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DR. JAY LIPOFF: Arthritis
“If you cannot get rid of the family skeleton, you may as well make it dance.”
– George Bernard Shaw
The longer you are alive, the greater your chances are of developing arthritis. I’d rather take that chance then consider my alternatives. As we age everyone experiences changes in their body. Some sooner due to abuse the body has withstood over its lifetime like: sports injuries; falls; poor posture; bad spinal alignment; car accidents; whiplash; lack of flexibility; and genetics.
Arthritis is a condition that can seriously limit the movement of people of any age as they become older. The healthy joints that we are born with become worn; a condition known as degeneration. This can lead to abnormal motion in the affected joint and in the spine create uneven stress to the disc space between the spinal bones and eventually instability of the area altogether.
Arthritis is a slow process and will decrease the range of motion in our body. With less space between our joints and an inability to move our bones like we once did, our muscles corresponding to these regions will also shorten and become tight. Many elderly people will notice less motion and flexibility in their entire spine as they age.
This is an adaptation to the change in our ranges of motion due to arthritis. The more we repeat an activity, the more that area will be under stress and break down over time. That’s why repetitive motion causes many problems in our body.
The most common type of arthritis is Osteoarthritis, which commonly forms after degenerative changes occur over time, after an injury or an infection. It affects either side of the body and usually is noticed more as we age.
Rheumatoid Arthritis and Psoriatic Arthritis are other types of arthritis. In these cases the body actually attacks itself, destroying the joint space, leading to deformation of the joints it involves. Grandparents with fingers that become splayed away from the thumb or have large swollen joints probably have a condition similar to this.
Your body will try to stabilize a troubled spot by depositing bone where there is too much stress or uneven wear. In our spine, bone can grow out from our vertebra in an effort to limit further damage and support the area, known as Osteophytes or spurs. Such growths can also interfere with our motion and space for the spinal cord, called Stenosis, and its nerves causing encroachment and a condition called radiculopathy or radiating nerve pain (like sciatica).
I know they call it the “Golden Years” but I have yet to have one patient confirm this proclamation. Everyone always tells me, “It gets worse after 40”“Doc, wait until you hit 50”“After 60 it’s all downhill,” etc. So in light of these patient’s statements I’ve decided to never grow old. I think the real reason it is called the “Golden Years” is because it was a term derived by doctors who were seeing patients more and more during this aging process.
In the neck, patients usually experience a loss of the ability to turn and bend their head. This can be associated with pain into the arms and headaches.
The Thoracic or midback is famous for the “hunchback.” Nobody wants that big dowager’s hump like Aunt Betsy, which makes her look hunched over and frail looking. I have had several patients with that problem because of what they did in life.
One example was Carl, the crane operator, who sat all day hunched forward to see out his front windshield to see the boom of his machine. That habitual forward bending posture curved his midback over into what is called a hyperkyphosis, or an excessive kyphotic curve. Reading can do the same thing. So can texting!!
Another reason why this forward curve has a tendency to increase is because the shapes of the bones in the thoracic spine are shorter in front and higher in back. As the disc between them degenerate and shrink, this allows the curve to increase. To some degree, rounding of the back can be part of the normal aging process.
When we bend and lift to do everyday chores or work, many of us bend at the waist instead of keeping our back straight and lifting with our legs. Over time this causes excessive wear and tear, like a hinge on a door, and that can lead to deterioration.
As the discs wear down, the space or height between the vertebrae decreases too. This means there is less space for the nerves to exit this region along the side of these vertebrae. This is often called Degenerative Disc Disease, Degenerative Joint Disease or Spondylosis.
With more and more stress, the discs will continue to change size and the body will respond and adapt. Calcium will be deposited to stabilize the area as a direct counter measure to the continued stress.
A minimal decrease in disc height results in more stress on the surrounding segments of the vertebra and has been shown to cause degeneration in the facets. With closer proximity of moving parts there is increased resistance. This will cause abnormal movement of the spine and worsening arthritis.
A 2007 study by Eubanks et al. found at age 60, 100 percent of their subjects had arthritic facets. The kicker? Arthritic facets can cause chronic pain.
What can we do to limit Arthritis in our body you ask? Well here we go …
Nutrition is key. Specific dietary changes and supplementation with glucosamine sulfate and chondroitin sulfate may prove beneficial for some patients. It contains the building blocks that help your body repair worn cartilage. Vary your diet and eat a wide range of foods for well-balanced nutrition. Limiting sugar intake can help avoid excessive inflammation in your joints as well.
Use common sense. You need to take breaks during long periods of continued stress, work or stationary positions to reduce fatigue and strain on your body. Move around to keep nutrients flowing and keep the joints loose.
