"My doc says I have degeneration of my joints and that is why I'm having pain." I often hear this in the office. Osteoarthritis (OA) or degenerative joint disease is one of the most common reasons people are told they have pain in their joints. I want to shed light on this diagnosis and empower you to understand this problem, maybe prevent drastic and often experimental options for treatment.
OA is when the cartilage surrounding the joint gets damaged and inflamed. OA may cause pain, stiffness, irritation, and inflammation around the joint. The most common joints affected are the knees, hips, spine, and fingers. The diagnosis of OA is made by reviewing symptoms, imaging (x-ray, MRI), physical examination of affected joints, and a blood test to rule out other diseases. I should note that only around 50% of people with positive x-rays findings have symptoms of pain or stiffness. Showing that tissue damage doesn't always equal pain. The actual cause of OA is unknown, but risk factors are genetics, inactivity, age, history of trauma, weight, and other inflammatory disorders. A common misconception of OA is that it is a "wear and tear" disease, that you will get worse because of the specific exercises or activities you do. As more research comes out, this is showing to be inaccurate, and have negative consequences on their health. The thought of having OA creates fear that loading your joints will cause it more damage and more pain, which leads to inactivity. Inactivity is shown to be one of the worst risk factors in creating OA and increasing the symptoms above. Think about a door hinge, if it doesn't get used it rusts, for us rust is OA. The World Health Organisation reported in The Lancet Global Health that more than one in four adults globally (28% or 1.4 billion people) are physically inactive! The other thing I hear is that certain activities are avoided due to "arthritis" pain and then when they do the activity again their "problem" joint will hurt afterward. Usually, it is an instance of not doing that activity very often and then saying when you do it, it causes pain. Consistency is key and doing activities sporadically will make most people sore or have pain.
Common Medical Treatments
Now that you have a diagnosis of OA the conventional treatments when you see your Primary Care Physician are to rest the joint and take either acetaminophen or NSAIDs. If the problem persists joint injections are recommended, and if you can't stand it any more replacement. I listened to a podcast and a few videos on OA treatment by MDs. The focus was on controlling the pain with medicine, injections, and replacement. The research is not excellent for a lot of the treatments suggested above, some may work, but do you want to risk your joints and body on "may"? I am not saying MDs are bad, but the medical community needs to shift the focus to encouraging patients to increase physical activity as the first option. If we become more preventative as a culture than curative, we could eliminate more health problems.
The Better Option
Research is showing more and more the best thing for OA symptoms of pain and disability, is increasing your physical activity. Coming in and seeing me can help improve motion so that when you are ready to be active you can be. Our bodies adapt to stress, so think if you don't use it, you lose it as a mentality. One study of runners they did an x-ray at the beginning and ten years later did an x-ray, and they had no increase in OA! Please say this with me, "I am not fragile!" It is an essential first step to improve your confidence and body image. Knowing that your body is not going to fall apart is so vital for your health and well being, it will empower you! Being smart is the next step, and that is making sure you approach physical activity by entering the shallow end of the pool, not just jumping in the deep end. I want you to choose exercises that you enjoy, but you have to be consistent. Some ideas walking, swimming, tai-chi, strength training, biking, or dancing. Regular physical activity might be the closest thing to a cure-all we have, so make sure you take your daily dose of exercise. As always, movement is medicine; please move well and move often!