Understanding Osteoarthritis
Osteoarthritis is often viewed with fear and resignation—many people believe an arthritis diagnosis means inevitable pain, disability, and loss of independence. This couldn’t be further from the truth. While osteoarthritis is indeed common as we age, it doesn’t have to define your quality of life or limit your activities. In fact, the decisions you make each day, particularly regarding movement and exercise, have a dramatic effect on whether arthritis becomes a problem for you.
What Is Osteoarthritis?
Osteoarthritis (OA) is the breakdown of cartilage around your joints. Cartilage is the smooth, slippery tissue that covers the ends of bones where they form joints, allowing smooth, pain-free movement. When this cartilage wears down, bones can begin to rub together, causing pain, stiffness, and swelling.
Osteoarthritis can affect any joint in your body, but most commonly impacts:
- Knees
- Hips
- Hands and fingers
- Spine (neck and lower back)
- Feet
Common symptoms include:
- Joint pain and stiffness, especially after periods of inactivity
- Swelling around affected joints
- Reduced range of motion
- A grating or grinding sensation with movement
- Joint tenderness
- Morning stiffness that typically improves with movement
- Pain that worsens with activity in severe cases
The Truth About Arthritis and Aging
Here’s what you need to know: Osteoarthritis is a natural part of the aging process, much like gray hair or reading glasses.
Research shows that:
- By age 60, over 80% of people show some evidence of osteoarthritis on X-rays
- Many people with arthritis visible on imaging have no pain or symptoms
- The presence of arthritis on X-rays does NOT predict disability or pain levels
- People with similar degrees of arthritis on imaging can have vastly different functional abilities
What determines whether arthritis becomes disabling?
Not the arthritis itself—but rather:
- Your activity level and movement patterns
- Muscle strength supporting the affected joints
- Your beliefs about arthritis and movement
- Whether you stay active or become sedentary
- Body weight and overall health
- How early you address symptoms
This is empowering news: You have significant control over how arthritis affects your life.
The Biggest Mistake: Resting Arthritic Joints
When joints hurt, the natural instinct is to rest them, avoid movement, and “save” them from wear and tear. This approach, while seemingly logical, is actually one of the worst things you can do for osteoarthritis.
Why Rest Makes Arthritis Worse
When you avoid moving arthritic joints:
- Muscles around the joint weaken rapidly
- Joint stiffness increases dramatically
- Cartilage health deteriorates (cartilage needs movement for nutrition)
- Synovial fluid (joint lubricant) production decreases
- Range of motion becomes progressively limited
- Pain actually increases over time
- Weakness leads to poor joint mechanics, accelerating degeneration
- Fear of movement develops, creating a downward spiral
- Daily activities become increasingly difficult
- Independence is threatened
Research consistently shows that people who rest arthritic joints:
- Experience more pain
- Have greater disability
- Lose function faster
- Have poorer quality of life
- Become increasingly sedentary
Why Movement Is Medicine: “Motion Is Lotion”
There’s a saying in rehabilitation medicine: “Motion is lotion.” This perfectly captures the reality of osteoarthritis management.
When you move arthritic joints appropriately:
- Synovial fluid (your body’s natural joint lubricant) circulates, nourishing cartilage
- Muscles strengthen, providing better joint support and stability
- Joint mechanics improve, reducing abnormal stress
- Stiffness decreases
- Pain levels often reduce significantly
- Range of motion is maintained or even improved
- Bone density is preserved
- Balance and coordination improve
- Inflammation is reduced
- Mood and overall health improve
- Independence is maintained
The science is clear: Exercise and movement are among the most effective treatments for osteoarthritis—more effective than many medications and with far fewer side effects.
Understanding What Causes Osteoarthritis
While aging is the primary risk factor, several factors contribute to osteoarthritis development:
Risk factors you cannot change:
- Age (natural cartilage changes occur over time)
- Genetics (some people are predisposed)
- Previous joint injuries
- Joint abnormalities you were born with
- Gender (women are more likely to develop OA after menopause)
Risk factors you CAN influence:
- Being overweight or obese (extra weight stresses weight-bearing joints)
- Sedentary lifestyle (lack of movement weakens supporting muscles)
- Poor posture and movement patterns
- Muscle weakness around joints
- Repetitive stress from certain occupations or activities
- Smoking (reduces blood flow and impairs healing)
The good news? Many modifiable factors are within your control through daily decisions about movement, exercise, and lifestyle.
Osteoarthritis and Degenerative Disc Disease
A specific and common form of osteoarthritis affects the spine, particularly the intervertebral discs and facet joints. This is often called degenerative disc disease, though “disease” is a misnomer—it’s really age-related change.
