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Fri, Nov 28, 2014

DR. KESTNER: Arthritis may not be causing your pain

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A patient came to see me a few years ago who began the conversation with, “I don’t expect you will be able to help me. I’ve got arthritis.”

“Who said you had arthritis?” I asked.

“My doctor told me I had arthritis in my back and my knees.”

“Why do you believe that I can’t help you?” I continued.

“My doctor said there wasn’t anything to do except take anti-inflammatory drugs.”

“How’s that working for you?” I asked.

“I feel better as long as the pills are working, but when they wear off I hurt. I seem to be getting worse overall.”

The patient had brought some X-rays that had been taken earlier in the year of his lower back.

The X-rays did reveal some degenerative changes in the lowest lumbar spinal joint. The disk at that joint had deteriorated and several bone spurs were present.

I explained to the man that he did have some degenerative changes in his back, but that didn’t necessarily explain why he had back pain.

“Why’s that” he wondered.

“Here’s the reason I don’t think the bone spurs are causing your pain,” I explained. “Over the years, I have seen thousands of X-rays of other patients that look like this or worse. I often see X-rays that show degenerative changes in the neck or back. In almost all of those cases, proper chiropractic or acupuncture treatment, therapy and rehab exercises have resulted in the patient finding relief from their pain.

“If those degenerative changes that are seen on X-rays were the actual cause of the pain, none of those patients would have improved.”

“What do you mean?” he asked.

“I mean that I never did anything to make those bone spurs go away or eliminate the signs of arthritis that are visible on the X-rays. Even though the patient might be completely pain-free in two to three months, if we took another X-ray the bone spurs and degeneration are still there. If the degenerative changes and bone spurs are still there, and the pain is gone, then it was not the arthritic degeneration that was causing the pain.”

“Then what was causing the pain if it wasn’t arthritis?” he asked.

“I have found repeatedly in thousands of cases that if normal motion and function can be restored to the spinal joints and the muscles and ligaments that attach to the bones, the patient will have less pain and improved ability to carry out their desired activities. Patients that have been told that they have arthritis in their back or neck or even hips, knees and shoulders have often been able to get rid of their pain entirely through proper treatment.”

Here’s the rest of the explanation for this concept that might sound contradictory.

Often, when a person has back or joint pain that is persistent, X-rays are ordered. It is not unusual to find signs of joint degeneration in the same place the patient hurts.

It is natural to assume that since the patient hurts in the same place the joint degeneration is seen, there must be cause and effect relationship.

In fact, this assumption is made countless times every day in clinics around the world.

Fortunately for the patient, this assumption is often incorrect.

If it were correct, then the patient would have little choice but to take pain medication.

However, based upon my experience over the years, it appears that the presence of bone spurs, decreased joint space and other signs of joint degeneration that is called arthritis is often not the actual cause of the pain.

Fortunately, the actual pain is often coming from the tissues such as muscles, tendons and ligaments that can be helped, even though the degenerative changes are not reversible.

Physical therapy, massage, acupuncture, chiropractic manipulation, exercise, yoga and other treatments are used to resolve the pain, but none of these actually reverse the arthritic degenerative changes.

That’s good news for millions of patients that have been told they hurt due to

arthritis.

For more articles about arthritis click on DrKestner.com. Next week: Old dogs can learn new tricks.

Until then stay happy and stay healthy!
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Dr. Kestner
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Health, Health Care, Living Well, Mark Kestner, Voices
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