Spinal subluxation can lead to common forms of arthritis
Arthritis can comes in different forms. The two most common forms are
osteoarthritis and rheumatoid arthritis.
Whether the spine or any other joint is involved, the degeneration of a joint known as osteoarthritis is often results from the accumulation of periarticular fibrosis (scar tissue buildup from repetitive strain) and neuropathy (abnormal nerve function). Rheumatoid arthritis is caused by a malfunction in the immune system which causes and attack on the joints.
Arthritis From Neuropathy
Spinal nerve root pressure causes tightening and shortening of the muscles (hypertonicity) that act on the joints. Pressure on nerves also reduces the flow of nutrients to the tissues. Both the restriction of joint motion and the reduction in nerve function to a joint lead to atrophy (wasting away) of the cartilage and soft tissues.
The tight tendon sheaths produce pressure and stretch along the entire length of the ulnar and median nerves going to the hand. Neuropathy can cause what are known as “trophic changes” which include wasting of connective tissue and joint cartilage.
For hand and finger joint pain it is most effective to address motor point and myotomal (muscle nerve distribution) involvement of the forearm flexor and extensor muscles and the associated lower cervical innervation.
In other affect joints of the body the treatment process follows a similar approach. It should be remembered that the spine should be evaluated both segmentally and on an overall biomechanical level for potential involvement. Areas of the spine with nerve root involvement are often the result of other areas of biomechanical compromise either above or below the level of the involved spinal nerve root.
Many arthritic patients are relieved by correctly
adjusting the spine
I have had quite a number of patients who were diagnosed with knee osteoarthritis (OA) who have had complete resolution of the knee pain with only adjustment to the spine and absolutely no treatment at all to the knee. I’ve had the same experiences with osteoarthritis of the hips and hands where pain has significantly or completely cleared up with spinal adjustment. This clinically confirms the underlying etiology of neuropathy in these osteoarthritis conditions. It’s unclear how “far gone” a joint can be and still experience symptomatic improvement with reduction in the underlying neuropathy. There are clearly cases where the damage is far too great. However, even in situations where the symptomatic changes are minimal or non-existent it makes sense to treat the condition in order minimize further damage to the joint as well as the less obvious general health (autonomic) effects of neuropathy.
Arthritis From Pericarticular Fibrosis
Every strain of the ligaments and other soft tissues that support the joints triggers a healing response. However, the repaired tissue is not the same as the original tissue. Instead, the body uses scar tissue to mend the injury. There are several problems with scar tissue. One of the problems is that it is stiffer than normal ligament tissue. Without proper and timely treatment the mobility of the joint will be adversely affected. To appreciate the affect this has you have to understand that cartilage is avascular. This means that rather than getting its nutrients through blood circulation like most tissues the cartilage absorbs its nutrients directly from the joint fluid (synovial fluid) between the joint surfaces. The process of absorbing nutrients through the synovial fluid is called imbibition and it occurs only if the joint is moving properly. Fibrosis (scar tissue) in the supporting structures of the joints directly restricts individual joint mobility and leads directly to starvation of the cartilage. The malnourished cartilage wastes away leading to “bone on bone” in the joint. This is seen on x-ray as a loss of joint space and and a thickening of the bone tissue beneath the joint surface known as subchondral sclerosis which literally means “thickening under the cartilage.”
Even joint building supplementation like glucosamine, chondroitin, etc. are limited in their effectiveness when the joints are not moving properly. Even though the nutrients may get into the blood stream, they cannot make it into the cartilage without releasing the restriction of the fibrotic joint. Only with proper chiropractic care can the nutrients even be delivered to the very places they are needed the most.
Another affect of lack of movement is atrophy of the bone itself which leads to osteopenia (bone thinning) and osteoporosis (porous bones). Just like the soft tissues, bones need movement in order to stay strong and healthy. The immobilization caused by periarticular fibrosis and the soft tissue calcification that follows it prevents normal movement.
Fibrosis also causes thickening of the soft tissues. When this occurs in the spinal joints (facet joints) the thickened fibrotic ligaments shrink the openings (stenosis) where the spinal cord and spinal nerves travel. This pressure on the spinal nerves (radiculopathy) and spinal cord (myelopathy) can affect the sensory nerves and cause pain or numbness, motor nerves and cause muscle spasm or weakness) andautonomic nerves and cause organ, gland and circulatory dysfunction.
Regular chiropractic care not only treats and helps to prevent neuropathy, it also helps prevent the progression of joint degeneration, disc degeneration, spinal stenosis and possibly osteoporosis as well. The old folk wisdom, “If it ain’t broke don’t fix it” could not be further from the truth. In these conditions you probably won’t become aware of the problem until significant damage is already done.
Rheumatoid Arthritis (RA) is not just a disease of joint destruction. It can involve almost all organs. It is among a class of diseases call “autoimmune disorders.” Essentially the immune system misfires and begins building antibodies again the patient’s own tissues. In the case of RA the immune system attacks the joints causing inflammation and damage to the joint. Other types of autoimmune disorders include Type I Diabetes and multiple sclerosis. There is treatment for these diseases, but no cure.
Even so, chiropractors often see their arthritic patients improve. Chiropractors general believe that it is because the nerves are released that control essential parts of the immune system, hormonal system and detoxification systems such as the liver.
In a number of recent experimental studies scientists have shown that chemical signals which normally allow nerve cells to communicate with each other are also involved in directing the actions of the immune system. It may be that releasing interference from the spinal nerves through chiropractic care can help normalize the flow of communication between the nervous system and the immune system.
Many chiropractors including myself have observed that many arthritic patients are relieved by correctly adjusting the spine. Researchers at U.C. San Francisco in 2001 found that in the nervous system, neurotransmitters that normally stimulate nerve cells also affect the migration of circulating lymphocytes and allow them to respond to signals from other immune cells in order to mobilize the bodies defense against infection. Through its action on lymphocytes cells, these neurotransmitters can affect the process in which the immune system turns against normal tissues and foreign substances and lead to problems like allergies, asthma and arthritis. When the response mechanism of the immune system is altered it is called an allergy. (The word “allergy” is actually a compound word from the words “altered” and “response.”)
Spinal subluxation (misaligned vertebrae) is the most common cause of nerve signal disruption. This fact combined with what we now know about the impact of the nervous system on the immune system suggests that chiropractic should always be considered in cases of allergy.