Degenerative Joint Disease.

Alternative Names: Hypertrophic osteoarthritis; Osteoarthrosis; Degenerative joint disease; DJD; OA; Arthritis-Osteoarthritis.

Causes
Unfortunately most of the time, the cause of OA is unknown. It is mainly related to aging, but metabolic, genetic, chemical, and mechanical factors can also lead to OA.
The symptoms of osteoarthritis usually appear in middle age and almost everyone has them by age 70. Before age 55, the condition occurs equally in both sexes. However, after 55 it is more common in women.

The disease causes the cushioning (cartilage) between the bone joints to wear away, leading to pain and stiffness. As the disease gets worse, the cartilage disappears and the bone rubs on bone. Bony spurs usually form around the joint.

OA can be primary or secondary.
Primary OA occurs without any type of injury or obvious cause.
Secondary OA is osteoarthritis due to another disease or condition. The most common causes of secondary OA are metabolic conditions, such as acromegaly, problems with anatomy (for example, being bow-legged), injury, or inflammatory disorders such as septic arthritis.

Symptoms
The symptoms of osteoarthritis include:
Deep aching joint pain that gets worse after exercise or putting weight on it and is relieved by rest
Grating of the joint with motion
Joint pain in rainy weather
Joint swelling
Limited movement
Morning stiffness
Of course some people might not have symptoms.
Examination and Tests
A physical exam can show limited range of motion, grating of a joint with motion, joint swelling, and tenderness.
An x-ray of affected joints will show loss of the joint space, and in advanced cases, wearing down of the ends of the bone and bone spurs.

Treatment
The goals of treatment are to relieve pain, maintain or improve joint movement, increase the strength of the joints, and reduce the disabling affects of the disease. The treatment depends on which joints are involved.

MEDICATIONS
The most common medications used to treat osteoarthritis are nonsteroidal anti-inflammatory drugs (NSAIDs). They are pain relievers that reduce pain and swelling. Types include aspirin, ibuprofen, and naproxen.
Although NSAIDs work well, long-term use of these drugs can cause stomach problems, such as ulcers and bleeding. Manufacturers of NSAIDs include a warning label on their products that alerts users to an increased risk for cardiovascular events (heart attacks and strokes) and gastrointestinal bleeding.

Other medications used to treat OA include:
COX-2 inhibitors (coxibs). Coxibs block a substance called COX-2 that causes swelling. This class of drugs was first thought to work as well as other NSAIDs, but with fewer stomach problems. However, reports of heart attacks and stroke have led the Drug Licensing Authorities to re-evaluate the risks and benefits of the COX-2s. Ask your doctor whether the drug is 1. Still available and if so 2. Right and safe for you.
Steroids. These medications are injected right into the joint. They can also be used to reduce inflammation and pain.

Supplements. Many people are helped by over-the-counter remedies such as glucosamine and chondroitin sulfate. There is some evidence that these supplements can help control pain, although they do not seem to grow new cartilage.
Artificial joint fluid (Synvisc, Hyalgan). These medications can be injected into the knee. They may relieve pain for up to 6 months.

LIFESTYLE CHANGES
Exercise helps maintain joint and overall movement. Ask your health care provider to recommend an appropriate home exercise routine. Water exercises, such as swimming, are especially helpful.
Applying heat and cold, protecting the joints, using self-help devices, and rest are all recommended.
Good nutrition and careful weight control are also important. If you're overweight, losing weight will reduce the strain on the knee and ankle joints.

PHYSICAL THERAPY
Physical therapy can help improve muscle strength and the motion at stiff joints. Therapists have many techniques for treating osteoarthritis. If therapy does not make you feel better after 3-6 weeks, then it likely will not work at all.

BRACES
Splints and braces can sometimes support weakened joints. Some prevent the joint from moving; others allow some movement. You should use a brace only when your doctor or therapist recommends one. Using a brace the wrong way can cause joint damage, stiffness, and pain.

