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  • Q&A with Australian Health Practitioners

    Can my arthritis be reversed and if not, what can I do about it?

    I'm 40 years old and suffering with left hip pain. My medical doctor ordered x-rays which show some osteoarthritis. My doctor has given me anti-inflammatory medicine and told me that I'll eventually need a hip replacement. Is there anything I can do to reverse the problem or at least stop it getting worse?
  • Find a professional to answer your question

  • Dr Michael Powderly

    Chiropractor, Kinesiologist

    4

    Agrees

    65

    Thanks

    .Dr Michael Powderly is a Chiropractor of 22 years’ experience, practicing in Surrey Hills Melbourne, and consulting for the Melbourne Rebels Super 15 Rugby Union ... View Profile

     
     
    First the bad news… any osteoarthritis (the ‘wear and tear” arthritis) that you already have in your joints probably can’t be reversed……..Stem cells may provide an answer in the future, but that’s not much use to you right now.
    The good news is that there are some simple and very effective steps that you can take straight away to limit the pain and progression of osteoarthritis.
     
    The first step to dealing with osteoarthritis is to know what it is and what causes it.
    Osteoarthritis, otherwise known as Degenerative Joint Disease, involves a progressive “wearing away” of joints, especially the joint cartilage, resulting in bony spurs and cysts at the margins of the joints. The pain of osteoarthritis comes mainly from inflammation which also causes joint stiffness and reduced mobility. Although age increases your risk of osteoarthritis, it’s not the key cause………. many people in their 90s have little or no sign of arthritic change.

    The main local causes of osteoarthritis are injuries and repetitive movements that concentrate stress on particular joints.
    Systemic causes of osteoarthritis include obesity, gout and other inflammatory conditions.  The same lifestyle choices that cause heart disease, diabetes and other degenerative conditions ( eg. Diets high in meat, high in sugar, alcohol, etc)  accelerate the progression of osteoarthritis.
    Immobility is also a major cause of osteoarthritis since limiting joint movement stops  the natural lubrication of the joints. That’s the reason why dogs chained up in a small yard can quickly become arthritic.
                                                                    
    So what can you do about osteoarthritis?

    Let’s start with relief measures
    The pain of osteoarthritis comes from joint inflammation. Anti-inflammatory drugs are fine for the short term relief of swelling (up to 1 week), but long term usage is known to damage cartilage and cause stomach ulcers. Anti-inflammatory drugs such as the cox-2 inhibitor Celebrex, are also known to cause heart attacks and stroke.

    However, there are many safe, effective, long-term options for relieving inflammation.  Try fish oils (choose a practitioner brands like Metagenics …. they have lower mercury levels), Glucosamine or a natural anti-inflammatory blend ( Metagenics and Bio-Ceuticals brands are good).  You can also use a topical anti-inflammatory like arnica cream. In this way you will at least reduce any reliance on medication.

    Second - deal with any local causes of arthritis.
    If you have an unresolved hip, knee or back problem causing your hip pain, it may be accelerating joint decay, due to faulty movement and uneven weight-bearing. Get these injuries assessed professionally: Choose a Chiropractor for spinal issues, a physiotherapist or Sports Chiropractor for extremity joint problems. For more advanced problems, you may need to consult an orthopaedic surgeon or a sports physician.

    By dealing earlier with an arthritic hip, for instance, you may get an extra 10 - 20 years mileage from it.

    Finally, clean up the lifestyle factors that lead to osteoarthritis:

    1. Stop “setting fire to your joints”- cut back on foods that increase inflammation in the body, such as sugar, white flour, meat and alcohol.
    2. Reduce weight: excessive weight bearing accelerates arthritis, especially in the knees and hips.
    3. Get moving: Exercise such as walking, cycling and swimming, etc  keeps the joints moving, better lubricated and healthier.
    I hope this helps……

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  • Sunil Mulay

    Massage Therapist

    19

    Thanks

    Sunil is a professional remedial massage therapist with a deep interest in the functioning of the human body’s structural systems, and the conditions that are ... View Profile

    Excellent, detailed response from Michael.

    Only thing I would add is that often with arthritis, the surrounding musculature tightens up as a reponse to the pain and to “protect” the joint.

    Regular, deep tissue massage and release of associated trigger points can be extremely useful to relive pain and allow the joint to move more freely.

    For arthritic patients, I usually provide a lot of what is called Passive Range of Movement. I find this provides great relief and promotes fluid exchange in the joints, reducing inflammation, etc.

    I have several patients with arthritis who now are hardly even aware of it. It's there, but by getting them to their optimum posture and mechanics, the condition does not cause any noticeable symptoms and doesn't seem to progress any further.

