Problems diagnosed as Osteoarthritis CAN be cured in some cases.
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If you're a proactive individual that's been diagnosed with incurable Osteoarthritis it's *possible* that you can in fact beat the diagnosis and get back to full fitness and functionality. It happened to me.
I should add that I was diagnosed at age 42 and was very fit and active at the time. I think it might be very different for older individuals, people who's condition is advanced, or people that don't enjoy exercise.
Here's my story. I can't make any promises that it'll be the same for you. But I will if people are interested share some of the resources that helped me to beat what I considered to be a life shattering diagnosis, for which I was assured there was no possibility of a cure. I don't know whether to believe I was misdiagnosed and never actually had Osteoarthritis, or whether they're wrong when they say Osteoarthritis is incurable. What I can say is that I was told my symptoms were 'classic' and that the diagnosis was certain - that my symptoms couldn't be explained by anything else. The whole area is so poorly defined and slap-dash that it's impossible to tell. Either way, it means there's at least hope of beating it if that's what you want to try and do.
I've spent 8 years battling against the people that were hell bent on brow beating me into believing I had Hip Osteoarthritis when I knew I didn't. My real problems were ignored - I was essentially left to rot. I was treated like an idiot. Told I researched too much. That I was in denial. Told that I was making my problems worse by training to keep myself fit, strong and active. Told I should swim and cycle and give up all other sports. I was asked repeatedly "You've had numerous experts try to help you - don't you think one of them would have succeeded if this really was curable?".
Finally I've been vindicated. I figured it out for myself. A simple, treatable muscle imbalance causing all of my problems. Obviously I wanted to let the people know that have tried to help over the years. I expected them to be amazed - a breakthrough that could help lots of people. These cases that we think are incurable can in fact be fixed!!
My excitement was met with apathy: [paraphrasing]. "The reality is that most people are inactive and unwilling to put in the work needed to address muscle imbalances like this. Even if the correct diagnosis was made, for most people the end result would be the same. People who are willing to put in the work necessary to reverse the condition are so few and far between that they aren't statistically significant to make it worth the cost of training and research. We were unable to solve your problem because we've not been adequately trained to do so. But well done for hanging in and figuring it out yourself."
Why wasn't I told this BEFORE I discovered the solution for myself? Why did they try to convince me I had incurable OA when they knew how determined I was to beat it?
Here's the reality as I now understand it (as it's been explained to me). This may not reflect every health professionals view, but it is a summary of what I've been told by various health professionals:
GP's are responsible for diagnosing OA. Yet they know very little about bio mechanics (unless they've got an interest and educate themselves).
They don't understand the condition in great detail, but they don't need to. They're working to a script. It seems not to be widely known who writes that script (so who to go to with questions or doubts)...which is a little bit of a worry.
Some know that often it's a misdiagnosis - more forward thinking GP's are aware that it's frequently a treatable soft tissue issue. But like the physios, think it doesn't matter too much as for most patients it makes no difference. They lead inactive lifestyles and any attempts to restore them to full functionality will fail. There is little point in wasting resources trying to give an accurate diagnosis when the end result will usually be the same regardless. So OA is the 'catch all' category you put them in. There is no cure - you manage with drugs and operate if and when necessary.
Even when someone is in great shape, keen to be proactive in their treatment and has an active lifestyle worth preserving there's nothing to be gained in finding the correct diagnosis as there is no one to refer them to to get it fixed. People worth bothering with (because they can be restored to a good, active life) aren't statistically significant enough to be worth the research and training needed to put systems in place to help them.
So, the GP's make the OA diagnosis despite not necessarily knowing much about OA. Who are the specialists then if you're determined to find the real cause of your joint stiffness or pain? Well, there's a bit of an oversight there. There is no one.
Orthopedic surgeons know about surgery. If your problem is an easily curable soft tissue issue they probably won't know enough to detect it. They may well put you under the knife unnecessarily. Or tell you that you have an incurable problem that will deteriorate over time - that your active life is over (that's what happened to me). But this is more a case of them forcing your problem into something that fits their specialist knowledge. Not a proper diagnosis.
