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Who here has been to the doctor complaining of joint pain, got sent for a scan that showed signs of arthritis, in which the doctor quickly blames it for your pain? It was once thought that the reason why our joints become sore and painful is because of arthritis, making the joints grind on each other as we move. It is true to a small extent, but it does not mean that we need to stop moving or use it as an excuse.
A lot of patients I speak to in the clinic always tells me the same story, “I have arthritis in my knees, so I can’t walk too far”, or “My back has arthritis that is why I can’t garden for too long”. This is by far not true at all. Having arthritis does not stop you from enjoying life, you telling yourself you “can’t” is what is stopping you from enjoying life.
But before we continue lets explain what arthritis is. Arthritis is a common term to describe joint pain due to changes in the joint itself. The most common form is called Osteoarthritis (OA) which affects the whole joint, from the cartilage, ligaments and to the bone itself. There is no cure for arthritis but there are many ways to manage it.
Often Doctors tend to diagnose OA via a system developed in the 1960’s which uses X-rays to determine the severity of OA, rather than symptoms the patient is presenting. However recent research has shown that there is not a strong relationship between what is found on film to the amount of pain and disability a patient experience, as once believed.
Not all is lost, however contrary to what simple logic tells us to do, we need to continue moving to get better. Since OA causes us to lose integrity within our joints, we need to then strengthen the structures that surround the joint to prevent unnecessary mechanical load through the joint. You can think of your muscles surrounding the joint are like shock absorbers. The stronger the muscles the better it is at absorbing the force so that you can protect your joints.
All of the current literature on all types of OA points to an active approach, by exercising and having a healthy lifestyle. We understand that sometimes being active and exercising can be painful but that does not mean we need to stop, it should not define us. What we need is to seek proper advice from movement specialists such as a physiotherapist or an exercise physiologist who knows how to modify exercises to make it more comfortable, and to progress it in a safe and enjoyable manner.
What about surgery you ask? Well recently in 2018 the British Medical Journal (BMJ) held an expert panel on the matter and concluded that they strongly discourage knee surgery and strongly support conservative treatment for degenerative knee conditions such as OA. “Patients and their health care providers must trade-off the marginal short-term benefit against the burden of the surgical procedure”. I understand that with this panel spoke about knee OA, but we can extend this for all joints in the body.
I guess the take home message here is think of arthritis like a speed bump, you approach it slowly, take your time to go over it. It does not stop you in your tracks.