Doctor James on Health and Wellness

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Archive for August, 2008

Osteoarthritis…Prevention and Correction

Posted by doctorjames on August 14, 2008

A smart man once said the best thing a person can do is to see it plainly and tell it simply! That is what I am going to try to do. If you have been reading any of my postings, I try to make all of this medical terminology come to life in analogies and stories that are easy to understand.

Arthritis means inflammation of a joint. Arthro means joint, and itis means inflammation. Osteo means bone. Osteoarthritis is mostly seen in weight bearing joints like the spine, knees, hips, and shoulder. Rheumatoid arthritis is an autoimmune disease. The body actually begins to attack the tissues that make up the joint. For this conversation, we are going to focus on osteoarthritis.

Arthritis is simple to understand when we look at the joint from a pattern of wrong movement. The only way, and I repeat, the only way osteoarthritis can occur is if the joint undergoes constant stress in a repetitive manner with abberant joint mechanics. This can be the result of an injury, simple postural distortion that started in childhood, or a constant wrong movement pattern that stresses the joint when in use.

Simple, isn’t it! An injury can cause osteoarthritis due to trauma suffered by the joint. It is the trauma that initiates the arthritis to start, but it is the assumed postural distortion and wrong movement pattern that the joint begins to take on that really causes the problem and promotes it to get worse. Some of the most common terms for this is a tracking problem, segmental dysfunction, or a simple alignment issue.

When I talk about a postural distortion, I am talking mostly about a person’s hips. If the tailbone, which connects the hips, is not level, with the ground, arthritis will be the result! When the tailbone, or sacrum tilts in any direction, it causes the iliac bones (hip bones) to change their normal range of motion and joint mechanics. Typically in this scenario, one hip moves more than the other when the person is in motion. This causes hypermobility in one of the hip joints, and hypomobility in the other hip joint. In fact, a study done by Dr. Ogi Ressel found that out of 650 children, 96% of them presented with a hypomobile left sacroiliac joint and a right hypermobile sacroiliac joint. This is very troubling.

This means that as early as we begin to walk, if our sacrum has a tilt to it, arthritis has already begun! You heard me right, if the child is only 7 years old, the process has begun. Now, there are many doctors who would choose to refute this with me, but if this inferiority, or tilt, of the sacrum exists, one of the discs in the back is slowly beginning to change on a histochemical level. The cells that make up the cartilage are beginning to change to support the compression on one side versus the stretching force on the other side. This happens because as one person put it “as the twig is bent, so grows the tree!”

If the sacrum is low on one side, which is called a sacral inferiority, the lowest lumbar vertebra either is parallel and tilted to the same degree as the sacrum, or it is compensating for the inferiority and it is rotated and “wedged.” Wedging means if looking at an x-ray, the vertebra produces and acute angle instead of a parallel condition with the sacrum. Now, if it is not L5 that wedges and rotates, it will be L4, L3, or L2. This is because the sacral inferiority will most of the time produce a convex scoliosis on the side of its inferiority. But, at some point in time, the lumbar spine has to compensate for this condition to try and make the spine straight. Therefore, it causes one of the vertebra to twist and wedge. This lumbar scoliosis usually creates a compensating thoracic scoliosis.

Now, where does arthritis come into play in all of this. As I said above, as soon as a sacral inferiority exists, arthritis has begun. There may not be any pain, and there may not be any radiographical evidence of this process, but it is on its way! Why do we wait until we can define this as flow blown disease…ARTHRITIS? This is absolutely not OK.

As if the sacral inferiority wasn’t enough, it causes a change in the height of the femur head due to a rotation of the ilium on the sacrum. When height of the acetabulum changes, which is the place where the femur connects to the hip, it causes a medial rotation in the femur which creates torque as the femur joins the tibia. This constant torque causes a postural distortion, gait changes, and abberant biomechanics of the knee joint. This overtime will create osteoarthritis in the knee. The medial meniscus will begin to degenerate and will start to cause pain and ultimately new bone growth. This also causes the medial arch to be lost in the foot and resultingin plantar fascitis and bunions in due time due to a postural distortion of the sacrum!

