All About Arthritis
By: Kelsie Mazur, DPT
This week's blog is dedicated to my Arthritis warriors. Did you know there are over 100 types of arthritis known today?! Arthritis is one of the most prevalent diagnosed movement disruptors today, with 54 million currently diagnosed with the condition, affecting all people: young, old, and in between. Arthritis is a broad term but it basically means “joint inflammation”. This inflammation causes joint pain, stiffness, swelling, and decreased range of motion. But why does arthritis occur? What is “bone on bone”? Is it even a real thing? Why does it affect me and not my friends? They say exercise is the best way to combat it, but why should I even move, if moving causes pain? These are all questions we are going to cover.
The most common forms of arthritis include osteoarthritis, rheumatoid arthritis and psoriatic arthritis. If you don’t suffer from one of these, chances are you know 1-2 people who do. For the sake of this blog post, we are going to cover Osteoarthritis, which is the most prevalent form of arthritis today and a common diagnosis I educate my patients on. Osteoarthritis (OA) is a common joint condition that happens when the protective cartilage that cushions the ends of your bones wears down over time. This process is natural and occurs in mostly everyone even if you have zero symptoms. Think of cartilage like a smooth pillow between your bones. When it breaks down, the bones can rub against each other, leading to pain, stiffness and swelling in the affected joints. It often affects weight-bearing joints like the knees, hips and spine, but it can also occur in the hands. This is where the phrase “bone on bone” comes into play.
Is “Bone on Bone” Bogus?
“Bone on Bone” is growing to be a more controversial phrase. Orthopedic doctors have used the term for years to describe to patients severity of joint degradation and the pain a patient feels from wear on tear on a joint when cartilage is lost due to Arthritis. While bone on bone is one-hundred percent bonafide (a real thing that does happen) the context of this phrase can be, and is, taken too literally, instilling fears about movement in patients with arthritic pain. Patients with otherwise mild symptoms or people that are even asymptomatic (but have flare ups with certain movements from time to time) are told “x joint is bone on bone”. You may be asking yourself why am I taking the time to talk about this? Well, because currently, there is no cure to reverse even the mildest forms of arthritis, which might seem like a bummer, but I am here to tell you there is 1 single thing that can drastically improve the way your body feels with arthritis: MOVEMENT.
“The words ‘bone on bone’ seem finely tuned to emphasize the putative necessity of surgery & to teach patients to fear the very thing that we most need, even with severe osteoarthritis: exercise.”
Symptoms of Osteoarthritis usually develop gradually and can worsen with certain, not all, activity. Believe it or not, you can live an exciting pain free life with bone on bone Arthritis. That being said, Arthritis and being “bone on bone” is a condition that I like to explain to my patients is one that has an unpredictable nature about it, and encompasses both highs and lows. Simply put: It comes and goes based on unknown physical factors, and likely emotional ones as well (remember the brain plays a role too).
So you’re telling me to move, but how is moving my painful bone on bone joint going to improve my pain ?!
Yes, that’s exactly what I am saying, with some stipulations… Because the body is a complex network of nerves, emotions, joints, muscles, and fascia and the entire body needs to be working as a team. If a doctor told you you were bone on bone, what that means is that certain positions or movements may be painful due to cartilage degeneration. Interestingly, cartilage might be less essential than we assume, as not everyone with severe osteoarthritis experiences significant pain. This could be partly due to the way bone hardening (sclerosis is the medical term), similar to calluses on busy hands, can help protect the area. Additionally, it likely relates to complex factors involving metabolism and the nervous system, meaning some people may feel less pain than others, even in similar structural situations. Many people think that a painful joint needs rest, but not moving enough can actually weaken your muscles, making joint pain and stiffness worse. Gentle or moderate activity can protect your joints by strengthening the surrounding muscles, boosting blood flow to the area, and promoting healthy joint repair. Plus, being active can lift your mood and reduce pain…BONUS!!
I want to touch on one last thing, and that is diet modification with Arthritis. The term “itis” literally means inflammation, so it should not be surprising to learn that a diet rich in whole foods (fruits, veggies, protein) is optimal. That means, anything that causes inflammation of the body (sugar, gluten, seed oils) should be cut out. I am not a licensed dietitian or nutritionist, so questions on this part of lifestyle modifications can better be addressed by these licensed practitioners. But it is necessary to touch on this very important aspect of feeling great with Arthritis. Remember, the body keeps the score, and what you put into it and how you move it will ultimately affect the way you feel.
If you are interested in learning more about how to live optimally with Arthritis, please do not hesitate to contact me. Did you know that we offer free 1-on-1 injury screens? Wattage Physical Therapy will take an in depth look at your ergonomics, posture, muscle tone, muscle weaknesses, and movement patterns to create a plan for YOU. If this article intrigues you, you can directly email me, Kelsie at Kelsie@wattagept.com. I would be happy to help you start the process of living a life free from pain.