I was diagnosed with Osteoarthritis of the spine about 6 weeks ago. I have had it for just over a year but it took my consultant and numerous other medical people 14 months to find it as it got a lot worse after they first tested me. In the last few weeks I have noticed that as well as my back and neck being stiff first thing in the morning my fingers, thumbs and knees are also a bit stiff and painful. In addition to this my left arm elbow joint is always painful. Could this also be Osteoarthritis?
The trouble is, there is no test for osteoarthritis. It is a diagnosis of exclusion. If you're over aged 45 then mere presence of pain in your joints is enough to saddle you with an OA diagnosis. Your doctor will rule out some conditions, but not all of them. So the diagnosis is EXTREMELY unreliable.
Many think that xrays or MRI provide proof. However, all this can prove is the presence of 'radiograhpic osteoarthritis'. Radiograhpic osteoarthtritis is symptom free in most people.
So, the difficulty you have is that OA isn't a real diagnosis - it doesn't go any way towards explaining why you have pain, or why it might spread.
Now to share my story. I was diagnosed more than a decade ago with hip OA. It spread over the years through spine, shoulders, neck and feet. My neck showed very severe radiographic OA right back then; hips at that time were mild to moderate. I was disabled by all my joint pain at some points - the pain in neck, hip was unbearable and uncontrollable. I couldn't move my arms at all.
Well, MY case of OA turned out to be a whole body muscle imbalance. My pelvis was twisted and that put undue strain on joints throughout my body. It also caused joints to wear abnormally. So in my case the radiographic OA was a red herring. Once the muscle imbalances were addressed all symptoms in all joints disappeared. That 'severe' radograhpic OA in my neck? Well, I do things like balancing on my head (I love gymnastics and calisthenics) without a twinge.
So, yes, it most definitely could be OA if the cause of symptoms in YOUR OA is muscle imbalance.
The reality is that an OA diagnosis is a bit of a cop out. It's not helpful because it doesn't give you any information about WHY you have pain and WHY it progresses the way it does.
Marticulous
I have stiff joints in the morning as well
It’s in my neck and knees which have been validated as arthritis
GREAT NEWS! My hands are also stiff every morning..I had a MRI and they said that my hands were free of arthritis!! Just wanting to give you a little hope! Not al stiffness means arthritis 🌟🌟🌟
Prodigious - your case illustrates the problem with these 'willy-nilly' OA diagnosis.
MRI showed no degenerative changes in the joints in your hands. So we can conclude that something else is causing your pain. I would hope your doctor is trying to figure out what, or at least referring you to a physiotherapist?
For arguments sake, lets just say it is muscle imbalance - certainly muscle imbalance and resulting trigger points DOES cause hand pain. You could try treating that with massage and exercise and maybe you'd soon be pain free.
However, in an alternative reality lets imagine that you had an identical, pain causing, muscle imbalance in your hands but you also had benign, symptom free hand OA. Xrays / MRI would have picked up the radiographic OA and it would be assumed to be the cause of your hand pain. Confident in the diagnosis of OA no one would bother to look for the REAL cause of your symptoms and your pain would go untreated.
Dear Susan
I can’t put into words how much your texts mean to me! I love how knowledgeable you are and well read...
I ALWAYS read your comments!
You’re a real Dear Heart!
Respectfully
Prodigious
I’m sure my pain is directly related to what was found on the mri scans. I have degenerated cartridge in my neck and base of my spine and that is exactly where the pain is. It is not a muscular pain. I had my first scans a year ago and it showed degenerated cartridge that was a bit more than was normal for my age (57). A year on the pain is a lot worse and when scanned again it showed that the degeneration had got significantly worse, again matching the increased pain I was feeling. So it all fits and I am confident I have been diagnosed correctly.
Hi Prodigious. That’s good to know. Hopefully it’s not spreading. Thank you.
Marticulous,
I have the same thing in the cervical part of my spine. My Doctor is the Specialist for our states NBA team.
