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Ask the Doc....'There Are Many Different Types Of Arthritis'

By Dr. Lou Pack | 4/18/2014, 11:32 a.m.
And because exercise can make poorly aligned joints worse, “health is something you can go through on your way to fitness.” Yes, although I’m as big a fan of exercise as anyone, exercising in poor alignment can play havoc on the very joints we are trying to protect.

Q: “I was told that age has caused my arthritis. Then why do some of my joints hurt and not others?”

That’s a great question! There are many different types of arthritis and our understanding of these varies greatly. For example, while we’re not sure why seventy five percent of the cases of gout affect the big toe joint, or why psoriatic arthritis (the arthritis associated with the skin disease psoriasis) affects the ball of the foot, joint involvement in the type of arthritis you are referring to….osteoarthritis, the wear and tear joint disease associated with age…. is much easier to explain.

Although generally there’s great belief that age is the primary cause of osteoarthritis, that’s not true! If it were, then as you said, all of your joints would be affected. Obviously, there must be other factors involved.

As a matter of fact, the primary reason that arthritis affects the weight bearing joints of the feet, ankles, knees, hips and back is due to abnormal structure (alignment issues) and not age. Yes….age is a factor….it’s just not the primary cause as we’re led to believe. So as unrelated as pain in the arch of the foot and low back may seem, they are very often due to the very same problem; abnormal foot alignment.

Human joints wear out in the same way that the tires of our cars do. If poorly aligned, they wear out prematurely and unevenly, and if properly aligned, they last a lot longer.

Our feet are the foundation of our entire structural system, and if they’re not perfectly aligned, undue stress will be placed on them and all of the weight bearing joints they support. So for example, something that may seem as insignificant as a flattened foot (pronation) can cause knee, hip and low back pain.

Just when this will occur depends on a number of factors. These include the degree of severity of the structural problem (for example, how much the foot flattens), the amount of stress placed upon the joints (your weight and the amount of exercise you do), and how long these factors have existed.

And because exercise can make poorly aligned joints worse, “health is something you can go through on your way to fitness.” Yes, although I’m as big a fan of exercise as anyone, exercising in poor alignment can play havoc on the very joints we are trying to protect.

But clearly, the joint pains you have are not primarily due to your age. Indeed, I have seen the exact same changes in someone who is twenty, as I might see in someone who is ninety years old. And there are those in their ninety’s whose joints are as pain free as someone many decades younger.

The best prevention for osteoarthritis of the weight bearing joints is to be evaluated structurally, and to correct those problems. This should be done prior to any exercise program, especially if you are getting older and already have some arthritis. Most often these problems include a flattened foot (as mentioned above), a leg length difference and tightened calf muscles.