Then there's physios. They aren't trained to detect and treat curable soft tissue problems that lead to joint wear and might otherwise be diagnosed as OA. However, some are better than others. Some might actually be very capable. It's pot luck. I think it's unlikely to find someone with these skills working for the NHS, but I may be wrong. I have been told (by a physio) that the failure rate in these cases is 99% within the NHS.
There are people out there that do know how to diagnose and treat these soft tissue problems. And there's plenty of info on this on the internet that you can use to help yourself. It's down to the individual to separate the wheat from the chaff. Contrary to what we are led to believe, OA isn't an incurable degenerative disease. Strictly speaking it doesn't exist. It's a 'catch all' diagnosis used to put people with joint problems in when there aren't resources and training to find out and fix what's really wrong with them. Contrary to what we're led to believe, there is no category of the medical profession with expertise in the multitude of conditions commonly labeled as OA. If you think you've seen an expert and had a reliable diagnosis of OA - think again.
There is no easy fix - that's true. There is no way of knowing if yours is a curable soft tissue problem without trying to fix it. I'm led to believe that official research into OA is centered around keeping this 99% of people that are deemed incurable (because they are perceived to be inactive and unwilling or unable to adhere to the required rehab plan), as pain free and independent as possible at minimum cost. It's simply not cost effective to put time and effort into finding the cause, the cure, or training people to make diagnosis and cure soft tissue problems in the cases where how to do so is already known by some.
But there are people out there that have figured out how to diagnose and cure at least some of these cases. Some speculate that all OA is initially a soft tissue dysfunction. However, this is mainly in the private sector - or perhaps in the NHS, but on an unofficial level. You're faced with the dilemma of separating the fakes from the real deal. Most will claim to be able to help - and many will diagnose incurable OA when they fail. That doesn't necessarily mean you can't be helped. Many tried and failed with me before I figured it out for myself.
But if you're willing to work at it yourself - or maybe even find the right person (which is very difficult) then it is quite possible that what you have is very curable.
31 likes, 607 replies
fran64082
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I was diagnosed with early diabetes II, some years ago. Same attitude from the doctor,same old mantra from the dietitician, which I rejected. I am vegetarian, and went after the disease with a vengeance. I believe in fighting back. Found Neal Barnard's "Reversing Diabetes". Five years later I am still diabetes free.
So now let's get down to the battle with the pain in my hip which in fact is really a pain in my groin muscle that radiates to the hip which they named Osteoarthritis a couple of months ago. I've been very active all my life, and will not go quietly.
Please share some more if you can. Particularly any reading matter out there.
susan67756
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It's hard to know where to start!!
There is of course no way of knowing what exactly is wrong with you. The only way to find out if it's a curable muscle imbalance is to try and fix it. But I must warn - it's not easy. Health professionals don't have the training. Physios etc have the necessary background but not the in-depth training.
I think it'd definitely be worth putting a lot of effort into if you're willing as, based upon my research, I would guarantee that a lot of the symptoms experienced by EVERYONE with OA will be soft tissue problems and therefore treatable. So I would suggest that everyone can benefit greatly from putting effort into correcting their muscle imbalances - if nothing else to stop your arthritic hip from screwing up the rest of your body!
I suppose the best place to start is describe what turned out to be wrong with me. For years I struggled blindly with physios, chiros etc. More recently I started to study the biomechanics in depth myself and gradually tracked down the cause.
You say a pain in your groin muscle - snap!