    All the best.
    Sunil

  • Dana Rader

    Exercise Physiologist

    15

    Thanks

    Dana Rader is the owner operator of GYROTONIC® Melbourne. As an exercise physiologist she is passionate about the health benefits of exercise. Dana has been ... View Profile

    Great responses, in additon I wanted to stress the importance of exercise. I work with many clients, myself included, with OA, you need to keep moving. There is a fluid in your freely movable joints, such as the knee, called synovial fluid, think of it as a lubricant for the cartilage in the joints. Movement is crucial to stimulate the production of the fluid. This is one of the reasons we warm up before exercising. 

    An exercise physiologist is able to design a tailor made exercise program for you, evaluate your movement patterns to enabling you to keep moving. OA cannot be reversed however it can be managed. 

    Gyrotonic, Pilates, Yoga, walking, biking, all are good, care needs to be taken with high impact movements.      

  • Tina Garrett

    Occupational Therapist (OT)

    12

    Thanks

    Well Now Health Solutions offers high quality occupational therapy services to the adult population in Gympie and the surrounding regions. Our occupational therapy services aim ... View Profile

    The answers to this question constitute very good and accurate advice.  

    As an occupational therapist and qualified fitness trainer with over 20years experience  working with people like yourself, I would add the following:

    • consider aqua aerobics as a form of exercise.  The answers provided correctly identify the benefits of engaging in exercise for your condition.  One of the important factors, as mentioned, is the impact to the joint when undertaking exercise.  Aqua aerobics will provided a low impact but efficient form of exercise that will strengthen the muscles around the joint, help with range of motion in the joint, and also provide many other benefits at the same time.
    • In your activities of daily living, consider how much bending you are doing and whether your movements in these activities are adding to or exacerbating the pain you are experiencing.  An occupational therapist can conduct a home visit and look not only at your home environment to see if there are modifications that may assist in preserving your joint, but also your movements patterns in your activities of daily living.  Often pain can change the way we move or do an activity and this can contribute to the problem.  There are also some very simple strategies that can be put in place to decrease the amount of pain you experience in the day as a result of your daily tasks.

    Self management is important and you have shown great initiative in seeking out what you can do to help yourself - congratulations.   

  • John Stevens

    Exercise Physiologist

    1

    Agree

    8

    Thanks

    I'm an exercise physiologist working in private practice in the NSW Mid North Coast. My area of passion is in pain management and patient education ... View Profile

    Hi,

    Firstly let me say that I can only imagine how difficult it must be to hear that something giving you such concern is going to be with you for the indefinite future. Whilst none of the advice offered thus far is any different from the normal advice someone in your situation would be given, I would like to suggest that there is much for us to learn from the last 50 years of pain science that must be incorporated into modern health practice. To put it simply, osteoarthritis doesn't have to hurt (well at least not all the time) and nor does any other health condition or diagnosis for that matter. This, I can understand, is difficult to accept for some given that the majority of diagnosed arthritis sufferers testify to pain being a part of their everyday lives. However, if you consider that in your case you have a condition with an insidious onset (that is an unknown time of when osteoarthritis actually started) there will be no clear line able to be distinguished between the presence of the condition and the presence of pain. In fact, considering that pain is the prime reason why people will be diagnosed with arthritis we know that there are many with osteoarthritis who do not know it because they are asymptomatic. It has been well documented there are sufferers of osteoarthritis, for example, in the spine (30% in one study) who have no pain at all. We must distinguish between whether a joint is able to function properly (which is typically the case) and whether it is painful, as these are two different things. Providing the structure of the joint allows for its normal movements we can then work on improving your body's ability to function pain free.

    This is a tremendously important thing for all pain sufferers to understand and also for clinicians who treat them and the nitty gritty details require much more space than this. If you would like more information I'd encourage you to head to noigroup.com or bodyinmind.org and look into resources from Dr David Butler and Prof Lorimer Moseley who are the experts in this field. I would be more than happy to help you further with this if you would like to get in contact with me via any of my contact details

  • Kirsty Woods

    Exercise Physiologist

    6

    Thanks

    Hi I’m Kirsty Woods,I would like to use my experience, expertise and passion to help you reach your weight, energy and health goalsI have been ... View Profile

    Although the arthritis pathology cannot be reversed, taking the right action can reduce the pain and symptoms associated with the arthritis, as well as prevent progression.

    Keeping muscles strong can help unload the knee and therefor help with pain. Flexibilty and joint mobility is also important. Hydrotherapy is a great way to provide the above, as can the right kind of resistance/weights programme. A registered Exercise Physiologist can help design and exercise programme just for you. To find one in your area visit https://www.essa.org.au/find-aep/.

    Weight management is also key. Every time you walk more than 4 x your body weight is loaded through the knee joint. So even a 5kg weight loss can provide significant benefits.

    All the best. 