There’s hope for the neck pain which is always present as it’s holding up an eleven pound head!
I had a Medial cervical block done a month ago. It’s a test to see if my pain is improved several hours after the procedure. If pain is improved, as it was in my case, the next step is Radio Frequency Ablation...It is 1 1/2 Surgery...
Without getting too involved here this surgery has a 75% chance of sucess reducing pain for 1 year to a lifetime
You may already know all this...
I hope there are viable options for you as well🌟
Prodigious
Amen to that M!!
I had similar procedures last year when they were trying to find the cause of my pain. They injected cortisone into my spinal joints with a view to blocking the nerve pain permanently if it worked. Unfortunately it did nothing to ease the pain. I am on Pregabalin & Amitriptyline at the moment, gradually increasing the dose until it gets rid of most of the pain. No luck so far so I’m relying on Tramadol to sort the pain. Been on it from the beginning but I want to get off it.
Maybe, maybe not.
The thing is, when I explained my neck pain I was told that it was classic OA pain. I had severe degeneration in the big joint at the bottom of my neck - that was over 10 years ago. Back then the only neck symptoms I had was a stiff neck. 10 years on I had intense pain (at times requiring urgent medical treatment) and zero movement in my neck.
When the muscle imbalance was resolved all pain in all joints went away.
There is a link between the xray findings and the pain. However, that link was muscle imbalance. The muscle imbalance was causing the joint wear and the muscle imbalance was causing the pain.
I am not saying that your worn joints AREN'T causing your pain. What I am saying is that there is no way to prove this is the case. Muscle imbalance is another possible diagnosis.
Regardless, the treatment is identical. Exercise. You can't replace your spine so you don't have that option. It makes sense to give a little thought to the balance of muscles acting on your spine so that you can make your exercise treatment more effective.
Additionally, you can get a great deal of pain relief from self Trigger Point treatment. This is only symptomatic relief, but even if your degenerated joints were the root cause of your pain, that pain and stiffness will RESULT in muscle imbalance and that muscle imbalance will CONTRIBUTE to your pain. Massage the knots that form in the muscles and you may well find that with practice you can greatly reduce your pain.
You see, that suggests that the joint isn't the source of your pain.
I too was on Amitriptyline for a while. That was for the hip pain rather than neck pain. I went through a spell of several months of uncontrollable pain - drugs didn't touch it. 24/7 unbearable pain! I was written off and it was assumed I had this for life.
Amitriptyline did eventually break the cycle for me. I was on it for 4 months and that intense pain never came back. I was still a couple of years away from eliminating the joint pain, but what I'm trying to tell you is that there is hope. I am now symptom free. No matter how hopeless it seems - no matter how determined the health pros are to convince you that this is what the future holds for you, there is always the possibility of turning things around.
Hi Susan. If you had my symptoms how would you address the muscle imbalance?
Yes I am on Tramadol as well.
I had the steroid injections and they worked for a couple weeks. Then ouch it all came back.
Radio Frequency Abligation is where they burn the nerves that are sending signals to the brain of pain. They die but can re grow after a year thus another procedure to burn them again!
We’ve got to keep trying!
Thanks for your reply it helps me feel like I’m not alone!
Thank you susan🌟
Ahh I know what you mean now. That’s what they were going to do if the test cortisone injections worked, but they didn’t get. Your welcome, thank you too 😊
M
I’m so sorry they didn’t work for you
Only 50% have positive results.😓
Always
Prodigious
Thank you. Just my luck lol.
It's unfortunately not that straight forwards as you need to diagnose the imbalance before you can treat it.
There is a very definite pattern of imbalance associated with hip OA, and that imbalance can also manifest as knee, neck, back, foot and shoulder pain - either instead of, or as well as hip pain.
Generally speaking, joint pain will be the result of a whole body imbalance. Joints tend not to get out of balance in isolation. So for example, in retrospect I am aware of my 'twisted pelvis' developing for a long time - thinking back it was starting 20 years before I ever had symptoms. You tend not to notice it at the time because it's completely pain free, and any movement impairments can be written off as just 'normal for you'.
