Most people will develop arthritis over time but by caring for their spine from a young age and seeking chiropractic care to keep it healthy, people can avoid severe cases of it.
What is arthritis?
Dr. Gregg Rubinstein: Well, that’s a really good question. Arthritis, literally, if you just kind of break the word down, arth means joint, itis means inflammation. So, arthritis literally means inflammation of the joint.
Arthritis isn’t always a primary condition. It’s usually secondary to poor alignment and poor mechanics because when anytime a joint is out of alignment, the mechanics are altered, and it creates friction. Friction creates heat, heat creates inflammation. And then you start to see the beginnings of arthritic changes in the joint. What I mean by that is the joint spaces get narrower. You start to see bone spurs starting to form, which then contributes to mal-alignment syndromes. If arthritis isn’t taken care of or treated or the alignment is not corrected, it will continue to change the bone and the joint space and it’ll keep getting narrower. The bone spurs get bigger and then it starts to really degenerate and cause all kinds of pain and discomfort.
When the bones are out of alignment or what a chiropractor would call subluxated, if you can correct the alignment by doing the chiropractic adjustment and improve the mechanics, then it dovetails nicely to managing the conditions because there are different types of arthritis.
One of them is osteoarthritis, which they call everyone’s disease, and most people will get osteoarthritis over time. But how much you get and how fast it progresses is really determined by how you care for your spine, how much exercise you get, how often you see a chiropractor and get the mechanics improved. So, as we get older, the degree of arthritis development is truly dependent on how well the vertebrae and the joints are lined up and how smoothly they move. So, it really comes down to what we call self-care, which is stretching and getting good exercise, and healthcare, which are the periodic checkups with a chiropractor and avoiding the crisis care when things get so bad and painful conditions arise, then we have to do a whole bunch of corrective care. So, that’s the primary kind of arthritis.
Well, there’re also rheumatoid arthritis and psoriatic arthritis and there’s juvenile rheumatoid arthritis. So, there are a lot of different types that affect different people, but some of those are created by an autoimmune system deficiency, and that’s where we start to see those other types of arthritis. But anytime a joint becomes inflamed, a doctor’s going to call it arthritis.
There are many forms of arthritis, but what are the most common types?
Dr. Gregg Rubinstein: So, the most common, as we talked about before, is osteoarthritis or what they call everyone’s disease. And that’s the degeneration and the wear and tear that everyone’s going to see over time. But remember how you care for your spine, how much exercise you get and how much stress you have and how you manage that stress also plays a big part in how much arthritis will form.
The other form is rheumatoid arthritis, which again is an autoimmune type of disease where your body’s own immune system is attacking their own cartilage and wearing it away and that causes issues in the joint. I know this one firsthand because my mother is still alive with us, she’s 86 years old, and she’s been suffering from rheumatoid arthritis for decades. Rheumatoid arthritis is always bilateral. It affects both hands, both shoulders, both knees. It’s always a multitude of joints.
Osteoarthritis can usually be more left-sided or right-sided or affect only one hip more than the other. And it also has a high predilection for affecting the spine. So that’s the one we most commonly see, osteoarthritis.
There’s also juvenile rheumatoid arthritis. There’s something called psoriatic arthritis and a few other less common types, but the most common are the rheumatoid and the osteoarthritis, and we deal with those very efficiently in our office.
Are there any risk factors for developing arthritis and is there a genetic component?
Dr. Gregg Rubinstein: Most of the research out there that talks about risk factors for arthritis and almost all types of disease, according to the MacArthur Foundation, their research states that it’s 30% genetic and 70% lifestyle. But the most important thing to understand is that we inherit our genetics from our parents, but we also inherit our lifestyle. They taught us what we know about diet. They taught us what we know and think about exercise. They taught us what we know and think about posture, and they taught us what they did to maintain their spine. So, if your parents were excellent and exercised and saw a chiropractor and did all these things, then the risk factors probably go down for a child.
