“Arthritis”, also known as osteoarthritis or degenerative arthritis, is a natural part of aging (similar to wrinkles in our skin). Factors that lead to an earlier onset of degeneration include genetics, diet, obesity and a previous injury. Previous injuries are probably the best predictor of whether you will have early degeneration.
Studies have shown that more than 80% of 50 year olds will present with some form of degeneration (as seen on imaging) around the spine and not complain about pain. The prevalence of disk degeneration found in asymptomatic individuals increases from 37% of 20-year-old individuals to 96% of 80-year-old individuals (Brinjikli 2015).
Although degenerative changes increase as we age, low back pain symptoms do not. Low back pain peaks sometime in midlife. There is a poor correlation between aging (spinal degeneration) and low back pain (Louw 2017).
Similarly, 50% of people with knee arthritis as seen on X-rays have no pain. Therefore radiographic knee osteoarthritis is a poor guide to the likelihood of knee pain or disability (Bedson 2008). In addition, 50% of people over the age of 60 have pain free rotator cuff tears. Rotator-cuff lesions are found to increase as we age and are often present with no clinical symptoms (Milgrom 1995).
Pain is a complex process in the brain and not necessarily related to the amount of physical damage but our beliefs of the cause of pain. Chronic pain can be a result of a sensitized nervous system where the brain and nerves are in a heightened state of alertness and can misinterpret minor injuries. We also need to address the psychological and social stresses in addition to the physical component as a contributor to pain. Causes of your pain may include poor diet and sleep, emotional stresses, lack of activity, or poor body mechanics (primary or secondary to a previous injury).
Arthritis is as normal as wrinkles in our skin when it comes to aging. Let’s start treating the individual and their specific issues versus radiographic imaging results which may or may not be the cause of your problem.
At Lee Chiropractic Clinic we will incorporate your current physical condition and include your history of injuries when considering how to help you be the strongest, pain free you!
Bedson, J, Croft, PR, The discordance between clinical and radiographic knee osteoarthritis: A systematic search and summary of the literature. BMC Musculoskeletal Disorders 2008; 9-116.
Brinjikji, W et al. Systematic Literature Review of Imaging Features of Spinal Degeneration in Asymptomatic Populations. American Journal of Neuroradiology. 2015; 36(4):811-816.
Louw, A et al, De-educate to re-educate: Aging and Low Back Pain. Aging Clin Exp Res 2017; 29(6):1261-1269.
Milgrom, C et al, Rotator-cuff changes in asymptomatic adults. The effect of age, hand dominance and gender. J Bone and Joint Surg Br 1995; 77(2):296-8.