What Happens in Spinal Degeneration
Every day, your spinal discs absorb stress related to:
- Gravity compressing your spine
- Your posture (especially prolonged sitting or poor posture)
- Your movement patterns
- Lifting and bending activities
Over time, this stress causes natural wear and tear:
- Discs lose water content and become less flexible
- Disc height decreases
- Bone spurs may develop
- Facet joints develop arthritis
- Ligaments may thicken
These changes are visible on X-rays and MRIs in most people over 50, yet many have no symptoms.
Why Spinal Arthritis Becomes Symptomatic
Degenerative changes become painful when:
- Surrounding muscles weaken, forcing joints to bear abnormal stress
- Prolonged inactivity leads to stiffness
- Poor posture places excessive load on certain segments
- Inflammation develops around arthritic joints
- Nerves become compressed by bone spurs or disc changes
The key point: The degree of degeneration on imaging doesn’t correlate with pain or disability. Two people with identical X-rays can have vastly different experiences—one pain-free and active, the other disabled and hurting. The difference? Usually movement, strength, and lifestyle factors.
Our Comprehensive Approach to Osteoarthritis
When you visit our office with arthritis-related pain, we don’t simply accept that “you have arthritis and must live with it.” Instead, we conduct a thorough evaluation to understand:
What We Assess
- Current Functional Status: What activities are limited, and why?
- Movement Patterns: How you move and what compensations you’ve developed
- Muscle Strength and Balance: Weakness patterns around affected joints
- Joint Range of Motion: Current mobility and restrictions
- Posture and Biomechanics: How your alignment affects joint stress
- Pain Patterns: What makes pain better or worse
- Lifestyle Factors: Activity level, work demands, exercise habits
- Overall Health: Weight, other medical conditions, medications
- Beliefs About Arthritis: Understanding how your beliefs influence your approach
- Goals and Priorities: What activities matter most to you
Imaging and Arthritis
If you already have X-rays or other imaging showing arthritis, we review them—but we don’t let them dictate your potential. We treat you, not your X-rays.
If imaging is needed to rule out other conditions or guide treatment, we can coordinate appropriate studies. However, remember: the degree of arthritis visible on imaging is a poor predictor of your outcome.
Our Evidence-Based Treatment Approach
Our treatment philosophy for osteoarthritis centers on one fundamental principle: Keep you moving.
Movement-Based Therapy (The Foundation)
This is the cornerstone of arthritis management:
Therapeutic Exercises:
- Strengthening exercises for muscles supporting affected joints
- Range of motion exercises to maintain and improve flexibility
- Balance and proprioception training to prevent falls and improve joint stability
- Progressive resistance training tailored to your current ability
- Functional exercises mimicking your daily activities
The approach:
- Start where you are, not where you think you should be
- Progress gradually and consistently
- Focus on proper form and control
- Emphasize exercises you can continue independently
- Make exercise enjoyable and sustainable
Research shows: Regular exercise for osteoarthritis provides:
- Pain reduction comparable to medication
- Improved function and mobility
- Better quality of life
- Slowed progression of joint changes
- Reduced need for surgery
- Enhanced overall health
Manual Therapies
While movement is primary, manual therapy supports your progress:
- Joint mobilization: Improving movement in stiff arthritic joints
- Chiropractic manipulative therapy: Restoring proper spinal mechanics when spinal arthritis is involved
- Instrument-assisted soft tissue mobilization: Addressing muscle tightness and fascial restrictions
- Myofascial therapy: Releasing tension in muscles around arthritic joints
- Trigger point release: Addressing secondary muscle pain
These therapies help reduce pain and improve mobility, making exercise more comfortable and effective.
Advanced Technologies
- Laser therapy: Reducing inflammation in arthritic joints and surrounding tissues, accelerating healing
- Shockwave therapy: Stimulating cellular regeneration and reducing pain in severely arthritic joints
- Cupping therapy: Improving circulation and reducing muscle tension
Education and Lifestyle Modification
Knowledge is power in managing arthritis:
Activity Modification:
- Learning which movements to embrace and which to modify
- Proper body mechanics for daily activities
- Pacing strategies to balance activity and recovery
- Joint protection techniques
Ergonomic Optimization:
- Workspace setup to reduce joint stress
- Home modifications to support independence
- Adaptive equipment when helpful
Nutritional Guidance:
- Anti-inflammatory diet principles
- Weight management strategies (if relevant)
- Hydration importance
Sleep and Stress:
- Sleep positioning to reduce joint pain
- Stress management (stress increases pain perception)
The Three Proactive Strategies for Managing Arthritis
Based on current evidence, these three approaches are essential:
1. Daily Stretches and Exercises That Foster Balance of Strength and Flexibility
Why this matters:
- Maintains joint range of motion
- Builds muscle strength to support arthritic joints
- Improves balance, reducing fall risk
- Keeps you functional and independent
What to do:
- Perform gentle range of motion exercises daily
- Include strengthening exercises 2-3 times per week
- Incorporate balance activities
- Move each arthritic joint through its full range daily
- Stay as active as your joints allow—walking, swimming, cycling, yoga
Remember: Some discomfort during exercise is normal and acceptable. We help you distinguish between productive discomfort (building strength and mobility) and harmful pain (damaging tissues).
