LifeCare Chiropractic

The Best Chiropractic Care in Mesa, Arizona

Osteoarthritis

Hyaluronate Sodium Injections for Osteoarthritis – (02-18-02)

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Hyaluronate Sodium Injections for Osteoarthritis

This is a nice review on this subject. Unfortunately, the results do not appear to be quite favorable. I have seen mixed results in patients that have had this procedure done. If anyone does ask me about this procedure, I always try to push them towards the preparation without the formaldehyde (hyaluronic acid) vs the formulation with (Syn-Visc). I do hope that this idea can somehow be modulated in the near future to increase the efficacy of the procedure.

Hyaluronate Sodium Injections for Osteoarthritis: Hope, Hype, and Hard Truths.

Read entire article here

LEECH THERAPY VERY EFFECTIVE IN KNEE OSTEOARTHRITIS – (11-13-03)

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Effectiveness of Leech Therapy in Osteoarthritis of the Knee

Okay. I’m not saying I am going to start using this in my office, but I thought the article was quite interesting. Many times, gross, disgusting approaches are actually quite effective. Maggots have been used to save limbs that would otherwise have been lost to infection. I remember when my wonderful keeshound had severely injured his tail this summer. It did not look good and I kept it wrapped. To my dismay, several days later I unwrapped the bandage to replace it and maggots had infested the bandage. However, the wound was looking incredibly well.

Ann Intern Med — Abstracts: Michalsen et al. 139 (9): 724.

Read entire article here

Knee Osteoarthritis Symptoms: MRI Images of Knee of Little Benefit

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Everyone wants an MRI. It’s cool to take a peek inside your body without the downsides of autopsy. But for knee osteoarthritis symptoms does an MRI help anything?

Regular readers of the Rantings know how I feel about ordering imaging before it’s necessary. It doesn’t matter what region of the body it’s in; sometimes TOO much information is not a good thing.

We have already seen studies suggesting that the rates of knee replacements are increasing, but there has been no change in the amount of knee osteoarthritis seen on imaging. What this strongly suggests is that knee osteoarthritis may not be the problem in a large chunk of the cases of knee pain.

For those providers that treat the soft tissues (and no–I’m not talking about exercises and electric stim here–these techniques do NOT treat the soft tissues), this comes as no surprise at all.

I firmly believe, based on the research and my own clinical experience, that most knee pain does not come from arthritis, but rather from pain being created in the soft tissues (muscles, ligaments, tendons, fascia) surrounding the knee joint as well as the imbalance and altered stress placed upon the joint by these damaged soft tissues.

This particular study adds weight to my thought process. Researchers looked at a group of patients who were older than 50 and had no signs of knee osteoarthritis on X-rays. They then examined this group using MRI images of knee and looked for findings that are consistent with osteoarthritis. These included:

  • osteophytes (also known as bone spurs)
  • cartilage damage
  • bone marrow lesions
  • subchondral cysts
  • meniscal lesions (usually described as a torn meniscus)
  • synovitis
  • attrition (a wearing down of the joint surface)
  • ligament lesions

What they were basically doing was looking at MRI as a tool to see how well findings on an MRI compared with what the patient was experiencing.  Here’s what they found:

  1. 89% of the group had at least one abnormality noted above (osteophytes were the most commonly found at 74%,  followed by cartilage damage in 69% and bone marrow lesions in 52%.
  2. As expected, the higher the age, the higher the prevalence of abnormalities.
  3. The likelihood of at least one type of abnormality was high in both painful (97%) and painless (88%) joints.

The last point being the most important. Basically, over the age of 50, a MRI becomes less and less important, and may actually lead the unsuspecting physician to recommend a more invasive procedure (injection or worse–knee replacement).

The bottom line is that just because you have something wrong on your MRI, particularly as you get older, does not really mean anything. If you have knee pain, my biased opinion would be to find a chiropractor that specializes in soft tissue treatment (Graston, Nimmo / Trigger point, NMR, Active Release, Fascial Manipulation, etc…) before you do anything else.

It is always worth trying this approach first. If it does not help, you can still opt for more invasive procedures. But the reverse doesn’t work so well…

If you had a knee replacement, was soft tissue treatment recommended to you before the surgery?

TELOPEPTIDES USED TO DETERMINE EFFECT OF RHEUMATOID ARTHRITIS – (10-20-04)

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Telopeptides as markers of bone turnover in rheumatoid arthritis and osteoarthritis

This is an interesting route of attack on a different way to measure disease severity with RA. Using the breakdown products of bone in the urine as a way to check bone status is by no means new. But in this study, these bone turnover markers were used to determine the severity of inflammation in rheumatoid arthritis, since RA attacks the cartilage of a joint and to a certain extent the underlying bone.

Telopeptides as markers of bone turnover in rheumatoid arthritis and osteoarthritis – Internal Medicine Journal, Vol 34, Issue 9-10, pp. 539-544 –

Read entire article here

Arthritis Relief: Is Ginger Good for Joint Relief?

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We want to live life to our fullest; this means no arthritis pain. Many use drugs for arthritis relief, but safety is a concerns. Is ginger good for joint relief?

Mother Nature knew what she was doing.  Us–not so much.

It seems like anytime we try to mess with nature we screw things up.  Anti-inflammatories are certainly on this list.  Here is how things usually work:

  • Nature makes a compound that positively effects some pathway in our body.  This effect is usually subtle and takes time for the effect to show, but has a very good safety profile for long term use.
  • Scientists find said natural compound and modify it so that it has a strong short term effect but thus becomes dangerous in the long run.

Overall, the drug companies try to find compounds that have the greatest effect at the lowest concentrations.  They want compounds with as high of a LD50 as possible (the LD50 is the level at which the compound kills 50% of the study participants).  But they all will kill at high enough dosages (even water can kill if you stuff enough of it in our bloodstream).

While the list of problems associated with anti-inflammatories (specifically the NSAID class of drugs) is quite long and has been addressed in prior posts that can be read here, suffice it to say that I consider this one of the most dangerous classes of drugs, resulting from a combination of the broad spectrum of subtle side effects combined with the near-universal belief in their safety by the general population.

 There are many natural, unadulterated compounds that have been shown to lower inflammation and have solid research behind them.  Curcumin / turmeric, boswellia, cat’s claw and proteolytic enzymes to name a few.  Ginger is also on the list.

This particular study looks at the effectiveness of ginger to both control pain associated with arthritis as well as protect the lining of the stomach (a MAJOR concern with NSAIDs).  It was compared with diclofenac (Voltaren), a common anti-inflammatory used for arthritis pain.

The safety profile of ginger was, as expected, much better on the stomach than the diclofenac.  Surprisingly, the pain relief was equivalent in both groups (as measured by the Visual Analog Scale, or VAS).

If you have tried ginger for arthritis relief, what was your experience?