So, it’s important to understand the genetics, but I think it’s more of a lifestyle thing. So, if you teach your kids to exercise and get their spine checked, those things are going to diminish the effects and the severity of arthritis. Because if you leave arthritis undetected and untreated for long periods of time, again, you’ll start to see those bony degenerative changes that I talked about before, the narrow disc space, increased bone spurring, and those changes once they occur are not reversible, but we can certainly stop them dead in their tracks and make sure that they don’t progress or at the very least slow it down.
Can arthritis affect young people or is it mostly just older adults?
Dr. Gregg Rubinstein: Since the effects of arthritis are cumulative over a lifetime, you’re going to see it more prevalent in adults, but it certainly sets the stage and starts early on in life. Again, if a kid plays football and is constantly getting hit or hitting other people, those shots to the spine and those traumas are going to create misalignments and then wear the joints down faster. Sometimes we see some of these ex, idle athletes on TV and they’re really only in their early sixties, they’ve been retired from the game for 20 or 30 years and they look a lot older than they actually are. And you can see how stiff, and their posture and their spines look like question mark and they’re all curled up. So, it certainly can happen frequently in older adults and you’ll see the effects because it’s cumulative. But it certainly affects the young just as much.
I’ve said this a hundred times, and I’ll say it again, you’re never too old and you’re never too young to start caring for your spine. Because again, these things start slowly in childhood and then will develop through their teen years and then develop in their twenties and thirties. And usually, it’s about when people hit 20 or 30 that they start getting pain or discomfort associated with it. That’s when they start seeking care. But I’d rather prevent that problem and have them get checked early.
I always say that we don’t wait till our engine seizes and then say, “Gee, maybe it’s a good time to check the oil in my car.” You have to stay ahead of those things. So, prevention is huge when it comes to arthritis. And those things can be done by just having regular exercise, getting a pretty good diet, using good posture and seeing a chiropractor periodically. Even children with scoliosis at an early age are going to have more arthritis later in life because again, those misalignments change the mechanics and the mechanics being smooth are so important for keeping the joints healthy and preventing and slowing down the progression of arthritis.
What treatments are available for people suffering from arthritis?
Dr. Gregg Rubinstein: Well, it’s interesting. Depending on who you talk to, that’s what’s going to really be determined as to what is treatment, right? And treatment to me is something that happens after the fact. I’d rather go into the world of prevention, right? Because prevention is going to be the key. We all heard the adage of a stitch in time saves nine. You don’t wait till that rip is so gigantic and then you have to do a huge repair on it. It’s important to understand that early detection and early management is the key. So, getting your kids exercising, getting them to a chiropractor, making sure they have good alignment, making sure that they exercise good posture, all these things are going to be so important.
But the treatments available when you go to a medical doctor, typically if you have inflammation, they’re going to give you an anti-inflammatory. But I don’t think the cause of arthritis is a deficiency of anti-inflammatories or painkillers or muscle relaxers. Because those things only mask the symptoms, they don’t actually fix the problem, right? The problem initially was poor mechanics.
A chiropractor will make adjustments and restore normal mechanics, getting the pressure and irritation off the nerves. And once the mechanics are normal and smooth, there’s less friction and we will not see the arthritic conditions really progress at the same level or same rate, particularly with osteoarthritis.
For people suffering with rheumatoid arthritis, again, that’s an autoimmune disease and it’s your own body’s immune system attacking the cartilage. Well, why would it do that? When you think that your nerve system is the primary thing that regulates the immune system if the immune system and nerve system are irritated or hypersensitive and they’re looking for something to destroy, all those white blood cells, when they’re running around in the body, they see the cartilage and sometimes look at the cartilage as foreign and start to attack it. And then when they attack it and erode the cartilage, then we get more inflammation and everything starts to happen.
Getting corrective adjustments will calm down the overreaction of the immune system, and hopefully the people with rheumatoid arthritis will tend to do better. It’s not perfect, it’s not a panacea. It doesn’t cure every ache and pain that someone with arthritis has, but it’ll help mitigate the pain and discomfort, and slow down the progression. We always recommend trying the non-drug and non-surgical routes first.
To speak with Dr. Gregg Rubinstein, visit www.ChiropractorMidtown.com or call (212) 977-7094 to schedule an appointment.