The first thing in the trail was I realised my pelvis was a bit twisted. One of my legs felt longer than the other. I researched this, found diagnositc information and determined that I had a 'Right on Right Sacral Torsion'. Essentially this means that your sacram (the bit of your spine that the two wings of the pelvis are attached to) was twisted out of place and 'stuck' there. Your sacrum, along with the wings of your pelvis (innominates) move throughout normal gait. If your muscles get a bit out of whack (through overuse, bad posture etc) the sacrum and therefore the entire pelvis can stay stuck. The innominates (wings of the pelvis) move in relation to the sacrum. If the sacrum sticks so do the innominates. In my case (r on r sacral torsion) my right innominate was stuck in inflare, posterior rotation and downslip. In addition, when the sacrum tilts and rotates one way, the lumber spine tilts and rotates the opposite way, and the thoracic spine moves opposite to lumber spine. The dysfunction subtly spreads through your body. It may not be immediately obvious if this is the case with you. But I suspect most people will have some kind of pelvic dysfunction with hip OA - either cause or effect.
I can provide resourses and explain in more detail later. But essentially, with the boney structure of your pelvis out of place, all the muscles (which connect pelvis to femur and control the movement at the hip) are under abnormal strain. The distance between the muscle attachment points is altered and skewed. Some muscles are stretched too tight, some too slack and some in positions where they are disadvantaged and can't work properly. The body is highly adaptive and recruits whatever muscles it can to get the job done. But this can lead to joint wear and pain in time - as well as restricted range of motion.
There are lots of online explanations on how to diagnose a dysfunction like this, and how to treat it. But treatment won't always be easy. The problem can be well established and tricky.
I did the recommended corrective exercises and got noticeable improvements. But progress stalled. It became apparent to me that the current most limiting problem was the inflare. Basically, the right pelvic bone was rotated out of place and pointing inwards too much. Not noticeable to the naked eye. This made it difficult for my gluteus maximus (big muscle in your backside) to engage properly. I tried digging my fingers under the bone at the front of my pelvis and pulling it outwards. Miraculously my gluteus muscle was suddenly strong - my hip moved properly. It wasn't down to me moving the innominate into position though.
There's a muscle (actually a pair of muscles) known as the illiapsoas. It's a hip flexor and also a major core stabiliser. A very important muscle. Both bits attach to the top of your thigh bone (so it may be what you consider your groin muscle). One part - the iliacus - attaches at the other end to the inside of the pelvic bone. The other part - the psoas - attaches to the spine.
My iliacus had gone into spasm. This is what was causing the restricted range of motion and the 'hard end feel' that is indicative of OA. When I tried to move my innominate into position I inadvertently dug my fingers into the muscle which caused it to 'deactivate' - temporarily come out of spasm in a way. Immediately weak muscles were stronger, hip rom improved, hard end feel changed to springy, normal end feel and the discomfort went away. It was only when digging my fingers in though. The moment I took my fingers away the problems came back.
This was clearly the cause of the problem. But how to release the muscle? It proved to be impossible. I was missing something. Quite by chance (discussing something with a training partner) it occured to me that my right psoas (the other part of the iliapsoas muscle) simply wasn't working. It didn't fire.
THIS was the root cause of my 8 year problem. The psoas is a major hip flexor and a significant stabiliser. Without it my body was jumping through hoops trying to stabilise me and lift my right knee. Probably as a protective mechanism my nervous system put the iliacus muscle into a spasm - because I was dangerously unstable. It wouldn't release until the psoas started working again.
It's a bit tricky getting dysfunctional muscles working properly again, but very doable. The diagnosis is the hard bit. Once you roughly figure it out most physios can help.
I'll go dig out some resources that you might find helpful in tracking down the root of your problem (or at the very least, minimising your symptoms).
There are lots of other possible scenarios, but probably checking things out along these lines is a good place to start. I'll post back later with some useful links.
If you have any specific questions please ask. I plan to put this on a website at some point to share all I've learned with others in a similar situation.
fran64082
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Everything you said here makes sense to me. In fact I can dig my fingers into a particular spot and stop pain. Sitting appears to be the worst trigger for pain...when I stand up. I am a writer (and painter) and spend a lot of my time sitting. Walking is not usually a problem, although it is if I've overtired myself earlier. I can position myself, especially lying down, to have no pain at all. Religning myself temporarily?
