There are many different types of arthritis, with the most common being osteoarthritis (OA), also known as degenerative joint disease (DJD). Osteoarthritis is often referred to as the “wear-and-tear” type of arthritis, as the smooth, cushion-like, shiny cartilage covering the joints that allows for a nice gliding surface wears down. This can cause pain, swelling, loss of motion, and spurs that further limit motion. According to the Arthritis Foundation, OA/DJD affects about 27 million Americans and is most commonly found in the knees, hips, low back, neck, small joints of the fingers, and base of the thumb and big toe.
In one study, researchers reviewed cervical x-rays and detected spondylosis—degeneration of the intervertebral disks, which rest between the vertebrae of our spine—in approximately 60% of non-symptomatic persons more than 40 years old and in 95% of men and 70% of women over age 60. Similarly, cervical spine MRIs of individuals without neck pain frequently show a disk bulge or herniation. According to the AMA Guides to the Evaluation of Permanent Impairment (5th edition), 30% of us who have never had neck or back pain will test positive for a herniated disk and 50% or more will have bulging disks on a CT or MRI!
So, if you have neck pain and your doctor takes images that show arthritis or a disk problem is present, how do you know whether or not DJD is to blame? The answer is: it varies and must be clinically determined on a case-by-case basis.
Though frustrating, the ability to determine what is truly generating a patient’s pain can be a challenge. This is why a careful, detailed history and examination of the patient, as well as tracking their response to treatment, is so important. Doctors of chiropractic approach these conditions with various forms of manual therapies including (but not limited to): joint manipulation; mobilization; massage; trigger point therapy; exercise training; activity modifications; self-management strategies, such as traction; the use of specially designed pillows; modalities such as electrical stimulation, ultrasound, and laser therapy; and nutritional counseling to reduce inflammatory markers. Guidelines published around the world recommend joint manipulation for neck pain and headaches as one of the first courses of care because it is both safe and effective.