Arthritic Pain

There is NO correlation between the degree of Arthritis seen on X-ray and pain.

But I’ve had an x-ray and been told I’ve got arthritis and I just have to live with it and accept it. Does this sound familiar? Yes? Then you are not being advised based on the scientific evidence that is out there. Just about everyone over 30 will have arthritic changes on x-ray. But not everyone has pain. Why? Pain is felt through pain nerves that get activated because it gets easier to stimulate them. This is increased by the release of chemicals from damaged tissue and also from the pain nerves themselves. So sometimes you have pain just because you have pain! Sound confusing?

As we get older we all develop degenerative arthritis. This happens at varying rates for everybody and is related to your past history. For example trauma leads to arthritis and so can inactivity too. Diet can influence the rate of arthritic change too.

Rapid and effective treatment of injuries is aimed at calming inflammation and settling the pain nerves. Manipulation is the best way to achieve this and can help you reduce the chances of your arthritis causing pain. In other words get the problem treated early as the sooner you restore correct function the less long term damage through inflammation you are likely to get.

If however you already have it you don’t necessarily have to suffer from pain for the reasons highlighted above.

However if you’ve been told you have arthritis we will advise you on how to reduce the inflammation in your body, we will stimulate the nerves that reduce pain sensation by moving and manipulating you. Sometimes not even where you think the problem is.

The long term use of Paracetomol and anti-inflammatory medication for arthritic joint and muscle or “Rheumatic” pain.

While these are useful in cases where the pain is severe and unremitting it is worth noting that there is a growing body of evidence that long term use significantly increases your risk of developing potentially life threatening illnesses. It is well known that non-steroidal anti-inflammatories (NSAIDS) increase the risk of peptic ulcers. These can be life threatening (2000 deaths per annum in UK). They can also contribute to a 90% increased risk of heart attacks and I don’t need to tell you that they are life threatening! So if you have a 10% chance of heart attack in one year, your risk goes up to 19% with long term NSAID use. So is there anything that can be done for your degenerative arthritis or do you just have to live with it.

Treatment cannot reverse the structural changes that have taken place, but it can help to reduce the pain from the associated structures (muscles and ligaments). Treatment is aimed at reducing inflammation, improving strength and mobility. This may be enough to ease your discomfort and improve your mobility.

In some cases it is necessary to take pain killers such as Gabapentin to calm the nervous system and anti-inflammatories to break the cycle of inflammation if your problem is not responding as planned. We support this multi-disciplinary approach to achieve less long-term dependence. We do not however advocate the long term use of anti-inflammatories and Paracetomol as there is poor evidence of their effectiveness for back and joint pain. (Further information can be found here).

Any improvement will deteriorate if the exercises are not kept up daily and you will have a return of pain at some point if you do not maintain this. However if you are suffering, it is worth giving the treatment a trial of a few visits to see if it can help. If it doesn’t we can refer back to your GP for further assistance and pain management advice.

If you have an inflammatory arthritis or metabolic arthritis this needs to be treated by medication from your GP and a change in diet could also be of great benefit.

Most degenerative arthritis is due to an injury or repetitive strain that has not been rehabilitated correctly. If your joint is injured it is overstretched, this leads to a weakness of the joint. Further injuries cause more stretching, resulting in damage to the cartilage and a resultant laying down of bone as your body stiffens to limit the mobility of that joint. The surrounding muscles become weaker, knotted and tender and this pain contributes to the deep ache of arthritic pain.

Simply by reducing the pain with ice, easing muscle aches with heat, massage and acupuncture and gently mobilising and strengthening the muscles around the joint you could feel a great improvement in your symptoms and possibly even slow this process down.

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Don’t assume you have to live with it. It’s not just your age. It’s because its inflammed that it hurts and we may well be able to help you as we’ve helped thousands of others. Call the clinic on 01202 733355 for advice. We are here to help you and guide you.