Hi and welcome to my ENews!

This issue of my ENews is a unique one.  I have not written a newsletter in the past that addressed only one topic like this one does.  I thought that it would be fun and informative to look at one topic that affects each of us directly and run with it.  Out of that line of thinking comes the, 

 Arthritis ENews!

It took a considerable amount of time to gather and put all of this material together, so this will be a two-month issue (May-June) instead of just one month.

I have been treating patients for 22 years and during this time period I have realized that few people really take arthritis seriously, know how and why it starts or even care much that it is a treatable condition.  Most arthritis suffers only care about the arthritic progression when they can't work any longer or they require a dangerous surgery.

I don't really like the term 'degenerative joint disease', which is what they call osteoarthritis.  It is really a progressive joint deterioration that arises from neglect of trauma.  Neglect of treating trauma means that we likely cause our own demise!

When someone suffers trauma, they know it.  Rarely, if ever, will an individual sustain an injury and not be aware of it!  They may tell others that "It's no big deal" and 'tough it out', but what they really do is purposefully ignore a problem that will eventually get worse.

Just this week, I had this type of discussion with a middle-aged person who currently has extensive spinal deterioration, spurring and discal breakdown.  Neglect of many injuries over the past 25 years brought this person to a point in which surgery isn't a viable option and the Medical Specialists recommended conservative Chiropractic care.

This person's greatest concern, however, was not that he/she would have to see a Chiropractor, not that he/she would have to pay for all care out-of-pocket, and not even that he/she would only reach a point of pain-free and stable, rather than 'cured'.  What really upset this person was that he/she had to do ANYTHING AT ALL!!!  This just reinforced to me that it is often the effort of treating arthritis that hurts the most!

If you are an arthritis suffer, please take the time to address your problem earlier, rather than later.  Arthritis will respond favorably to care at any stage, but the results are better if arthritis is caught before the destruction begins.

  I hope that this ENews is informative for you.  As always, call me with any questions you might have!

Dr. Frisch

The Generic Arthritis

I'm not sure how accurate 'made in the U.S.A.' as it applies to good, old arthritis, but as a nation, we seem to suffer with more case of arthritis than the rest of the world, we have more hips and knees replaced because of arthritis than do other countries and we definitely take more arthritis-related medication than any nation on the planet.  

The Centers for Disease Control, the medical and investigative arm of the US Government, has reported that from 2003-2005 arthritis effected 1 in 5 people living in the United States.  That amounts to 46 million people.  They have classified it as a 'chronic disease'.  It accounts for over $128 Billion dollars in Government-related medical costs alone!  This doesn't even take into account the added dollars spent by individuals on over-the-counter medication, natural herb and vitamins, and let's not forget about the 'quick-fix remedies' and tonics found on late night TV. and radio!  What an incredible effort made by so many for so little!!!!!

"The reason that I titled this article The Generic Arthritis is because most arthritic conditions are just that; generic in nature with a predictable onset."

Most arthritis is predictable.  It is not who will get it, but rather, why!  The vast majority of Arthritis is classified as 'Osteoarthritis' and it is said to be a 'wear and tear' type of degeneration.  I contend that although osteoarthritis is the single greatest type of arthritis, there is more to it than just wear and tear on a joint.

Osteoarthritis is actually a form of healing to a joint.  In contrast to the much overused term of joint breakdown, osteoarthritis is really the result of long-term instability of a joint.  When a joint is injured and ligaments, muscles and bone are not allowed to regain normal symmetry.  The joint is not 'in sync'.  The brain does recognize instability and it does not like it.  Instability of a joint that is not corrected, will progress along a very simple pathway.  Here is a simple series of steps that result in osteoarthritis:

1. Injury is sustained to a joint (This includes vertebra) and instability is present.
2. The injury is not stabilized by an outside intervention (Doctor or Therapist)
3. The brain recognizes the instability and infiltrates the area with chemicals that form scar tissue, calcium that forms bone and other 'solidifying agents'.  
4. The soft tissue, including cartilage begins to dehydrate.
5. Improper, but fairly effective fusion/stabilized begins to occur and the brain is somewhat happy with the poor, but still improved joint stability..
6. The improperly stabilized joint continues to dehydrate, degenerate, and break down.
7. Pain medication no longer controls the pain and surgery becomes an option to fully fuse the joint or artificially replace it.