SURGERY
Severe cases of osteoarthritis might need surgery to replace or repair damaged joints. Surgical options include:
Total or partial replacement of the damaged joint with an artificial joint (knee arthroplasty, hip arthroplasty )
Arthroscopic surgery to trim torn and damaged cartilage and wash out the joint
Cartilage restoration to replace the damaged or missing cartilage in some younger patents with arthritis
Change in the alignment of a bone to relieve stress on the bone or joint (osteotomy)
Surgical fusion of bones, usually in the spine (arthodesis)

Outlook (Prognosis)
Your movement may become very limited. However Treatment generally improves function.
Possible Complications
Decreased ability to walk
Decreased ability to perform everyday activities, such as personal hygiene, household chores, or cooking
Adverse reactions to drugs used for treatment
Surgical complications
When to Contact a Medical Professional
Do contact your health care provider if you have symptoms of osteoarthritis.

Prevention
*Weight loss can certainly help in the management of DJD and reduce the risk of knee osteoarthritis in overweight women.

Degenerative Joint Disease

Alternative Names: Hypertrophic osteoarthritis; Osteoarthrosis; Degenerative joint disease; DJD; OA; Arthritis-Osteoarthritis.
Causes
Unfortunately most of the time, the cause of OA is unknown. It is mainly related to aging, but metabolic, genetic, chemical, and mechanical factors can also lead to OA.
The symptoms of osteoarthritis usually appear in middle age and almost everyone has them by age 70. Before age 55, the condition occurs equally in both sexes. However, after 55 it is more common in women.


The disease causes the cushioning (cartilage) between the bone joints to wear away, leading to pain and stiffness. As the disease gets worse, the cartilage disappears and the bone rubs on bone. Bony spurs usually form around the joint.


OA can be primary or secondary.
Primary OA occurs without any type of injury or obvious cause.
Secondary OA is osteoarthritis due to another disease or condition. The most common causes of secondary OA are metabolic conditions, such as acromegaly, problems with anatomy (for example, being bow-legged), injury, or inflammatory disorders such as septic arthritis.
Symptoms
The symptoms of osteoarthritis include:
Deep aching joint pain that gets worse after exercise or putting weight on it and is relieved by rest.
Grating of the joint with motion.
Joint pain in rainy weather.
Joint swelling.
Limited movement.
Morning stiffness.
Of course some people might not have symptoms.

Examination and Tests
A physical exam can show limited range of motion, grating of a joint with motion, joint swelling, and tenderness.
An x-ray of affected joints will show loss of the joint space, and in advanced cases, wearing down of the ends of the bone and bone spurs.

Treatment
The goals of treatment are to relieve pain, maintain or improve joint movement, increase the strength of the joints, and reduce the disabling affects of the disease. The treatment depends on which joints are involved.

MEDICATIONS
The most common medications used to treat osteoarthritis are nonsteroidal anti-inflammatory drugs (NSAIDs). They are pain relievers that reduce pain and swelling. Types include aspirin, ibuprofen, and naproxen.

Although NSAIDs work well, long-term use of these drugs can cause stomach problems, such as ulcers and bleeding. Manufacturers of NSAIDs include a warning label on their products that alerts users to an increased risk for cardiovascular events (heart attacks and strokes) and gastrointestinal bleeding.
Other medications used to treat OA include:
COX-2 inhibitors (coxibs). Coxibs block a substance called COX-2 that causes swelling. This class of drugs was first thought to work as well as other NSAIDs, but with fewer stomach problems. However, reports of heart attacks and stroke have led the Drug Licensing Authorities to re-evaluate the risks and benefits of the COX-2s. Ask your doctor whether the drug is 1. Still available and if so 2. Right and safe for you.


Steroids. These medications are injected right into the joint. They can also be used to reduce inflammation and pain.
Supplements. Many people are helped by over-the-counter remedies such as glucosamine and chondroitin sulfate. There is some evidence that these supplements can help control pain, although they do not seem to grow new cartilage.
Artificial joint fluid (Synvisc, Hyalgan). These medications can be injected into the knee. They may relieve pain for up to 6 months.


LIFESTYLE CHANGES
Exercise helps maintain joint and overall movement. Ask your health care provider to recommend an appropriate home exercise routine. Water exercises, such as swimming, are especially helpful.
Applying heat and cold, protecting the joints, using self-help devices, and rest are all recommended.
Good nutrition and careful weight control are also important. If you're overweight, losing weight will reduce the strain on the knee and ankle joints.


PHYSICAL THERAPY
Physical therapy can help improve muscle strength and the motion at stiff joints. Therapists have many techniques for treating osteoarthritis. If therapy does not make you feel better after 3-6 weeks, then it likely will not work at all.

