Joint Dysfunction – Interview with Dr. Rubinstein

With proper alignment, there is less stress on the joints, they function better and there is less irritation to the nerves. This equals less pain!

Can you list the most common areas of the body where people experience joint pain and what type of pain or discomfort they typically feel?

Dr. Gregg Rubinstein: That’s a fair question. As a chiropractor, I have to say that it’s definitely more skewed towards the neck and lower back. Those are the primary things that bring people into our office. Although we’d rather come in for prevention and wellness care, typically they’re going to come in with back pain and neck pain … are the most common things that a chiropractor is going to see. The type of pain that they’re going to be feeling can vary because there are a lot of different causes of back pain and neck pain but anytime that things get out of alignment and the joints aren’t lined up properly, that technically is the very definition of joint dysfunction. If the joints are not moving properly, they’re not lined up, they’re going to degenerate. When there’s friction on the joints, it will break down the discs. It will also cause the bones to decay or degenerate which is what most doctors will call arthritis.

What causes joint dysfunction?

Dr. Gregg Rubinstein: Well, the primary things that cause joint dysfunction, and we have a different name for it in chiropractic. We like to call it a vertebral subluxation, which is almost interchangeable with joint dysfunction. The primary causes of it are really not caring for your spine when you were young. When the spinal bones get exposed to trauma, stress, tension, poor posture, accidents, falls, those things over a long period of time consistently will accumulate and create these misalignments which cause the joints not to move as smoothly as possible, then they start to get roughened edges and bone spurs and when the joints really start to get inflamed and they start to swell up, then it’ll put pressure on those delicate spinal nerves that are protected by the spinal joints, and then the real problems begin.

How does Chiropractic care help alleviate joint pain?

Dr. Gregg Rubinstein: Well, the main thing chiropractic does is it sets out to detect and remove those misalignments or what we call subluxations or the results of joint dysfunctions. By improving the mechanics and realigning the bones into a better position, they’re going to move smoother, they’re going to function better, and it’s going to create more space around the neural structures so they don’t get irritated. The less irritation to the nerve, the less pain you’re going to get. The smoother the joints move, the less degenerative change or arthritic conditions you’re going to see. Those are really the most important things. It’s very simple. By maintaining proper alignment, there’s less stress on the joints, they function better, less irritation to the nerves, equals less pain.

Do you create individualized treatment plans for each patient based on their age, injury, etc.?

Dr. Gregg Rubinstein: Absolutely. You know, you’re going to gather a lot of information when a patient comes in for their initial visit. You’re going to take a careful history. You’ll find out if they’ve had trauma or if it’s been a long, slow, degenerative onset. Either way, we’re going to look at that. Based on your age, the longer you’ve gone with a problem, the longer you’ve had it, the longer it’s going to take to get rid of it. Very often we’ll see that. The other factor that determines that is when we look at an x-ray, we can usually classify them into different stages of degeneration. There’s normal – there’s phase 1, there’s phase 2, and phase 3. If someone is typically in phase 1 and has straightening of their curves and misalignment but doesn’t have any real degenerative change in phase 1, those people can require usually about 2-3 months of care to really get their problem corrected.

After that, when you start getting into stage 2, there’s a lot more disc degeneration. There’s bone spurring and things of that nature. Those people are usually looking closer to like 3-6 months.

Then beyond that in phase 3, there’s a lot of degeneration. The discs are almost completely degenerated. There’s hardly any space. The bone spurring patterns have basically resulted in near fusion. For these people, we have a longer type of treatment plan but we can’t fully fix that spine. Once the disc degeneration and the bone spurs are there, we can’t really make that go away but we can take joy in knowing that we can prevent that thing from really getting worse and continuing on to progress into bigger problems later. It’s always very specific to the individual – how old they are, how long they’ve had the problem, how severe it is, and truly what stage or phase of degeneration we see when we take an x-ray. Those are the best criteria in determining how long each treatment plan is going to be, how often you’ll need to see them, the frequency and the intensity of it.

What is some advice everyone should abide by to help prevent joint pain and dysfunction?

Dr. Gregg Rubinstein: Well, really the best things you can do is you need to obviously keep your spine in good alignment and see a chiropractor periodically for checkups whether you have pain or not. No one ever wakes up on the morning on their dental appointment and says, “Hey my teeth don’t hurt, I’m not going to go.” You need to get your spine checked periodically by a professional to make sure that your spine stays healthy.

You want to avoid prolonged periods of inactivity or bed rest. You want to maintain a healthy weight and a healthy diet, right. You want to warm up and you want to stretch before physical activities even things as simple as gardening.

Maintaining good posture. Wearing comfortable low heeled shoes. Sleeping on a quality mattress of medium to hard firmness level is always great to minimize any curve changes in your spine. Lifting with your knees not with your back. Keeping objects close to your body, not twisting when lifting.

Then just other great ideas – don’t smoke, don’t engage in activities that are repetitive for long durations of time without stopping and stretching. There’s tons of tips to prevent back pain and problems with joint dysfunction but those are just a list of a few. Everyone should kind of be following that general advice.

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