This process is classified as DEGENERATIVE JOINT DISEASE, but I think that you can see that is really not a disease.  Is is actually a response to the neglect of an injury.  The reason that it gets disease status is because the Physicians Desk Reference states that only medicine cures disease, not doctors.  When a drug is found that can control inflammation, pain and swelling with a trauma, the symptom soon gets disease status.  How sad!

For this reason, a trauma that is not treated by a doctor trained in Neuromusculoskeletal rehabilitation (think Chiropractic here) allows the brain say, "I know what to do!",  and the above sequence of steps ensues.  The public needs to be better informed of how to care for their injuries and they should be told about treatment options that are available, which do not rely on drug therapy!

Osteoarthritis can be treated in all stages of repair

Other Arthritis?

When discussing arthritis, most people instantly associate their pain to osteoarthritis, which I discussed in the last article.  Patients are always surprised when I say that there are over 150 different types of 'inflammatory arthritis'.  One of the more common types of inflammatory arthritis is Rheumatoid arthritis, but there are many more that are just as important and less well known.

Rheumatoid arthritis is most often diagnosed by RED, HOT, SWOLLEN AND TENDER joints.  The individual may or may not have a fever as well.  This observation is followed by a blood test, which (usually) reveals a positive RA factor in the blood.  RA factor, however, can be present in the blood of an individual and he or she may never suffer from a violent and destructive arthritis like Rheumatoid.  It is just a blood factor.  The inverse is also true.  Someone may suffer from acute Rheumatoid arthritis and never have a positive blood RA.  This is why a patient may be required to see their doctor on a frequent basis until a timeline of symptoms can rule out other types of inflammatory arthritis.

What other types of arthritis can occur?  This list seems endless, but most inflammatory types of arthritis have one thing in common...they are autoimmune and/or genetic in nature.  That's right!  Some of us are pre-programmed to have specific types of inflammatory conditions, which begin at specific times in our lives!

Most people have heard of Lupus, but how many know that Lupus Erythematosis can actually develop a form of arthritis?  Psoriasis is a very common complaint in the United States, but I will bet that only a small percentage of those suffering with psoriasis are even aware that they are at great risk of developing an inflammatory-type of arthritis!

Gout is another condition that is common, but often taken too lightly.  Gout results from a problem with urinary breakdown.  This inability to properly break down urinary components may be genetic in nature or a secondary gout, which is developmental. Gout is usually associated with great toe swelling, burning and numbing, but any joint can be affected and fevers are common.  Medication may help with the acute bouts of pain in the genetic version, while dietary changes are often required in developmental gout.  Gout is called the 'disease of good living' because fatty foods, fried and greasy foods, and alcohol often flare a bout of gout.  However, trauma, temperature changes (cold), atmospheric pressure changes, surgery, and even diuretics can and do induce episodes of gout.  Long-term gout allows crystalline deposits of calcium pyrophosphate to accumulate in joint spaces, resulting in a painful arthritis.

Inflammatory types of arthritis are not only acutely painful at the time of onset, but they can be quite destructive to the bones and joints, resulting in painful and unsightly joints. If you are concerned about inflamed joints, simple blood and urine tests may calm your fears or put a name on your pain.  Either way, determining if you have an inflammatory arthritis may help you to intervene in a disease process that you did not even know that you had!

There are many treatment options for inflammatory arthritis conditions.  Do not be afraid to tell your doctor(s) about your concerns.  They can help prevent a bad problem from becoming catastrophic.

Chiropractic and Arthritis

Chiropractic care has offered countless numbers of arthritic suffers relieve over the past 112 years!  Even though you are well aware of my specialty technique (Activator Methods), all forms chiropractic care will benefit someone who suffers with arthritis pain.  There is no 'bad' type of Chiropractic care when it comes to arthritis! 

Chiropractic care is based on neuroanatomy.  This means that the Chiropractic ideology and science is concerned, first, with the structure and function of the human frame.  Arthritis is a dysfunction of normal body structure and function!  I can't put it any more simply than that.

The most difficult part of treating arthritis is getting each individual patient to take his or her problem seriously.  We live in a 'quick fix' society that demands instantaneous relief and permanent results.  The fact is, rarely is any problem fixed instantaneous, and even fewer solutions are permanent.  That type of thinking is unrealistic and void of any personal responsibility that we have to ourselves.

