Conditions We Treat – Joint and Bone

Rheumatoid arthritis

What is Arthritis?

Arthritis is a common condition affecting the joints and bones progressively. It causes pain, inflammation in joints, and decreased mobility. There are several types of arthritis categorized into one of two groups: Osteoarthritis and Rheumatoid Arthritis. 

 

Osteoarthritis vs. Rheumatoid Arthritis

Osteoarthritis is correlated with the use of joints, their deteriorating health, and how they affect the cartilage around the joints. Rheumatoid arthritis is an autoimmune condition that impacts healthy connective tissue. 

What does Osteoarthritis feel like?

  • symptoms of Osteoarthritis:

    • Swelling of affected joints
    • Pain that worsens gradually after usage of joints
    • Stiffness and restricted movement, pain, creaking
    • Joint deformity
    • Weakened muscles around affected joints

How can Osteoarthritis be managed?

  • Treatments for Osteoarthritis:

    • Physiotherapy
    • Acupuncture
    • Massage Therapy
    • Chiropractor
    • Active Rehabilitation

What is Rheumatoid Arthritis?

  • Rheumatoid Arthritis is a progressive, chronic, and inflammatory disorder. It is an autoimmune condition that is present when the patient’s immune system attacks their connective tissues. It affects the lining of the joints and surrounding tissue, causing painful swelling and inflammation, muscle weakness, loss of mobility, tendon/ligament rupture, deformity of joints, and bone erosion. 

     Joints that are affected by rheumatoid arthritis include: fingers, wrists, elbows, shoulders, ankles, hips, knees, and spinal joints. As the autoimmune disorder progresses, the patient’s joints may become deformed, eroded, or shift out of place.

What does Rheumatoid Arthritis feel like?

  • Symptoms of Rheumatoid Arthritis:

    • Swollen or inflamed joints which are warm and tender
    • Chronic pain
    • Joint stiffness which worsens after periods of inactivity
    • Weight loss
    • Fever
    • Fatigue

How can Rheumatoid Arthritis be managed?

  • Treatments for Rheumatoid Arthritis:

    • Physiotherapy
    • Acupuncture
    • Brace Application
    • Medications and antirheumatic drugs

Osteoporosis

What is Osteoporosis?

Osteoporosis is a disease that develops due to increased bone fragility and fracturing due to elevated brittleness of the bone. 55% of Americans over the age of fifty have been diagnosed with this condition, but it may develop at any age. Osteoporosis has two categories: primary and secondary osteoporosis. Primary osteoporosis is more common and is not connected to other diseases or conditions. Secondary osteoporosis occurs as a side effect of medication, a different disease or condition, or exposure to radiation.

 

What does Osteoporosis feel like?

Symptoms associated with Osteoporosis:

  • Bone fractures
  • Back pain
  • Episodic
  • Acute low thoracic/high lumbar pain
  • Compression fracture of the spine
  • Kyphosis
  • Dowager’s hump
  • Decrease in height
  • Early satiety
  • Decreased activity tolerance

 

Diseases/Conditions that may induce Osteoporosis:

  • Eating disorders
  • Cancer
  • Cancer treatment
  • Rheumatic diseases
  • Osteogenesis imperfecta
  • Chronic renal failure
  • Cushing’s Disease
  • Chronic pulmonary disease
  • Hypothyroidism
  • Gastrointestinal disease
  • Hepatic disease
  • Type 2 Diabetes Mellitus

How is Osteoporosis diagnosed?

Generally, osteoporosis is diagnosed by physicians using a bone density test. The World Health Organization (WHO) states that a normal bone density score is -1.0 or higher, -1.0 to -2.5 for osteopenia, and -2.5 or lower for patients with osteoporosis. The risk of fractures or breakage increases as the bone density decreases. The Fracture Risk Assessment Tool (FRAX) is more accurately used to determine a 10-year fracture probability, since many factors play into an individual patient’s bone quality.

 

Category

Bone mineral density score (T-Score)

Normal

-1.0

Osteopenia

-1.0 to -2.5

Osteoporosis

-2.5 or less

Severe osteoporosis

-2.5 or less with 1 or more fragility fractures

How can Osteoporosis be managed?

