What causes arthritis pain?
Arthritis changes the surfaces of a joint, and changed surfaces move differently. That makes an arthritic joint more vulnerable to a mechanical dysfunction, where the joint is loaded incorrectly and the muscles around it spasm in protection. Here is the encouraging part: you can have significant arthritic change on an X-ray without pain. Treating the mechanical problem shows how much of your pain truly comes from the arthritis, and it is often less than you were told.
Osteoarthritis gradually alters the cartilage and bone of a joint, most often in the knees, hips, hands, thumbs and spine. As the surfaces change, the joint loses some of its smooth glide and is more likely to get stuck.
Rheumatoid arthritis is an inflammatory, autoimmune disease that needs medical care from a rheumatologist. Inflammation affects how joints move, so mechanical dysfunction often rides along with it. Treating the mechanics gently can ease the pain that is not coming from the inflammation itself.
When a joint hurts, it is natural to protect it. But less movement means weaker muscles, stiffer joints and less support, which makes every step harder. Restoring easy motion first makes it possible to keep moving.
A knee reconstructed years ago or an ankle sprained many times can develop arthritic changes, and neighboring joints such as the opposite hip may take a beating as you compensate. Assessing the whole chain shows where the load is landing.
Strong muscles take pressure off worn joints. When the muscles around a knee or hip weaken, more load goes straight through the joint surfaces, and pain climbs.
Sometimes pain that was blamed on arthritis turns out to be mostly mechanical. Joint dysfunction and leg length changes can feel like arthritic pain, and they respond to treatment. Once the mechanics are fixed, you can see what, if anything, is left over.