In today's society, it is too easy to push blame.  In fact, many political campaigns are run on a platform that your pain and problem is not your fault and that "Everyone has a right (think 'free') to health".  They don't really care if you are healthy. They don't really care if you get better.  They are only concerned about you believing that they care.  Politicians and healthcare advocates want you to believe that you can't help yourself.  What a bunch of garbage!!!

Our grandparents knew well of the debilitating effects of arthritis.  They did not have any of the anti-inflammatory drugs we now take for granted.  They took arthritis as a common result of a life-time of hard work and they suffered with their pain.  Two generations ago, however, people ate better, went to bed at a decent hour, and usually worked much harder than we do today.

Unknowingly, a good diet rich in fruits and vegetables (anti-oxidants), physical work outside in the sunlight (Vitamin D and Calcium absorption) and sufficient rest each night, likely provided them as much relief of their arthritis pain as we can get from any of our current medications.  They knew that their arthritis problem was physical in nature.  I can only imagine how much healthier they would have been if Chiropractic care had been readily available.  That generation of people was not trained to look for health in a pill bottle!

If you or a family member has arthritis and is not yet under the care of a chiropractor, you do need to take that step for your health.  Chiropractic care will benefit all forms of arthritis and improve your quality of life.  Neglect of arthritis has only one outcome...degeneration in multiple forms!

Want to See What it Looks Like?

Arthritis occurs for many reasons.  The most common type is due to wear and tear on a joint from earlier trauma that was not stabilized.  This is called Osteoarthritis.  In later stages it is painful and debilitating.  Inflammatory-type arthritis is more complicated to diagnose and treat because the cause may not be readily evident and the bony destruction can happen so quickly.  Rheumatoid, gout, lupus, psoriasis, ankylosing spondylitis, Reiter's syndrome are all example of inflammatory arthritis.

Inflammatory and non-inflammatory types of arthritis are different in origin and onset, but both types of arthritis have things in common:

• Trauma to the body begins the osteoarthritic process and often 'triggers' the inflammatory type of arthritis to begin its sequence.

• Instability of one or more body joints forces the brain to begin responding with osteoarthritis.  The inflammatory-types of arthritis can be just as sensitive to instability of joints and organ system dysfunction.  Not all instability in the body is bony, but all instability does affect structure and function!

• Inflammatory and non-inflammatory arthritic processes are ALL destructive.  A 'little bit of arthritis' is a big deal and should not be brushed off because other body systems are often affected.

      Osteoarthritis of the lower neck                     Severe low back Osteoarthritis following                  Low back Osteoarthritis after    

            after a whiplash crash.                             years of lifting and trauma with no care.                     a vertebra fracture years ago.

           This is the same elderly lady as in the first x-ray.                       This is an example of Reiter's Syndrome.  The inflammation is

           This x-ray was taken two years after treatment.                      in the soft tissue, the bony joints and organs.  This middle-aged

           The arthritis is better with care, isn't it?                                   man has arthritis visible on the back of the spine, the last vertebra

                                                                                                        is smaller due to vertebral compression and the bones are already 

                                                                                                        losing density, which means he has osteoporosis as well.  These 

                                                                                                        are common findings with this type of arthritic process.  There is

                                                                                                        often organ dysfunction as well.

               This is an example of gouty arthritis in a 65+                                          This is an extensive scoliosis in a late-middle

               year old male.  Note the spurring behind the knee-                                aged female.  She has some whitened, arthritic

               cap and the swelling and roughened area behind                                    joints, but this problem should be much worse than

               the true knee.                                                                                        it is for her age.  She has treated with chiropractors

                                                                                                                           since young and it slowed any arthritic progression!

Not too many people would accurately diagnose this condition

without an informed patient history.  This is a compensation arthritis

in the neck of a young man with Cerebral Palsy.  Structural imbalances 

and physical impairments heavily stressed the vertebra of the neck and an

arthritic 'stabilization' naturally occurred.

I hope that you enjoyed and were informed by this x-ray demonstration of clinical, arthritic conditions.  This is just a small sampling of what your doctors must evaluate and treat on a daily basis.  The more that your doctor knows about you, the better the care will be.

Even though these arthritic conditions are all different, they each have one thing in common.......they respond well to chiropractic care!  'Structure-Function' chiropractic care limits the destructive effects of many types of arthritic conditions.  It is not uncommon for your chiropractor to work with your MD on the inflammatory types of arthritis as well because, let's face it, some arthritis needs medication too!

Take care,

Dr. Frisch