Simply put, osteoarthritis and degenerative joint disease are the same conditions and either term can be used. Out of the hundreds of different types of arthritides, osteoarthritis is the most common of them and this is because it is the ‘wear and tear’ arthritis. We’ve found that these terms arouse a lot of concern in many people, and we’d like to educate our community about it to reduce their fear – knowledge is power. With all the illnesses that exist in the present day, each day is a blessing. To grow older is a privilege but we cannot forget that aging is not painless. With gratitude for each day, we have to take care of ourselves.
We are much more likely to experience OA in later years of life due to its degenerative nature. The statistics show that of all the people who suffer from OA, 43% are 65 years of age or older and 88% are 45 years or older. In younger joints, early OA may occur, but this is less likely and would occur in a person who is exposed to predisposing factors such as a history of injury or significant overuse. It is important to know that OA is highly individualized. An individual may experience symptoms of varying degrees in different parts of their body. Here are two separate examples:
Tim, at 59 years old, presented to Chirolink suffering from chronic neck pain and stiffness. Tim had been a professional rugby player for nine years. He played a full-back which requires a large amount of impact, but he decided to stop playing altogether 30 years ago. Tim has lived a relatively sedentary lifestyle since then but has enjoyed playing golf every couple of weeks. Nine years ago, Tim’s symptoms gradually started and have slowly progressed ever since. He did not want it looked at for a long time, but he finally decided that he needed a better quality of life. In the mornings Tim could hardly turn his head and had consistent pain throughout the day. His neck was extremely stiff and noticed some ‘clicking and grinding’ sounds when he moved it. His hand was feeling numb. Tim’s X-rays demonstrated degenerative joint and disc disease and we set to work. Since this was such a long-standing condition, treatment required persistence. With regular care, Tim’s quality of life improved significantly and he ‘feels like a new person’.
Margret had just turned 69 years old. For two years she had aching hip pain. It didn’t start with much but in the previous six months, especially since the weather got colder, it had been very present in her life and she knew it was time to get it seen too. In the mornings it took about an hour to warm up and stop hurting and it felt better when she found she had the right balance between staying active and resting. If she did either of these for too long, she would ache afterward. After a set of x-rays were done, there was visible degeneration of the hip joint. Margret promptly booked her first session at Chirolink and experienced a large improvement from the get-go. She persisted with her treatment plan and now only comes in for her regular maintenance sessions.
According to Kirkaldy Willis’s model of spinal dysfunction and degeneration, there are three phases. The degeneration that occurs is a very slow process and each phase may come with differing symptoms. It is vital to know that many people adapt to changing conditions and experience limited symptoms.
The first phase is dysfunction. It starts with reduced mobility between joint surfaces. The thin lining that covers the joint surface (the synovium) may become inflamed but at this phase, there is minimal cartilage breakdown. The intervertebral disc may experience tearing along the outside fibers in a circumferential and radial pattern which reduces the height of the disc as it starts to herniate. It may encroach on the outside fibers of the corresponding spinal nerve.
The second phase is instability. Gradually, many of the soft tissue structures become laxer which creates some instability and the joint surfaces move ‘out of place’. The joint tries to stabilize itself and adhesions (scar tissue) form. The intervertebral disc experiences further disruption and bulges even further. This can reduce the size of the canal where the spinal nerves travel resulting in further nerve compression.
The third phase is stabilization. This is the stress reaction phase. The body is smart, it knows when things are moving abnormally. In response to the abnormal movement that’s occurring in the second phase of degeneration, the body does all it can to stop the movement and overachieves. The joint surfaces are under significant pressure, so the body lays down more bone to protect itself (what we call osteophytes). The bony enlargement with little to no movement as well as disc herniation results in compression of the spinal nerves but possibly the spinal cord too.
Statistics have shown that there is a 55% increase in all-cause mortality with OA. This directly corresponds to the sedentary lifestyle associated with it. This is a terrifying statistic when it need not be so high. We cannot deny that OA is a reality. It can be very painful or simply a consistent nagging ache that can significantly reduce one’s quality of life. The great news is that these symptoms can be managed, and quality of life can improve significantly.
It is very important to remember that this is a slow and gradual process, and it is not likely to reach such a severe state. Treatment would begin long before as the symptoms would be too severe. In the first stage, most people do not even know any changes are happening! This is why the best time to get treated is when you’re feeling good.
Each step is managed appropriately with the right care. The sooner one starts the better. The lack of mobility of the joint surfaces in that very first phase can be addressed easily, and this will slow down the progression. Each stage is managed with maintenance care and patients respond beautifully.
Humans are incredibly complex and we have to give ourselves the best chance at a good quality of life that we can. Start early. Exercise, eat well, and get adjusted. Respect your body the best way you can. And just like anything good, this has to be consistent. Taking care of oneself should become a normal part of life. It’s not the easy route but anyone who has done it can tell you that it was worth it. Start early but remember it is never too late either! Keep moving – motion is lotion.