Even at 45 I have to remind myself I can’t do things the way I used to even though I feel fine. I don’t need to move the furniture out of my house and into a new one. Could I do it? Sure. Do I risk the chance of injury and being out of work? Yep, and that is more costly in the long run. That’s recognizing your limits and doing the smart thing. File that under, “You can teach and old dog new tricks!”
Got Back? Just because you can’t see it doesn’t mean it doesn’t need care. If you never smiled would you still see a dentist? Ignoring your back that protects your spinal cord, attaches to the muscle of your body and provides movement is careless. The more uneven stress to the joints of your body, the greater your risk of Arthritis in the body. Replacing body parts in the back is trickier than a knee and more dangerous.
Last week I had a mid-30s, well-built, gym enthusiast tell me he was concerned about the returning pain in his back. He told me he really wasn’t into regularly caring for the spine, just to make sure it was “fixed.” I asked him why he took such good care of the muscles of his body and back and not what they were attached to. That’s like driving a Shelby Cobra and running it on cheap gas. It may look great but it doesn’t run that well. He got the point.
If you continue to drive you car with an alignment problem, it will get you from point A to point B. Eventually it will breakdown and the repair bill will much higher than if you just had the alignment checked even though you couldn’t see it needed attention.
Check the scale. If you have extra weight, that can wreak havoc on other parts of your body. Additional stomach weight can be multiplied by 10 in terms of additional stress to your lower back. Ten pounds up front is 100 pounds of degenerative changes in the back. In the knees, additional weight is multiplied by five. So 10 pounds overweight is 50 pounds of added stress to the knees. Do what you can to drop a few pounds.
Stay fit. We hear it all the time. Exercise is extremely important to your health on many fronts. Keeping active forces the calcium to stay in the bones and keeps your bones and joints strong. As we age you may have to limit contact sports and high impact moves but riding a bike, toning in the gym, remaining flexible, yoga, Jazzercise, massage, Pilates are examples of things you can do to help yourself.
What’s up Doc? Always see you medical and chiropractic doctors to have them run blood work or order films if you are having chronic or worsening pain. They may be able to offer you treatment in terms of medicine or nutritional recommendations, ergonomic changes, postural corrections and more.
For instance Vitamin D deficiency is running wild because we are trying to limit sun exposure, which helps the natural production of it in our bodies. Without it we are more likely to lose bone density and become arthritic.
Also your MD could determine if hormone therapy would be beneficial in maintaining your bone mass. As we age and have decreased production of Estrogen in women and Testosterone in men, we have a greater susceptibility to Osteoporosis.
The party pooper. Both smoking and alcohol consumption can lead to Osteoporosis, or weakening bone quality, and fractures. The best thing you could do for your overall health is to quit smoking. As far as the alcohol, it is recommended that you just use moderation as your guide.
Bad Posturing. Take care of your posture and sleep, sit and lift healthier. Common chores and habits will lead you down a path of abnormal stress to your body. If you haven’t read my previous articles, my book is filled with simple ideas to correct your posture when performing many of the everyday chores we are all faced with. A healthy body is your first step in the right direction to limiting Arthritis in your body.
These topics come from my book, “Back At Your Best; Balancing the Demands of Life With the Needs of Your Body.” It is available in book and Kindle format at Amazon, www.BAYBBook.com and at my office.
If you have any personal health concerns or questions, feel free to email me at DrJay@BackAtYourBest.com. I will answer them in private or in this section in a week or two.
Dr. Jay M. Lipoff is the owner of Back At Your Best Chiropractic & Physical Therapy, LLC, which is located in the Wildewood Shopping Center. He received his Bachelor of Science degree from Syracuse University in 1990, a Doctorate of Chiropractic (D.C.) from New York Chiropractic College (NYCC) in 1994 and he became a Certified Fitness Trainer (CFT) in 2005.
Dr. Lipoff is an Executive Board Member, International Chiropractic Association Council on Fitness and Sports Health Science; has a radio segment: Back At Your Best in 5 Minutes or Less, Co-Founder, Drug Free Training USA; Member, NY Strength-promoting the importance of physical conditioning; Board Member of Public Relations Committee, Maryland Chiropractic Association; has done over 15 nationally broadcasted radio interviews, has articles in print and referenced in over 100 print papers, magazine and on websites, President, Wildewood Business Network-promoting better business relations and community outreach.
* DISCLAIMER: THIS ADVICE AND ANY OPINIONS MENTIONED ARE THAT OF DR. JAY LIPOFF AND NOT OF THE BAYNET.
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