2. Maintain Proper Ergonomics and Posture
Why this matters:
- Poor posture places excessive stress on arthritic joints
- Ergonomic strain accelerates degeneration
- Proper alignment reduces pain
For spinal arthritis specifically:
- Keep computer monitors at eye level
- Use a standing desk if possible to alternate positions
- Avoid prolonged sitting—change positions every 15-20 minutes
- Maintain neutral spine positions
- Support your low back when seated
For all arthritis:
- Use joints in their most stable, aligned positions
- Distribute loads evenly
- Avoid repetitive stress in poor positions
3. Follow an Anti-Inflammatory Diet
Why this matters:
- Chronic inflammation accelerates cartilage breakdown
- Certain foods promote inflammation
- Other foods reduce it naturally
- Diet impacts pain levels
Key principles:
- Emphasize fruits, vegetables, whole grains, lean proteins, healthy fats (especially omega-3s)
- Limit processed foods, refined sugars, excessive red meat
- Stay well-hydrated
- Consider anti-inflammatory spices like turmeric and ginger
- Maintain healthy weight (every pound lost reduces knee stress by 4 pounds)
Special Considerations for Spinal Arthritis
Your spine requires particular attention because spinal health affects everything:
Daily spinal care:
- Move your spine through its full range of motion each day
- Avoid prolonged static postures (especially sitting)
- If you must sit for work, take movement breaks every 15-20 minutes
- Consider a standing desk to alternate positions
- Practice good lifting mechanics
- Maintain core strength to support your spine
The inactivity-posture combination: Prolonged sitting in poor posture is especially harmful for spinal discs and facet joints. This common modern pattern accelerates degeneration and creates pain. Combat it with regular movement and postural awareness.
It’s Never Too Late to Start
Perhaps you’ve been sedentary for years, or you’ve avoided movement because of arthritis pain. Here’s the encouraging truth: It’s never too late to benefit from movement and exercise.
Research consistently shows that people in their 70s, 80s, and beyond can:
- Build muscle strength
- Improve joint mobility
- Reduce pain
- Enhance function
- Maintain independence
The key is starting where you are and progressing gradually with guidance.
What to Expect
When you begin moving more with arthritis:
Initial phase (first few weeks):
- Some increased discomfort is normal as joints adapt
- Stiffness may initially seem worse
- Muscles may be sore from new activity
- Benefits begin emerging within 2-4 weeks
Continuing progress (weeks to months):
- Pain typically decreases
- Function improves noticeably
- Confidence builds
- Activities become easier
- Quality of life enhances
Long-term maintenance:
- Continued exercise maintains benefits
- Stopping exercise causes regression
- Consistency is key
- Exercise becomes a sustainable habit
When Additional Medical Intervention May Help
While movement and conservative care are primary treatments, sometimes additional interventions support your progress:
- Medications: Anti-inflammatories, pain relievers (used strategically, not as primary treatment)
- Injections: Corticosteroid or hyaluronic acid injections for severe flares (temporary relief to allow engagement in therapy)
- Surgery: Joint replacement for severe, end-stage arthritis not responding to conservative care
These aren’t first-line treatments, but they have a place when conservative care alone isn’t sufficient. We’ll guide you on when these might be appropriate and coordinate with specialists when needed.
Your Arthritis Doesn’t Define You
The most important message: Having arthritis doesn’t mean you’re destined for disability, pain, or loss of independence.
Your choices matter more than your X-rays:
- Stay active, not sedentary
- Exercise regularly, don’t rest excessively
- Maintain strength and flexibility
- Keep good posture and body mechanics
- Manage weight if needed
- Eat an anti-inflammatory diet
Remember: Motion is lotion. Your joints need movement to stay healthy, lubricated, and functional.
Take Action Today
If you’re experiencing arthritis-related pain or stiffness, don’t accept it as inevitable. Schedule an evaluation so we can:
- Assess your current status and identify modifiable factors
- Create a movement-based plan tailored to your specific joints and abilities
- Teach you exercises you can perform independently
- Address pain and stiffness with appropriate therapies
- Correct posture and ergonomics reducing joint stress
- Provide dietary guidance for reducing inflammation
- Build your confidence in moving with arthritis
- Monitor your progress and adjust as you improve
- Support your long-term success with sustainable strategies
Don’t let arthritis steal your independence, activities, or quality of life. With the right approach emphasizing movement over rest, most people with osteoarthritis can remain active, functional, and living life on their terms.
The worst thing you can do is nothing. The best thing? Start moving. We’re here to guide you every step of the way.
Motion is lotion—keep your joints moving, and they’ll keep you moving.