Now, if all of this was not enough, the sacral inferiority can create either to big of a curve due to disc wedging, or to small of a curve in the lumbar spine. As if the scoliosis was not enough, now the thoracic spine has to compensate causing a larger curve or a straighter curve in the thoracic spine called increased or decreased kyphosis.

All of this finally works up to the neck or cervical spine. The cervical spine compensates for the increased, decreased, or scoliotic curvature of the lumbar and thoracic spine creating the same conditions in the cervical spine.

The interesting thing is that arthritis has nothing to do with aging! If it had anything at all to do with aging, then your whole spine would be arthritic, but that is not usually the case. Usually only one or a few vertebra become arthritic and the others are completely normal. This can be demonstrated time and time again on x-ray and MRI. We have been fooled all this time! IT IS NOT AGE RELATED! It is the result of the poor joint mechanics due to a previous postural distortion!

Arthritis can be treated chemically with drugs and/or supplements sometimes very effectively. It can also be treated with surgery and various other medical treatments But, this is treating an EFFECT and not the CAUSE…the postural distortion and corresponding abberant joint biomechanics! If you are not actively treating arthritis with movement and manipulations, the joint will never get the right message to begin to switch its healing process. Arthritis cannot be changed passively. To change this condition is has to be active treatment. The body thinks it is doing the right thing by stabilizing the joint with more bone…it is healing itself to prevent further damage! The body is constantly trying to heal itself, we simply have to change the message!

When curvatures change, and joints begin to degenerate, a whole host of things happen. Inflammatory molecules are released, and remodeling takes place. This can be a silent process for years until the body finally starts to have trouble dealing with it. The problem with a degenerative condition in the spine is that it changes the size of the foramen, which is the opening where the nerve comes out of the spinal column, which eventually will put pressure on the nerve root. This is not a good thing!

The nerve root sends messages to every cell in our body. The nerves are how our brain communicates with our body. If there is an interference or interruption to the way the nerve transports its message to the cell or cells, poor cell activity will take place. As you may or may not know, cells make up organs and tissues. If the nerve or nerves cannot “talk” with the body, the organ, gland, blood vessel, and/or, muscle will begin to lose the messages being sent to it to tell it how to perform its activities. This simply decreases the function of the organ involved. Definitely not a good thing.

Hopefully I have explained this well enough that you realize that posture is so very important. In fact, go to your local mall and do some observing. The people who are “bent over” due to poor posture have poor health! It is as simple as that!

Studies show that if osteoarthritis is caught early on, the body can actually reverse this condition! This has to give some of you hope. This is why every child and young adult should have x-rays taken to make sure that they don’t have a sacral inferiority that is going to cause them future problems. The fact is that it will take 10-20 more years to progress to radiographical evidence of an arthritic condition. Why not find it before this becomes a healing effect that the body is using to try and deal with the stress.

When caught early on, with an intense treatment program, this condition can be reversed in one to three years! This is only one to three years to treat something that may someday cripple your loved one! You are correct, not all cases reverse because there is no “silver bullet,” but most will! This can change the health outlook of an individual incredibly!

It is my honest belief that every child should have an x-ray of their spine taken at 5 years of age if an examination of their pelvis reveals that one hip is higher than the other. This is the start of a degenerative condition with a possible subsequent compensating scoliosis to some degree. We cannot possibly sit on the sidelines and not have our loved ones examined.

Hopefully you have learned some things today. Doctor means teacher. It is the highest calling of a doctor to educate a patient enough for them to be able to take control of their own health. I can only continue to teach what I know to be true to help the masses and loved ones of tomorrow!

To be continued…

Your Health and Wellness Advocate,

Dr. James R. Haakenson

P.S. If you have questions please contact me by email at thedoctorjames@gmail.com.

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