This groin "pull" happened years ago, and I've always favoured it. Every few years I reinjure it. It flared up again just six months ago when we moved house and I got way too physical. I am very strong, well-muscled, and have always prided myself on my strength, so this situation is particularly frustrating.
This morning, before I read your posting, I woke up pain free. This is a first in weeks. It's this that makes mine think I am somehow just out of alignment. If it were true joint damage, would the pain not be there all the time, mild or severe?
susan67756
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However, even if it has caused your joint to wear (evidence of degenerative changes on x-ray) this is pretty irrelevant. Very many people have degenerative changes in joints without symptoms. It's a perfectly normal and painless part of being alive! Fix the imbalance, get the joint tracking normally and the wear stops. Along with the symptoms.
Yours may be far less complex than my problem. Have you heard of trigger points? This is one possibility that's very easy to rule out. In fact, again, very many/most/all? people with OA are likely to have trigger points that may be causing all/some/most ? of their symptoms. It's worth looking at. There are reported cases of people being booked for joint replacement surgery that have been able to cancel it after treating trigger points.
There's a very good book, which I have :
http://www.triggerpointbook.com/
But large portions of this book are online:
http://books.google.co.uk/books?id=DLb7ShX-gskC&printsec=frontcover&dq=trigger+point+workbook&hl=en&sa=X&ei=oKL2UpCaE8KXhQfxnYGwBw&ved=0CDwQ6AEwAA#v=onepage&q=trigger%20point%20workbook&f=false
Basically, you look up where you hurt and it'll tell you where you're likely to find trigger points that refer pain to that point. If the trigger point is the primary cause of your pain it's possible that massaging the trigger point will get rid of it permanently. But I personally think it more likely in most cases that the trigger point is there because the muscle is being strained due to imbalance. It'll keep coming back until you address the imbalance.
They say that joint pain is worse on activity and better at rest. But that first getting moving after rest the joints can be stiff for 20 mins or so. But that's true of other things too.
Anyway, I don't think they actually know for sure that OA pain has anything to do with the joints. People feel it in all sorts of places indicating that it's actually soft tissue pain. Some people have virtually disintegrated joints and no pain or symptoms. Others have bad pain and next to no joint wear. This indicates to me that OA is not always a genuine joint problem. Far more likely that the joint wear is the result of muscle dysfunction - or movement impairment.
I'll post some other things to explore later. As a writer that sits a lot psoas and iliacus are strong contenders for at least being involved. The psoas can shorten and cause all sorts of problems. I'm a software engineer so also did lots of sitting. Also practiced martial arts and weightlifting for 20 years. The combination of intense exercise and lots of sitting is a bit of a recipe for disaster (in that the muscle don't like it and are liable to complain in time)!!
susan67756
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fran64082
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Emis_Moderator
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Sorry for the delay in getting round to this. I have approved the links in this case but for future reference if you post your reply then post any links in a separate post this saves waiting for the whole comment to be approved. Alternatively post your comment then use the message service to exchange the links. This is the better way of doing it in case the links are not approved if they are to commercial sites etc.
Regards,
Alan
Emis Moderator
fran64082
Posted
I am very encouraged by everything you've said. If, in the end, this is not helpful to me, I have lost nothing by trying. It certainly can't make this discomfort (understatement) worse.
I appreciate the amount of research you've done on the subject...probably years of work, and you share this so freely.
I'll stay in regular touch, of course, and look forward to further information from you as we go.
Fran
Fran
susan67756
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I'm not sure what to tell you next. Maybe if you let me know what your symptoms are and if anything sounds familiar I can tell you what might be worth trying next?
Inability to lift you knee to your chest (or opposite shoulder) is a common one? Maybe pinching or soreness in the groin?
If you have that, have a feel about and see what muscles are active as you lift your knee. It's easiest to do when lying on your back. I know that's tricky if you don't know what you're looking for. Just compare the two hips and see if there's anything different - a muscle that's very active on one side but not the other perhaps?