BRACES
Splints and braces can sometimes support weakened joints. Some prevent the joint from moving; others allow some movement. You should use a brace only when your doctor or therapist recommends one. Using a brace the wrong way can cause joint damage, stiffness, and pain.
SURGERY
Severe cases of osteoarthritis might need surgery to replace or repair damaged joints. Surgical options include:
Total or partial replacement of the damaged joint with an artificial joint (knee arthroplasty, hip arthroplasty )
Arthroscopic surgery to trim torn and damaged cartilage and wash out the joint
Cartilage restoration to replace the damaged or missing cartilage in some younger patents with arthritis
Change in the alignment of a bone to relieve stress on the bone or joint (osteotomy)
Surgical fusion of bones, usually in the spine (arthodesis)

Outlook (Prognosis)
Your movement may become very limited. However Treatment generally improves function.
Possible Complications.
Decreased ability to walk.
Decreased ability to perform everyday activities, such as personal hygiene, household chores, or cooking.
Adverse reactions to drugs used for treatment.
Surgical complications.

When to Contact a Medical Professional
Do contact your health care provider if you have symptoms of osteoarthritis.

Prevention
*Weight loss can considerably help in the management DJD and ceratainly reduce the risk of knee osteoarthritis in overweight women.

The Pain of it all!

Lower back pain is one of the most common ailments people suffer from and approximately 8 out of 10 people will deal with back pain at some point in their life. That's a lot of people… are you one of them? I am.


I have bulging, herniated discs and have had low back spasms (that knock me to my knees) and sciatica. I have been on all kinds of pain killers, including narcotics which only mask the problem and is by no means a permanent solution.

I have avoided back surgery like the plague as there are so many with horror stories.

The only relief I have found is with the proper exercise and stretching. I can assure you will find back pain relief if you do this regimen the correct way, do it the wrong way and you might up under the knife! Out of all of the various forms of back pain, lower back pain is by far the most common and there's a good explanation for this.


Any idea why? It's not car accidents, it's not work-related injuries, and it's not a lack of prescription medications either. Lack of movement and use is the number one cause of lower back pain! It's the lack of movement in various muscles over years that leads to muscle imbalances and uneven wear and tear on your body, especially the spine. For example, how many times a day are you bending, leaning, or twisting?

Here's what the typical person's day is like:

Wake up - Eat breakfast (hopefully) - Drive or ride to work - Sit at desk - Eat lunch - Sit at desk some more - Drive or ride home - Eat dinner - Sit on couch and watch television - Go to bed
Notice the trend here?

That's an awful lot of sitting and not moving. Well, this is what leads to serious muscle imbalances and so what do we do, we go to the gym and perform exercises that only make the imbalances worse! The key to eliminating lower back pain (nearly any ache, pain, or injury for that matter) is to identify the muscle imbalances that are pulling the spine, bones, and joints out of place and then stretch the tight muscles while strengthening the weak muscles.


Many people who seek professional help are often mis-diagnosed and end up following a treatment plan that fails to eliminate the cause of their back pain. ( Seek out Physical Therapy)
Nearly all of the individuals I worked with were able to eliminate their back pain, or significantly improve their condition even though all of the traditional treatments failed them , cortisone injections, anti-inflammatory medications, back surgery, etc). Even more amasing is the fact that most of these individuals were able to eliminate their back pain in a matter or days or weeks simply by performing a handful of exercises and stretches!

These weren't your basic exercises or the standard back stretches and stomach exercises most "experts" recommend - these were specific exercises and stretches prescribed based on the individual. Many of these people had suffered for years and years with aches, pains, and stiffness and lived inactive lives because of their back pain.


Most back pain treatments offered for lower back pain only address the symptoms and don't address the cause, which usually delivers just temporary relief for the individual. In addition to helping hundreds of others eliminate lower back pain, I also have had personal experiences with back pain and other various conditions such as sciatic pain, tendonitis, muscle strains and sprains, and more.

In every single situation the traditional treatments did nothing but treat the symptoms (often times not successfully) and the only approach that gave lasting improvements and relief was targeted stretches and exercises.


Have you tried traditional treatments and found little relief? I am not saying these treatments are not effective at temporarily reducing the pain or inflammation, but I am saying nearly all fail to get rid of the underlying cause of the problem.
I wish you the best and remember, the key to a healthy back is movement!


