The role of age, gender and activity level
Musculoskeletal joint conditions are extremely prevalent in the U.S. Osteoarthritis (OA) is the most common of the dozens of forms of arthritis. The Center for Disease Control and Prevention (CDC) predicted correctly that by 2020, arthritis will gain more patients than any other disease form in America. OA can affect any joint but most often occurs in the fingers, wrists, knees, hips, lower back, and neck. Typical symptoms include joint pain, swelling, redness, stiffness, instability, immobility, or crepitus (crackling, popping, or squeaking sounds emanating from the joint). Because OA is a degenerative disease related to “wear and tear” of the cartilage in the affected joint, symptoms gradually worsen over time. Age is the biggest risk factor for OA (but trauma to joints due to accidents or sports injuries are also significant risk factors). Gender is also a major risk factor in that OA is more common in women than men. In the United States, symptomatic knee OA alone affects almost 10% of males and 13% females over the age of 60. Indeed, knee pain is one of the most common joints for which people seek treatment from an orthopedic doctor or surgeon.
How does OA begin?
OA develops and worsens slowly over time and is classified as a degenerative disease. Over time, the outer layers of the menisci wear down leading to a loss of joint space which increases friction on the thinner, weaker articular cartilage, which can then become further damaged, increasing the friction between abutting bones causing pain, swelling, stiffness, and decreased mobility. Loss of joint space due to damaged or missing menisci or articular cartilage can also be accompanied by the growth of osteophytes or bones spurs, making it painful to extend and bend the leg.
Got knee pain? Learn about the four phases of degeneration
The Kellgren and Lawrence (KL) system is a common method used by orthopedic doctors and surgeons to classify the severity of OA. The KL system can be used to chart a patient’s disease progression and is used as an outcome measure in clinical research studies evaluating the efficacy of various treatment modalities. While the KL system can be used to describe OA in many different joints, we illustrate its use to describe OA in the knee using X-ray images as seen in Figure 1. Five grades (0-4) are used to rate disease severity. In general, subjective pain is non-existent or minimal in grades 0-2 and increases significantly during grade 3, altering the quality of life. By stage 4 disease, pain, and lack of mobility can be debilitating.
The following is a summary of KL grading system for OA3:
- grade 0 (none): definite absence of X-ray changes of osteoarthritis
- grade 1 (doubtful): doubtful joint space narrowing and possible osteophytic lipping
- grade 2* (minimal): definite osteophytes and possible joint space narrowing
- grade 3 (moderate): moderate multiple osteophytes, definite narrowing of joint space, and some sclerosis and possible deformity of bone ends
- grade 4 (severe): large osteophytes, marked narrowing of joint space, severe sclerosis, and definite deformity of bone ends
*Osteoarthritis is deemed present at grade 2 although of minimal severity
In Figure 1, four X-rays of the knee are shown depicting progressive osteoarthritic degeneration. Fig. 1A shows a normal knee of a younger person corresponding to grades 0 and/or 1 on the KL scale. At this point, OA cannot yet be diagnosed. Note the ample amount of space between the abutting femur (top) and tibia (bottom) bones. Fig. 1B Corresponds to grade 2 on the KL scale, where osteophytes or bone spurs are forming, but loss of joint space remains questionable. Fig. 1C shows a loss of joint space between the femur and tibia corresponding to moderate or grade 3 OA. Significant pain is typically reported by patients by this point. Physical therapy together with conventional drug therapies and natural joint & back pain management therapies are typically recommended or should be considered at this point. Conventional drug therapies include painkillers, NSAIDs, and steroids. Fig. 1D shows the near complete loss of joint space commonly referred to as “bone on bone” corresponding to grade 4 OA.
Pain management options
Pain experienced by patients may continue to increase from grade 3 to grade 4 OA and mobility may be severely limited at this point. Orthopedic surgeons often recommend joint replacement surgeries although natural joint pain management therapies may offer effective alternatives to postpone or avoid surgical procedures depending on the state of their disease or if surgery is not an option. Because natural joint pain management procedures fall outside the expertise of surgeons, they may not always offer these options readily to patients. It is therefore essential patients are educated about all available treatment options to determine their best options.
OA is a very common form of arthritis with many risk factors for developing the disease, where age, activity levels, and gender are among the most significant. The disease involves cartilage degeneration leading to increased friction within joints that can cause significant pain and immobility. The KL scale is used to score or grade OA disease progression. When considering treatment options, patients with OA should consult with their doctors to evaluate the risks and side effects of conventional drug therapies and surgical interventions. Natural joint pain management approaches offer non-surgical options with none of the steroid side-effects for promoting healing, and relieving pain in addition to restoring mobility.
Natural joint and pain management for OA
The field of natural joint & back pain management has revolutionized the treatment of osteoarthritis. The advantages are:
- Little to no downtime due to the procedure
- Results can be boosted with physical therapy
- No side effects from pharmaceutical and cortisone drug therapies
- All-natural treatments to help avoid surgery
To learn more about natural methods for treating your osteoarthritis, contact the Spark Health team. Located in Solana Beach, CA, our practitioners will spend time evaluating how the internal and external parts of your body interact in order to develop a comprehensive care plan that is specifically designed to address your biggest health needs. Contact us to schedule an initial appointment!
We enable patients to get out of chronic pain and increase mobility without the need for surgery.
Article written by Dr. Pepe Hernandez
- Centers for Disease Control and Prevention (CDC) Arthritis prevalence and activity limitations: United States, 1990. MMWR Morb Mortal Wkly Rep. 1994;43(24):433–438. [PubMed] [Google Scholar]
- From the Centers for Disease Control and Prevention. Arthritis prevalence and activity limitation–United States, 1990. 1994;272(5):346–347. [PubMed] [Google Scholar]
- Kellgren, JK; Lawrence, JS. Radiological assessment of osteo-arthrosis. Ann Rheum Dis. Dec;16(4):494-502.