Treatments for Osteoporosis:

  • Weight-bearing exercises to elevate the loading on tall bones and calcium uptake
  • Flexibility and balance exercises to strengthen physical abilities and functions, posture, and minimize the risk of accidents
  • Strengthening exercises to improve muscle stability and increase the traction of bones
  • Postural exercises such as chin tucks to reduce the risk of changes in the vertebrae position.
  • Core stability exercises to provide the patient with a better foundation and strengthen the lower back and hip muscles.
  • Dietary management to support bone growth and solidification since the ability to absorb calcium is reduced with age. A diet with increased amounts of calcium-rich foods ensures that the bones receive the amount of required calcium to stay healthy and strong. Milk, cheese, almonds, yogurt, broccoli, and soybeans are all examples of calcium-rich foods. Patients with osteoporosis are not suggested to have high amounts of protein in their diet as the kidneys flush out calcium alongside excess protein. Supplements such as vitamin D and fish oil may be suggested to treat osteoporosis.
  • Clinical yoga and pilates with a qualified instructor
  • Testosterone treatment

 

Osteopenia

What is Osteopenia?

Osteopenia is a condition where the bones are weakened, but not to the relative severity to qualify for osteoporosis. Osteopenia may progress into osteoporosis if the bones lose more calcium and wear down without treatment. Like osteoporosis, patients with osteopenia are more likely to fracture or break bones due to reduced bone health.

What causes Osteopenia?

  • Hormonal/Genetic factors
  • Smoking
  • Thin, small frame
  • Excess intake of alcohol
  • Medications such as Antiseizure, Prednisone, Corticosteroids
  • Bone loss after chemotherapy/radiotherapy
  • Immobility
  • Chronic inflammation

How can Osteopenia be managed?

Treatment for Osteopenia:

  • Strengthening exercises
  • Weight bearing exercises
  • Bisphosphonates
  • Hormone replacement therapy
  • Supplements such as Calcium and Vitamin D
  • Testosterone treatment
  • Selective estrogen receptor modulator

Scoliosis

What is Scoliosis?

Scoliosis is a bone condition that affects the spine. It causes a patient’s backbone to curve and sometimes shift in both directions in separate areas of the spine. A patient is considered to have scoliosis when the spine’s curve angle exceeds 10 degrees. Commonly, there is no precise reason for scoliosis. The condition is considered “idiopathic” if the doctor cannot determine a definite cause.

 

The diagnosis for scoliosis is separated into one of two categories: structural and non-structural. Structural scoliosis is diagnosed when the curve of the spine is too stiff to be treated and straightened. Non-structural scoliosis is diagnosed when the curve of the spine can be corrected and reversed with treatment. 

 

Causes of Scoliosis:

  • Structural: birth defects, cerebral palsy, genetic conditions, infections, tumours, muscular dystrophy, or injury
  • Non-structural: inflammation, muscle spasms, or a difference in leg heights

What does Scoliosis feel like?

Symptoms of Scoliosis include:

  • Uneven shoulder blades where one pops out or sticks higher than the other
  • Rotating spine
  • Uneven hips
  • Breathing problems caused by a restricted chest area
  • Back pain

How can Scoliosis be managed?

Treatments for Scoliosis:

  • ART and IASTM
  • Dry needling
  • Manual therapy
  • Rehabilitation exercises
  • Acupuncture
  • Chiropractic and massage therapy
  • TENS for pain

Tendonitis

What is Tendonitis?

Tendonitis consists of the inflammation, irritation, or tearing of tendons. Tendons are strong tissues that connect muscles to bones, and allow for the contraction and use of muscles. 

 

Causes of Tendonitis:

  • Sports injuries or trauma
  • Motor vehicle accidents
  • Repetitive use of a particular muscle group
  • Sudden, sharp movements
  • Poor posture
  • Poor technique when playing a sport

What does Tendonitis feel like?

  • Symptoms of Tendonitis:

    • Pain that worsens as the affected area is used or moved
    • Muscle stiffness
    • Muscle weakness
    • Inflammation, redness, warmth of affected area
    • Grating or crackling sensation when moving affected area

How can Tendonitis be managed?

Treatments for Tendonitis:

  • Physiotherapists will suggest varying exercises to reduce the risk of tendon injuries.
  • Improving ergonomics in the workplace and at home to reduce the damage to tendons caused by repetitive movements. 
  • Physiotherapy with exercises that strengthen, stretch, and increase mobility of tendons  
  • Acupuncture
  • Dry needling
  • Manual therapy
  • Chiropractic therapy 
  • Massage therapy
  • Rehabilitation exercises