About the Author:

Terry O’Brien served 15 years in the Army (Medicine) (Airborne Forces).
He then embarked on Air Crew Emergency Medical Training for Global Airlines and has been actively involved in Sports Medicine, Rehabilitation and Community Care.
www.backtrouble.co.uk/

Does Physio do the Job?

Physiotherapy & Rehabilitation

One of the most important components of each patient's treatment is a progressive, well planned and executed rehabilitation programme. This will focus on maximum functional restoration and return you to a healthy active life-style. Our aim is to fully assess the patient and provide a comprehensive programme of treatment to anable you to get back to your full potential in the shortest time possible. This will consists of a variety of physical therapy techniques and modalities to assist you in attaining your goal.

All Back Trouble UK clinic’s physiotherapists are chartered and state registered.

We are here to help address your pain and discomfort.

www.backtrouble.co.uk/

Diagnosing Your Condition:

Clinical Examination:

The exam will probably begin with a medical history during which the practitioner will ask about your symptoms, your lifestyle, and about how the pain affects your daily life. This will help the doctor assess the contribution stress and lifestyle factors make to your pain. If this is your first visit, the doctor will also ask about your other medical conditions and about any surgeries you have had.

The practitioner will examine your neck and/or back and will check your ability to sit, stand, walk, and lift your arms or legs. He/she will also assess sensation (what you feel and how you feel it) and the strength of the reflexes in various parts of your body. This will help determine where the pain originates from (which is not always the same place where you feel the pain), what degree of pain-free motion you have, and whether you have muscle spasms. It will also help rule out a more serious underlying condition as the cause of the pain.

Based on the findings of the clinical examination, the practitioner may recommend some diagnostic tests. The most common ones are:

Xray

Computed Tomography (CT Scan.)

Myelogram

Magnetic Resonance Imaging (MRI)

Electromyogram (EMG)

After the clinical examination and the diagnostic studies, the doctor may determine the best way to treat your pain or may refer you to a specialist (such as an orthopaedist or neurologist), a physical therapist, or a chiropractor for further evaluation and treatment.
If you do not understand what is being explained to you, don’t be afraid to ask for clarification. It is important for you to understand your back pain so you will be better able to make informed choices and to cope with your pain.

Diagnostic Tests For Back Pain:

X–ray imaging can create detailed images of different types of tissues. For example, an x–ray of the spine can show the vertebrae and the central nervous system. It can detect fractures, infections, dislocations, tumours, bone spurs, and disc disease and help doctors evaluate spinal curvature and defects. However, not all spinal injuries can be seen on x–rays, so doctors sometimes recommend other tests such as a CT scan, MRI, or myelogram to provide more information about the structures in the back.

CT (computed tomography) scan—sometimes referred to as a CAT scan—can show the size and shape of the spinal canal, its contents, and the structures around it. A CT scan is especially helpful for showing bone detail, including stenosis. Sometimes a CT scan is done in combination with a myelogram of the spine to provide additional information.

Myelogram is a type of x–ray study that uses a special dye to make the spinal canal and nerve roots clearer. After the area is numbed with a local anaesthetic, a thin needle is used to inject the dye into the subarachnoid space (the fluid-filled space between the bones in the spinal column). It is sometimes used when other tests, such as a CT scan or MRI, do not detect the cause of the pain.

Magnetic resonance imaging (MRI) produces a three-dimensional image of body structures using powerful magnets and computer technology. It can show the spinal cord, nerve roots, and surrounding areas and can identify tumours and areas of enlargement or degeneration.

EMG (electromyogram) measures the electrical impulses in a muscle when it is at rest and when it contracts. This allows doctors to diagnose problems that damage muscles, nerves, and the places where nerves and muscles meet. Herniated disc is one of these problems. This test involves the placement of an electrode into a muscle. A wire connects the electrode to a machine that records the electrical activity in that muscle.

Reiki-What's it about?

Reiki

Reiki is the Japanese word for "Universal Life Energy" and is a form of healing which involves the laying on of hands.

This life energy flows through all living things and can be activated by the channeling of spiritual well-being and healing through the hands of the practitioner - it activates the body's own ability to heal and energise.

Whilst treatment is being received, sensations of warmth or cold are often felt and occasionally a tingling sensation is experienced through the areas being touched.

During treatment, patients have often been known to fall asleep as they feel so relaxed. Patients are fully clothed throughout the treament and are usually lying down on a bench (called a "plinth").