  • Simon Lacey

    Healthshare Member

    8

    Thanks

    Hi I also have osteo arthritis of the hip, I found heaps of great info from John Bergman he has reversed arthritis, check him out on you tube he has videos on reversing arthritis, also a books on it

    Mine was very bad couldn't walk or sleep in so much pain, it has improved heaps, operating normal

    im only 35 so I'm going to give it the best shot at reversing it,

    medigenics do have some great products inflavioud itensive care will help take the information away. 

    Diet is the biggest thing that will help,

    i have put months of researching different options and I also see a couple of people that help 

    If you want to know more just let me know 

  • Lisa Gardner

    Healthshare Member

    1

    Thanks

    Hi, thanks for the uplifting and hope inspiring post.  I'd love to hear more about how you've managed to improve your arthritis.  My condition sounds like yours was so I'd be very grateful if you could let me know what you did to get to where you are now.

    Many thanks

    Lisa

  • Dr Chien-Wen Liew

    Orthopaedic Surgeon

    9

    Thanks

    Adelaide Orthopaedic HIP, KNEE and SHOULDER Surgeon specialising in Sports Injury and Joint Replacement. Specialising in Direct Anterior Approach Total Hip Replacement Specialising in Patient ... View Profile

    You are very young to have hip osteoarthritis. In these cases, there is often something in your past that can give a clue as to why you have developed it. Often this is due to a fracture (broken bone) or you may have a slight difference in the way your hip developed. This has been linked to a condition called Femoroacetabular Impingement which is a mismatch between the ball (femoral head) and socket (acetabulum) of the hip. 

    Unfortunately there is little you can do to actually REVERSE osteoarthritis. Osteoarthritis is a condition where you lose the cartilage that covers the bone of your joint. The cartilage is very important, and stops your bone from rubbing on bone. Once the bone is exposed, you will start to release inflammatory cells from the bone into the joint, which is why you start experiencing pain. This is also the clue to treatment in the first instance. 

    Due to the inflammation, the pain can be managed with pain relievers that target inflammation. This includes drugs such as an Anti-inflammatory (Nurofen, Voltaren, Mobic etc) as well as natural anti-inflammatories (Glucosamine and Fish Oil). Glucosamine and Fish Oil have been shown in large studies to be beneficial in 60% of patients suffering from osteoarthritis. I tell my patients to try it for 3 months, and stop if there is no improvement. 

    The exposed bone in your joint starts to create other changes within the joint. Bone spurs (osteophytes) develop, as do bone cysts (Voids next to the joint devoid of bone) which create stiffness in the joint. Along with the pain associated with osteoarthritis, these changes limit the movement of your joint. In your hip, you will probably find that bringing your knee to your chest is affected. Functionally people with bad hip arthritis find it hard to rotate their hip, and find that cutting their nails, tying shoes, and getting in and out of a car are affected. 

    Current research is aimed at growing cartilage. Whilst we have been able to successfully grow cartilage, we have not been able to tell it where to go. Our studies with stem cells, and other agents have resulted in the production of loose bodies in the joint. The general consensus here is that regenerating a joint is probably at least 5-10 years away, unfortunately. 

    In your current situation, your options are:

    - Medical Management: Analgesia, weight loss, walking aids. 

    - Surgery: Total Hip Replacement of Fusion (Fusions are not as widely performed currently, due to the excellent results of Total Hip Replacements and their infrequent use)

    I hope this helps to answer your question. 

  • Dr Surendar Advani

    GP (General Practitioner)

    1

    Thanks

    I love to see patients of all ages and gender and ethnic backgrounds. Providing continued, community- based, whole patient care is my primary goal. View Profile

    Physiotherapy can have slow progression. Phsyiotherapy should be done by a certified physiotherapist and should be long term. But OA is not a reversible condition unfortunately. You will benefit from weight loss if that is applicable. Regular exercise has shown benefits. 

    Moreover, pain killers help if in severe pain. 

  • Mr Ilan Freedman

    Orthopaedic Surgeon

    1

    Thanks

    Mr Ilan Freedman is a fellowship-trained Melbourne Orthopaedic Surgeon with specialist expertise in Direct Anterior Minimally Invasive Hip Replacement, Patient-Specific Knee Replacement, Robotic Hip and ... View Profile

    Arthritis, at present, cannot be reversed. Ads for "stem cells" are currently largely selling false hope and should be approached with caution.

    On the positive side, there is plenty you can do to reduce pain: Exercise, weight loss, physiotherapy (or other allied health treatments), activity modification and simple pain killers.

    If symptoms not sufficiently manageable with all of the above, you can take comfort in the knowledge that surgical techniques have greatly improved and are now very reliable.

  • Simon Lacey

    Healthshare Member

    5

    Thanks

    Hi guys,

    i had grade 3 arthritis in my right hip, couldn't walk now can walk and starting to run, after 5 months had new x/Rays with greater gap in the femur head, femur reshaping, please don't tell this guy only option is a hip replacement, all from a organic plant based diet and amazing Chiro's. Look up John Bergman

    thanks Simon

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