Exercise program often alleviates chronic joint pain

Joint pain has caused Americans to waste millions of dollars each year on worthless treatments. They are lured by claims from a wide variety of things, from acupuncture to moon dust.

The problem lies in the fact that there is still little known about the cause of arthritis and joint pain, and there is little specific medication for treatment of these problems.

Doctors treat the symptoms of pain with a variety of medications including aspirin, which is effective in treating the inflammation associated with arthritic pain as it decreases the awareness of pain in the mind.

Those suffering from severe arthritis often can benefit from recent advances in surgery. We frequently hear of a crippled arthritic who has responded well to bilateral hip joint replacement.

Methyl methacrylate cement, which has been used in dentistry for years, is now used to connect hip and knee bones to metal or plastic joints. Finger joints can now be replaced with flexible silicone rubber implants.

There has also been improvement in the procedure to surgically remove synovial membranes — lining membranes — which are the center of inflammation and ultimately the cause of damage to bone cartilage. And some people with arthritic conditions benefit from physical therapy treatments or osteopathic manipulative therapy.

Not all people complaining of joint pain are true arthritics. Poor posture often is found to be the root of the problem. Such pain can also be caused by a too-soft mattress or sporadic participation in strenuous sports or activities. High intakes of coffee, tea or cola can be contributing factors. Stress can also be a factor.

Sometimes considerable time and money goes into diagnostic testing to differentiate between true arthritis and pain caused by external factors. Such a diagnostic workup might include myelogram studies, or electromyelograms.

Even CAT scans can be used to determine if there is abnormal bone pressure on the nerve due to rupture or tumor. At times the Minnesota Multiphasic Personality Inventory with true-false questions is given to patients complaining of joint pain to determine whether there is a subconscious reaction to depression or psychological problems.

Within the past few years it has been found that stretching exercises can eliminate joint pain, even low back pain, in a number of cases.

One osteopathic physician has developed a specific series of such exercises that are based on a combination of yoga and osteopathic manipulative therapy techniques. The exercises include forward bending, side rocks, leg-overs, shoulder rolls, peanut rolls, the yoga twist and “cat stretch,” all of which the physician recommends doing two or three times a day.

The American Back Society recognizes that most low and upper back injuries are not disc disease, fracture, or pathologies described as osteoporosis, crippling arthritis, spondylolisthesis, or any other bony pathology.

They are soft tissue injuries, representing some 88 percent of the problems associated with malfunction of the low back and resultant disability and pain. I have found in the last 15 years of practice that with instruction, anti-inflammatory medication, judicious daily stretching, postural training, advice from a physician concerned about and trained in these soft tissue problems, and the administration of manipulative techiques, patients can return from severe disability to moderate function, wherein their daily activities are not prohibited.

This requires them to understand that it is a daily effort on the part of the patient or disabled person to reverse mild arthritis and reverse soft tissue pathology. I think that, in working with a professional physician and often physical therapist, one must improve.

I have personally prescribed exercises in my own medical practice with excellent results. Patients who were once seen weekly for osteopathic manipulative treatment are now doing the exercises at home, able to progress on their own and come into the office only a few times a year for checkups.

Such an exercise program has added one more dimension to the treatment of arthritis and is considerably less expensive than many remedies, with the added benefit of improving the cardiovascular system and relieving daily stress and depression.

Richard Perrotta is an osteopathic physician in Bangor.