The pain and joint stiffness will typically start in one joint. It will normally happen as a result of a muscle acting on that joint being under so much strain that an RSI (repetitive strain injury) occurs. Normally, RSI's recover with rest, but when that RSI is a result of a severe muscle imbalance it never gets that rest. Once the pain and stiffness sets in the muscle imbalance progresses (worsens) rapidly and it's hard to treat. This puts even more strain on multiple muscles/joints and you can start to find that one by one the joints in your body develop pain and stiffness. Potentially, it can manifest in fingers and toes as the way in which you use your hands subtly adapts in order to accommodate changes in the core and major joints.
Now this is where we get to the big catch - a major, whole body muscle imbalance is VERY hard to correct. Especially for someone that's never taken an interest in human biomechanics or sport. There are no professionals to help you as mainstream medicine has seen fit to focus on surgery and drugs to treat people with OA. Lots of physios have the skills to make some headway with this (although they tend to be trained to get things done and dusted in three sessions and that's not long enough for a problem of this severity). However, if you have an OA diagnosis - especially if you're over 45 - they tend not to even try. They're trained not to try and resolve imbalances once someone has been given the OA 'death sentence'. Some are more willing to try than others - sports physios tend to be better than the NHS variety.
HOWEVER, many people get significant improvement with a more generic approach. Having the confidence to really take on board the advice to exercise can help. Even generic exercise can significantly reduce symptoms simply because your body is stronger, fitter and better able to cope with the imbalance without developing RSI's. Without a reasonable diagnosis of your imbalance you just need to try various approaches to exercise and see what helps and what makes things worse. Start slow, and build up. If you get some positive results you may start to home in on the type of exercise that actually helps correct your imbalances.
If you have a good council run gym where you live - one that has well trained fitness trainers that offer members free training programs - then that could potentially make the world of difference. A lot comes down to luck, but many have great skills and abilities and whilst I doubt they'd resolve the imbalance completely it is VERY possible that they could get you to a point where your symptoms are no longer too much of a bother to you. A big part of the battle is in your own mind - being told you have an incurable joint disease and that your joints are crumbling can cause your brain to over-react to signals from the nerves. You can actually experience more pain than you would if you believed that you simply had muscle imbalances that needed exercise to resolve the pain. An important thing to remember though is whatever the cause of your pain, the evidence based recommendation is to EXERCISE. Really work hard to find an approach that makes you feel better - you may have to stick at it for a while. Some cases are more stubborn than others, but this really is worth a proper try.
Some good news - research shows that hand and knee oa often runs it's course and gets better on it's own. Something like 40% of cases.
The other thing I'd recommend is really taking on board looking into 'trigger point treatment' (google for info). It's a self administered massage technique. There are resources freely available that help teach you how to find and trigger points that are responsible for your specific pattern of pain. Some people get tremendous results with this, but typically it's only symptomatic improvement. Still, it can help make life more bearable and keep you off pain relief.
If you're genuinely interested in going for the long haul approach and really trying to fix this muscle imbalance (there will be muscle imbalance that's at least partly responsible for your pain) at it's source I could perhaps give you some crude test that you could try to see if you can pin point which muscles are mostly responsible for your symptoms. A very good way of looking at it is to figure out the resting position of the pelvis - always with a muscle imbalance the pelvis is a good predictor of what's wrong in the rest of the body. Is it tilting forwards? tilting back? hitched up on one side? rotating back on one side? Once you have answers to that question you can start homing in on the problem muscles.
Thank you for the detailed reply. Throughout this whole thing I have exercised 4-5 Times a week. I’ve always kept myself fit. I cycled to work for 19 years (70 miles a week). At the moment I go for a 20 min walk each lunchtime and do step aerobics and yoga at home 5 times a week. I actually enjoy doing it BUT I’ve seen no improvement in regards to the pain. I’m at a loss.