The reason I mention this is because this is a common symptom. Yet in me the problem was that the main hip flexor (psoas) wasn't working correctly and the iliacus, adductors, TFL and rectus femoris were taking over. This makes the leg pull to one side and causes groin pain and restricted movement.
It's tricky, but if this is happening to you, with practice you can get the over-active muscles to shut down and the knee tracks nicely to the chest then (or it did with me).
If this is familiar let me know and I'll explain more. Or else let me know any other symptoms and I'll pass on all that I've discovered that's relevant.
susan67756
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The thing that finally got me moving in the right direction enough to figure this out was diaphragmatic breathing. It sounds ridiculous, I know. I was skeptical. The reason that it can be so helpful is that by breathing deep into your diaphragm you activate all the pelvic floor muscles, and help activate chains of muscles going up and down from your pelvis. It's just the way muscles are connected.
So it can help get your muscles balanced and working correctly even when you haven't got a clue what's wrong.
Look up Postural Restoration Institute. Have a good read - look at some of their articles. For example, the ones on AF IR - these really help you to understand how muscle imbalances can pull the actual hip joint out of alignment and make it stiff, sore and even worn in time. There are also articles explaining how muscle imbalance can lead to hip impingement - they're worth a read too. It just lets you really grasp the relevance.
Physios/doctors etc don't have a problem grasping that pain and restriction (and even degenerative changes) in a shoulder are frequently due to a shoulder impingement which is the result of muscle imbalances in the thoracic spine/scapular. Very fixable.
Yet when someone has hip pain they NEVER consider the possibility it's down to muscle imbalances in the pelvis (EXACTLY mirroring common shoulder problems) - they always jump straight to OA.
I think this (Postural Restoration Institute articles - and read their 'science' page) was probably what led me to my breakthrough that finally solved everything.
fran64082
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I'm even more confident after looking at the hip chapter of that book...where they describe areas affected, symptoms.
Stay in touch. Don't go anywhere.
fran64082
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Found it difficult to navigate the Institute's website. In order to register, it seems I must sign up for a professional course. Is this right?
I did learn about the breathing technique, which is a whole new take on wellness, but really want to see the exercises.
The book will not be here for a couple of weeks (I'm in Australia) so I'll have to be patient.
In the meantime, I'm already feeling much better about the discomfort. I have taken charge of it, think of it as a "thing" that needs to be confronted. How strange the mind is - from feeling like a victim, I now feel like a warrior.
I look forward to being the first follower of your blog, so get started please. (I'm a pro, if you have questions about that!)
One thing I'm missing from you. I can't see where you mention how long it took you, from the time you identified the apparent cause of your pain, to your successful outcome. And did you, and do you now, practice the techniques on a daily basis?
fran64082
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fran64082
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susan67756
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I guess it's only been in the last couple of months that I've started to figure this out. First the twisting in my pelvis - got some results dealing with that. Discovering the iliacus spasm and psoas dysfunction was only very recently. It's just unraveled it all so quickly. But I had to figure it out first - that's the hard bit. I guess you could say that took 8 years!
Now I'm back doing karate kicking - low kicks - only about waist height, but flexibility is improving every day and it's very comfortable.
I actually tried to buy course material from the PRI - they wouldn't let me. They say it's only for health and fitness professionals. Ridiculous!! You'll find some exercises if you look through the articles. But without knowing what's wrong with you how are you going to select the right exercise? I think this site can only give you clues.
If there are any positions you find difficult you could try holding that position and 'breathing into it', if that makes sense?
It's heavy going, but if you think you might have some twisting in your pelvis (normally you would if you have muscle imbalances) this can help you figure it out. http://osteopedia.iao.be/uploads/ilium_e.pdf
I can't say it was easy to figure out. It is complicated. Getting an understanding of what's going on with your body is the first - and the hardest part. Your problem won't be the same as mine - mine was caused by doing karate. From what you've said, there's a possibility yours is a result of the injury you had a while back.
But maybe the basic mechanisms are the same. I can only really tell you about what worked for me.