 88% of those who tried a chiropractic adjustment reported positive outcomes  and 59% were "completely" or "very" satisfied. The complete results are:

Professional

Highly satisfied

Chiropractor

59%

Physical therapist

55%

Acupuncturist

53%

Physician, specialist

44%

Physician, primary-care doctor

34%

 

We have concluded that there is a definitive clinical correlation between low back pain and osteoarthritis as a prognostic indicator of significant future problems if the low back pain is not resolved. We have also concluded that chiropractic care is a safe, highly effective treatment choice for low back pain patients and as a result, low back pain cannot be ignored. These studies along with many others conclude that a drug-free approach of chiropractic care is one of the best solutions for patients with low back pain. To find a qualified doctor of chiropractic near you go to the US Chiropractic Directory at www.USChiroDirectory.com and search your state.



References:

1.  American Chiropractic Association. (2010). Back Pain Facts & Statistics. Retrieved from https://www.acatoday.org/level2_css.cfm?T1ID=13&T2ID=68
2.  Stupar, M., Pierre, C., French, M. R., Hawker, G. A., (2010). The association between low back pain and osteoarthritis of the hip and knee: A population-based cohort study. Journal of Manipulative and Physiological Therapeutics, 33(5), 349-354.
3.  Dawson, E. G., & Shaffrey, C. I. (2009, December). Osteoarthritis: Degenerative spinal joint disease. Spineuniverse. Retrieved from http://www.spineuniverse.com/conditions/spondylosis/osteoarthritis-degenerative-spinal-joint-disease
4. 
The Association of Chiropractic Colleges. (2010). Bylaws. Retrieved from http://www.chirocolleges.org/paradigm_scope_practice.html
5.  Aspegren, D., Enebo, B. A., Miller, M., White, L., Akuthota, V., Hyde, T. E., & Cox, J. M. (2009). Functional scores and subjective responses of injured workers with back or neck pain treated with chiropractic care in an integrative program: A retrospective analysis of 100 cases. Journal of Manipulative and Physiological Therapeutics, 32(9), 765-771.
6.  Painter, F. M. (2009). Consumer reports survey shows hands-on therapies were the top-rated treatments. The Chiropractic Rescue Organization. Retrieved from http://www.chiro.org/LINKS/ABSTRACTS/Hands_on_Therapies.shtml

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Arthritis and Low Back Pain:
Chiropractic Care vs. Heat Treatment

 

A report on the scientific literature 



Chiropractic care rendered significantly greater relief of pain
and significantly more mobility


By

Mark Studin DC, FASBE (C), DAAPM, DAAMLP
William J. Owens DC, DAAMLP
 

"31 million Americans experience low-back pain at any given time" (The American Chiropractic Association, 2010, https://www.acatoday.org/level2_css.cfm?T1ID=13&T2ID=68)
 
Interesting facts about back pain:1

  1. One-half of all working Americans state that they experience back pain each year.
  2. One of the most common reasons people call out of work is back pain.  It is also the second most common reason for a visit to the doctor's office.
  3. Back pain is often mechanical or non-organic, meaning it is not caused by a serious condition, such as inflammatory arthritis, infection, fracture or cancer.
  4. At least $50 billion per year is spent by Americans on back pain.
  5. Experts estimate as much as 80% of the population will experience a back problem at some time in their lives.

 
What Causes Back Pain?

 
The back is made up of bones, joints, ligaments and muscles. Ligaments can be sprained, muscles can be strained, disks can rupture, and joints can be irritated.  All of these can result in back pain. It doesn't always take a major event like a sports inury or an accident to cause back pain. Even the simplest of movements, like picking a small object up from the floor, can have painful results. There are also numerous conditions that can cause or complicate back pain, such as arthritis, poor posture, obesity, and psychological stress. Disease of the internal organs, such as kidney stones, kidney infections, blood clots, or bone loss, can also result in back pain.1

 
The most common form of arthritis is called osteoarthritis. It is also known as degenerative joint disease and is a disease of the joints. It affects more than 20 million American adults. The cause of osteoarthritis is a breakdown of cartilage, the connective tissue that provides a cushion between the bones of the joints. Healthy cartilage is what permits bones to move over one another and acts as a shock absorber during physical movement. Those afflicted with this disease experience a breakdown of cartilage that wears away. As a result, the bones under the cartilage rub together, resulting in pain, swelling, and loss of joint motion.2

 
What Causes Osteoarthritis?2


There is often no known cause of osteoarthritis. Risk factors include:

  1. Age – More people over the age of 45 are affected by osteoarthritis
  2. Female – Osteoarthritis more often affects women than in men
  3. Particular hereditary conditions like defective cartilage and joint deformity
  4. Joint injuries that result from sports, work-related activity or accidents
  5. Obesity

 
Signs and Symptoms of Osteoarthritis2


Osteoarthritis often begins at a slow rate. Early on, joints may be sore after physical work or exercise. The pain of early osteoarthritis dissipates and then returns over time, particularly as a result of overuse of the affected joint . Other symptoms may include:

  1. Swelling or sensitivity in one or more joints, especially when related to a change in the weather
  2. Loss of joint flexibility
  3. Stiffness in the joint(s) after getting out of bed
  4. Either a crunching feeling or sound resulting from bone rubbing on bone
  5. Bony lumps on the finger joints or at the base of the thumb
  6. Intermittent or regular pain in a joint

 
In 2006, "...an experimental design was used to compare the effects of chiropractic care (and moist heat) to the effects of moist heat alone for treating lower back pain that is secondary to [arthritis] of the lumbar spine" (
Beyerman, Palmerino, Zohn, Kane, & Foster, 2006, p. 107).  This was the first study of its kind. There were 3 parameters measured, pain, mobility and activities of daily living. The results conclusively revealed in every metric analyzed that chiropractic care rendered significantly better results, rendering greater relief of pain and significantly more mobility had been restored.
 
Low back pain and osteoarthritis is a very common condition treated daily in chiropractor’s offices nationwide. This study confirms scientifically the clinical results treating chiropractors have been experiencing for over 100 years. The degree to which pain interferes with aspects of daily living was statistically measured, specifically with walking, sitting and social life and those test subjects under chiropractic care had superior results that simply utilized moist heat.3

 
These studies along with many others conclude that a drug-free approach of chiropractic care is one of the best solutions for patients with low back pain and arthritis. To find a qualified doctor of chiropractic near you go to the US Chiropractic Directory at www.USChiroDirectory.com
 and search your state.




References:

1.  The American Chriopractic Association. (2010). Back pain facts and & statistics. Retrieved from https://www.acatoday.org/level2_css.cfm?T1ID=13&T2ID=68
2.  Dawson, E. G., & Shaffrey, C. I. (2009, December). Osteoarthritis: Degenerative spinal joint disease. Spineuniverse. Retrieved from http://www.spineuniverse.com/conditions/spondylosis/osteoarthritis-degenerative-spinal-joint-disease

3.  Beyerman, K. L., Palmerino, M. B., Zohn, L. E., Kane, G. M., & Foster, K. A. (2006). Efficacy of treating low back pain and dysfunction secondary to osteoarthritis: Chiropractic care compared with moist heat alone. Journal of Manipulative and Physiological Therapeutics, 29(2), 107-114.

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