This treatment is extremely beneficial to clients who suffer from depression, stress, migraine, menstrual problems, sinus pain, menopause, back pain and so on. Reiki is completely safe and can be used in conjunction with other forms of medication. Each treatment lasts an hour.

Call Back Trouble UK or simply Request a FREE Consultation?

Lifetime "Spinal Health" Programme!

Our network of clinic’s practice is very much a wellness based practice - recommending ongoing preventative treatment rather than alleviating the present symptoms and waiting for a further reoccurrence.

Our Lifetime ("Back" to Health programme) has been developed specifically for patients who have experienced recurring episodes of back pain. It has been developed to prevent continual reoccurrence. Up to now we have as practitioners been using reactive treatment. What we now offer is proactive treatment.

Reactive treatment is likened to saving a drowning woman, emptying her lungs and then returning her to the water. Our spine plays a fundamental role in our health as it supplies every organ in the body sending and receiving messages to and from the brain.

When a vertebra moves out of place it is called a "subluxation". This can cause nerve impingement and can affect the function of the organ that it is supplying. This can prevent "Optimum Health" and can cause degenerative changes leading to stiffness, pain, and other problems.

Recent research shows that within 3 weeks of a subluxation occurring, the first signs of wear can be detected. We therefore recommend monthly spinal health checks so that any misalignment can be corrected before they cause problems.

To encourage patients to attend monthly we have based it on a standing order. The cost is a modest £25 per month, which is less than 83p per day.

To find out more, simply email: consultants@backtrouble.co.uk

Acupuncture For Neck Pain

A study by a team of researchers at the University of Southampton has revealed that Western style acupuncture can be effective in treating chronic neck pain.

Moreover its beneficial effects may be as much to do with the non-specific but powerful effects of the treatment process as the specific effect of the needles.

The results of the study are set out in a paper that appeared in the Annals of Internal Medicine on 21 December 2004.

Chronic neck pain presents a substantial problem and may be responsible for as many days' absenteeism as low back pain. It is usually associated with unspecific degenerative changes such as osteoarthritis.

Acupuncture is the most frequently used complementary and alternative medicine (CAM) therapy for the treatment of osteoarthritis, with approximately one million people in the USA seeking CAM treatment each year. However, despite this huge increase in popularity and use, there has been little sound evidence to date that acupuncture helps patients with chronic neck pain.

Led by Dr Peter White and Dr George Lewith of the University's Complementary Medicine Research Unit, this new study aimed to evaluate whether 'Western style' acupuncture is an effective treatment for chronic neck pain. 'Western style' acupuncture involves a conventional diagnosis followed by the use of an individualised acupuncture treatment using a combination of prescriptive points. In contrast, a traditional Chinese approach formulates an individualised diagnosis based on Chinese theories of meridians and energy.

A total of 124 patients with chronic neck pain aged between 18 and 80 years took part in the study. Patients received eight treatments over four weeks having been randomly assigned either acupuncture or mock stimulation to acupuncture points by the same therapist.

Patients were only allowed to use paracetamol for pain relief and were not allowed to undertake any other forms of treatment - even exercises or stretches - during the study or for two months afterwards. During the treatment all patients kept a diary to record pain and also completed questionnaires before, during and after their treatment to assess ease of movement and quality of life.

The results show acupuncture was effective at reducing neck pain and produced a statistically but not a clinically significant effect when compared to the mock treatment or placebo.
Over the 12 weeks of assessment, patients from both groups reported a similar and significant decrease in pain levels of over 60 per cent. The number of patients taking paracetamol also fell, as did the average number of tablets taken by patients. Interestingly, the study also showed that female patients tended to respond better than males and further research is required to establish whether there is a real difference in response in the sexes.

The results of the study cannot be generalised because only one therapist treated all the patients; more information would be gained by using several therapists. It is also impossible to identify whether treating patients with a traditional Chinese medicine-based approach might produce a different outcome so the research team cannot comment on the 'best' type of acupuncture.

Dr Lewith comments: 'Our rigorous and methodologically sound study clearly shows that there was significant and long lasting improvement for both treatment groups. The implications for this are two-fold. First, acupuncture was clearly very effective at reducing pain, with patients experiencing large decreases over a prolonged period which would recommend its clinical use. Second, our study also implies that most of the improvement gained from acupuncture was not due to the needling process itself but due predominantly to the non-specific yet powerful effects which are probably part of the treatment process.