Arthritis simply means inflammation in a joint. I feel it’s a diagnosis given too loosely, too often. And I agree with the late Dr. David Walther in that: “Arthritis is often used as a wastebasket term for joint pain.” When people use the term/diagnosis “arthritis”, they are almost always referring to osteoarthritis; as opposed to rheumatoid, psoriatic, or others. The prefix “osteo” refers to bone involvement. Osteoarthritis specifically, is considered the most common joint condition, and that’s what I’ll be discussing in this article. In general the joint symptoms consist of: pain, swelling, aching, stiffness (especially in the morning), crepitus (a grinding noise or sensation), limited range of motion, and pain or stiffness in rainy weather. In general, the signs of osteoarthritis are basically a wearing down of the cartilage between the bone; and eventually destruction of the bone with possible bone spurs. Other more technical changes can occur, but that’s the basic idea. I will use the terms arthritis and osteoarthritis interchangeably.
Unfortunately, as with many diagnoses, the cause and most appropriate treatment is rarely investigated. Almost all pain accompanies inflammation, and many times people experience joint pain. And this is why I feel it’s a wastebasket diagnosis. However, many people experience the same symptoms and have the same diagnosis for entirely different reasons. With this being such a common problem, you’d think the medical and chiropractic community would look a little deeper into the cause and most effective treatments. I’m not saying every case of arthritis is “curable”, I’m saying a lot more can be done than the typically prescribed treatment of rest, anti-inflammatory medication, weight loss if “necessary”, surgery, braces or supports, ice or heat, and/or physical therapy. Sometimes a healthy diet will be recommended, which is obviously a good idea whether or not you have arthritis.
Usually the cause of arthritis is considered unknown. Although the following list has been considered as a cause or exacerbation: over-use, or wear-and-tear; genetic factors; structural or mechanical factors; and perhaps metabolic factors.
I believe a doctor should diagnose the process in which a person acquires a disease, not simply it’s name. It can be very helpful to diagnose the names of conditions, but that doesn’t mean you should stop there and try to cover up the symptoms. Again, that may be all that’s possible in certain cases, but I feel the physicians can do better in almost all cases. Additionally, I’m not saying medication is not necessary at times, and I’m not saying that diagnosing the process can resolve a condition completely. However, you can be sure that you have a much better chance of overcoming your condition (or at least some of it’s nagging symptoms) if you figure out how it began in the first place.
This leads me to my next point in some of the proposed causes and treatments. The wear-and-tear scenario doesn’t totally add up because many people who don’t have arthritis in fact put more wear-and-tear on their joints than those who do have it. Second, many normal or underweight people have arthritis, though I agree being overweight may exacerbate the condition. Genetic factors may certainly play a role, but I think it’s way too prevalent for that to be a major concern; and lifestyle changes should be implemented in order to overcome those limitations if that is found to be the reason. I certainly think metabolic (chemical/nutritional) problems are an issue, and should get a lot more attention. And lastly, mechanical problems will definitely play a role, and that’s where chiropractic and applied kinesiology is key. Hmmm, NO! – it’s definitely not a deficiency of non-steroidal anti-inflammatory medications (NSAIDs). Although your joints may feel better, a lot more damage will most likely occur in other areas of your body as a side effect.
Here is how I approach osteoarthritis. Evaluation of the patient should always include an assessment and treatment of the muscles, tendons, ligaments, fascia (specific connective tissue), joint motion, bursa(s), and even skin (receptors) in some rare cases. Additionally, you should never simply focus on the joint in question only. Assessment of the joints above and below where applicable is always recommended. My patients are always keen to this as they never wonder why I’m looking to another area while still focused on their area of complaint. By the way, you’d be surprised how much the TMJ and cranial joints can affect other joints (and muscles) in the body. Lastly, when it comes to structural treatments, the muscles need to be neurologically facilitated before you begin strengthening them. So physical therapy is fine after that facilitation is done properly. You can read more about muscle facilitation in my article on applied kinesiology.
Next, let’s talk about metabolic or nutritional treatments. If NSAIDs work to relieve your arthritic pain, you can almost be certain that you have a deficiency in essential fatty acids (Omega 3 or 6 oils); as these both work on the same anti-inflammatory pathways. It’s just that NSAIDs block the production of inflammatory mediators (with side effects), while essential fatty acids work to promote the production of anti-inflammatory mediators. And remember, they are considered essential (not just by me)!
Also, the nutrients necessary to build collagen and cartilage need to considered, as an arthritic patient is most definitely deficient in those nutrients. Otherwise, they wouldn’t be degenerating cartilage and connective tissue faster than they are regenerating. These would include protein and vitamin C (the most basic nutrients) to build collagen; in addition to possibly zinc, manganese, iron, vitamin A, sulphur, copper, and perhaps others indirectly. Don’t forget blood sugar metabolism as glucosamine (the popular nutritional supplement that your body should naturally be making) is very important for joint cartilage. Note the first half of that word – “glucos(e)”, or sugar.
Calcium metabolism can also be of prime importance. This may prevent the bone spurring that occurs. Bone spurring essentially occurs because the calcium is not being “directed” to the proper place. Also, chronic inflammation in general will tend to cause calcification in areas of the body where it shouldn’t. For this, the most basic things to think of are magnesium and, again, essential fatty acid deficiency. I’ll speak more about calcium metabolism in another article as it can be complex and is beyond the scope here.
In conclusion, diet and food choices are key, as always. First, consider getting off of ALL food allergens, sensitivities, and those foods that cause lectin reactions. More can be read about that, and other natural anti-inflammatory compounds in my article on inflammation. Foods that promote an alteration of the body’s normal pH (acidity or alkalinity) can often be a problem. I’ll talk about that another time. For now, think whole foods, instead of processed. Lastly, consider a 3-4 week dietary “detox” program and see what that does for you. And please don’t forget the nightshades.
I can go on and on as you can see. I’ll end it with making one last point about making sure to rule out any underlying infection (local, systemic, or gut-related) of any kind. This includes fungal, yeast, (very important), parasitic, protozoal, bacterial, and viral. Toxic metals and other environmental chemical sensitivities can play a role as well.
The purpose of this article was obviously to share information. But perhaps more importantly, to get you to think. Please look for what process is occurring in your body that is causing your problem, not just a name for it.
Dr. Robert D’Aquila – NYC Chiropractor – Applied Kinesiology
sources: some basic reference information for this article was obtained from google health