Family in field

Arthritis (Osteoarthritis)

Thousands of people suffer from pain which has been diagnosed as arthritis. Any time a person has pain around a joint, their back, a lingering pain in the muscles which doesn't get better, stiffness and tightness upon waking up or general aches and pains the normal conclusion is arthritis.

Unfortunately the catch all term "arthritis" is made up of many different and unrelated conditions. These conditions are very different. In addition, many times osteoarthritis (OA) is used as a diagnosis because it may be present on an x-ray but it is not what's really causing the pain felt by the patient.

Symptoms and Case History

The typical patient is one who complains of mild pain on a regular basis often with no particular history of recent trauma or accident. The pain may have gradually gotten worse over a long time. Typically there is stiffness in the morning or after resting for a while. If work is done pain usually develops quicker than what would be considered a reasonable time for that person.

After ruling out other possible pathologies based on history, pertinent lab tests and x-rays, the one test that can prove diagnostic is the Trigger Point (TP) Test. If this test is positive then it is not specifically arthritis. Trigger points are tiny chronic knots in the muscles which are actually micro spasm. They generally only feel tight until they are irritated and flare up. This can be dealt with effectively with therapy.

Rational of Condition

OA is a very slowly progressing joint (bone) condition. This is usually due to reduced activity. Putting a cast across a joint can lead to OA if it is left on too long. An active person's spine can remain free of arthritis. About the age of 35 almost everyone can find some OA within their spine. This doesn't mean it causes stiffness or pain. The old adage of "use it or lose it" is true. The best prevention is regular use of the muscles and joints of the body, even when done moderately.

When we have some pain near a joint and we can't think of a particular traumatic incident we tend to think of it as getting older, stiffer and somehow it must be arthritis. The majority of the time the true culprit is tight or shortened ligament and muscles and the development of trigger points or micro muscle spasms. These will give the normal arthritic picture of stiffness, pain relieved with moderate activity and occasional worsening pain with some activities. Depending on the location of the pain other similar conditions are bursitis, tendinitis, actual sprain of local ligaments and actual strain of local muscles. These are the most common conditions within this picture of pain.

Unfortunately, the actual joint where the degeneration is occurring has very few pain nerves and the pain in those nerves doesn't really fit the pattern described above. However, TPs do and they are much more likely to be the true cause of the pain. As joints begin to wear out the muscles have a tendency to try to work differently than normal to alleviate the stress on the joints. This leads to the classic TP condition. A simple TP test of firm pressure in the muscles near the joint will cause the recognizable pain pattern and relief after a short time. A simple test for the joint condition is to apply force to push the bones together (press down on the head for the neck, press the straight arm and hand against a wall for the arm, push the straight finger back into the hand without bending the joints, etc.). Even with pain of arthritis the muscles will almost always have TPs, too. Working on them will do much to relieve much of the pain.

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