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Conditions
Osteoarthritis |
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Most of the joints in the human
body are designed to allow different bones to move, relative to
each other (for example, the knee allows the fibula and tibia of
the lower leg to move, relative to the femur of the upper leg).
Where the bones meet (to form the joint), they are covered in a
layer of smooth cartilage, designed to lower friction and reduce
shock; in addition to this, most joints are lubricated by synovial
fluid (similar in appearance to uncooked egg white). Osteoarthritis
refers to a condition where the cartilage, and/or fluid, is damaged
by wear and tear.
Note: Osteoarthritis is a degenerative condition;
that is, one that generally happens as a result of aging (it is
not the same as rheumatoid arthritis, which is an auto-immune
disease a disease where the immune system actually attacks the
joints in the body).
Why does this happen?
When a particular joint moves, the cartilage of one bone slides
against the cartilage of a second (and possibly third) bone. Over
a long period of time this motion is repeated thousands of times,
and it may lead to wear and tear. If the joint is weight bearing,
the risk of developing osteoarthritis is far higher because the
cartilage is more likely to rub together examples of weight bearing
joints include the ankle, knee, hip, and joints in the spine.
Osteoarthritis often begins around the age of 40, although symptoms
may take longer to emerge (as we get older the structural composition
of the cartilage and synovial fluid may change, making them more
susceptible to this deterioration).
The various stages of the condition are shown in the diagrams below:
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How is it diagnosed?
In general, the symptoms (pain and stiffness in the joints),
combined with someones age, are usually sufficient to warrant
a diagnosis. For example, the symptoms tend to follow a set
pattern:
- Overnight, the spinal joints are largely inactive and,
as a result, they tend to seize up hence, the symptoms are
most severe first thing in the morning.
- During the day, normal movement tends to promote the formation
of fluid in the joint it becomes more lubricated and hence
the pain and stiffness decline.
- Towards the end of the day, the symptoms tend to increase
due to the cumulative build up of stress on the joints.
If necessary, imaging methods (including X-ray, MRI or CT
scan) can be used to provide more information it should
be noted, however, that imaging techniques are largely worthless
in determining the exact cause of pain. |
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| What are the consequences
for back pain? |
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The human
spine is made up of vertebrae, or segments of bone (shown
opposite).
At the base of the spine (turquoise and blue) the vertebrae
are fused together into solid units these are very strong,
but theyre not flexible.
However, the segments in the neck,
thorax and lower back (red, yellow and green) are separate,
individual units, held together by flexible joints. Like
other joints in the human body, the articular surfaces of
these joints are covered in a layer of smooth cartilage;
the joints are also lubricated by synovial fluid.
In addition to this, all of the joints in the spine are
weight bearing; as a result, the neck, upper back, and lumbar
spine are all susceptible to osteoarthritis. |
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What are the risk
factors?
The primary risk factors for osteoarthritis are:
- Age
- Sex
- Weight
- Previous injury
- Biomechanics
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Ageing is a primary
risk factor (however, it should be noted that osteoarthritis
is not an inevitable part growing older). Gender,
or sex, is also a determinant of risk for example,
approximately 21 million people in the US suffer from
osteoarthritis, but, of these, 16 million (76%) are
women.
Excess weight (especially clinical obesity) will almost
certainly lead to an increased risk of osteoarthritis
it literally forces the weight bearing joints together,
causing the cartilage to break down more quickly.
Injury to the joints (for example, caused by a sporting
or car accident) can also affect the cartilage, leading
to increased wear and tear. |
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Osteoarthritis accounts
for half of all chronic conditions in persons aged
over 65. Some 25% of people over the age of 60
have significant pain and disability from osteoarthritis.
The economic consequences of osteoarthritis are
enormous; for example, it is rated the highest cause
of work loss in USA, despite being a condition that
causes most problems to people after retirement
age.
Source: Bone and Joint Decade. |
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| Finally,
biomechanics the way in which the joints move
and distribute the weight of the body is a
primary risk factor. For example, if someone
suffers from short leg syndrome, where one of
their legs is significantly shorter than the
other (typically > 5mm), this may, over time,
lead to cartilage abrasion in a number of weight
bearing joints. |
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Can it be
treated?
It is unlikely that the effects of osteoarthritis
can ever be reversed. However, both the rate
of cartilage abrasion and the symptoms can be
significantly reduced, by conservative forms
of treatment.
Compression (of the weight bearing joints) is
the single, largest risk factor that can be
actively managed we cannot, after all, change
either our age or sex. If at all possible, excess
weight should be lost by increasing your level
of exercise, and decreasing your calorie intake
if your joints are already painful, then physical
activity in a pool is a good idea as this reduces
the weight carried by the joints in question.
Decompression of the spinal joints can be achieved
by using the
backrack™, or by visiting a specialist in
orthopaedic medicine both of these techniques
are gentle, non-invasive and highly effective.
If you have spinal osteoarthritis, you may wish
to consider treatment from an
osteopath or
chiropractor. This may relieve pain
in the short-term, but we believe that the methods
used are too violent to offer a long term solution
ultimately, they may do more harm than good.
If you experience significant pain, analgesics
(or
painkillers), especially NSAIDs (Non Steroidal
Anti Inflammatory Drugs for example, ibuprofen)
may relieve symptoms in the short-term. However,
drugs will not treat the causes of osteoarthritis
and, in the long-term, are potentially detrimental
to your health.
Spinal surgery is most certainly not
the answer. A
fusion, for example, will prevent arthritic
joints in the spine from moving and (in theory)
stop the pain caused by this; however, the fusion
will almost certainly create more problems than
it solves we strongly recommend that
surgery is avoided. |
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