ON Chiropractic Winter 2014 - Page 18

ON Chiropractic FEATURE STORY / OSTEOARTHRITIS I t is very common for chiropractors to provide treatment to osteoarthritis patients both before and after the onset of symptoms and diagnosis. Recent research indicates that chiropractic care in conjunction with other therapies, predominantly exercise and education, can result in reduced pain and increased mobility for these patients. Risk Factors and Diagnosis: f more than 100 types of arthritis, osteoarthritis is the most common. It is a leading cause of pain and disability worldwide, predominantly impacting the hips, knees, hands and spinal facets. Prevalence of osteoarthritis increases with age, with a sharp increase after age 70. It does not only impact senior patients, however. Previous injury and overloading joints, for instance, have been connected to onset of secondary osteoarthritis. Systemic factors, such as family history and lifestyle, can play a role in the development of osteoarthritis as well. Excessive weight in the lower extremities is particularly problematic as the added strain can hasten or exacerbate symptoms. At least one study has demonstrated that incidences of knee, hip and hand osteoarthritis in women increase around the time of menopause, indicating a possible hormonal causation. A 2013 article in Osteoarthritis Cartilage points out that osteoarthritis is not a single disease, but rather a common end stage phenotype of many different disease processes which involve joint tissues.b Osteoarthritis involves damage to and loss of articular cartilage, remodeling of subarticular bone, osteophyte formation, ligamentous laxity, weakening of the periarticule muscles and possibly O 18 WINTER 2014 synovial inflammation. This has led to inconsistent approaches to the diagnosis of osteoarthritis.s The Arthritis Society of Canada tells patients to expect a combination of diagnostics to be used to form an osteoarthritis diagnosis, including patient history, discussion of symptoms, manual examination of joints and radiographic analysis. However, the use of radiographic criteria alone generally leads to a higher diagnosis rate of osteoarthritis.l A balance of radiographic and clinical evidence is encouraged. Understanding Osteoarthritis Painn: steoarthritis pain is difficult to pin down. In fact, for some time there has been an incomplete understanding of the etiology and mechanics of pain in osteoarthritis patients. In some cases, observed radiological changes are not consistent with pain reported by patients. These findings seem to contradict the belief that greater degeneration of joints would result in greater levels of pain. This can be explained by variance in individual patient perceptions of pain levels, but the lack of a clear relationship between structural damage and pain has led some researchers to consider whether other mechanisms may be responsible for the pain experienced by osteoarthritis patients. Like other chronic musculoskeletal conditions, central sensitization has been proposed as one such mechanism. A focus of recent study has been on osteoarthritis pain being the result of central pain mechanisms. Several conditions, including fibromyalgia and temporomandibular disorder, have been grouped together in the category of “central sensitivity syndromes” (CSS). To date, osteoarthritis has not been O Statistics According to The Arthritis Society of Canada: 100+ Number of types of arthritis 4.6m