Seniors and Related Conditions
As we wend our merry way through life, the things we do leave a legacy in our tissues.
I am fond of saying to my patients, "If you are over the age of 25, and you've had a half-normal life, you've probably got some wear and tear". This is not to say that it's all downhill from your mid-twenties!
I think that using terms such as 'arthritis', 'degeneration' and 'wear-and-tear' are quite negative ways of thinking about this process, and make us assume things are going to hurt and inevitably get worse; when a better way of putting it would perhaps be they're just wrinkles, but on your inside.
I am fond of saying to my patients, "If you are over the age of 25, and you've had a half-normal life, you've probably got some wear and tear". This is not to say that it's all downhill from your mid-twenties!
I think that using terms such as 'arthritis', 'degeneration' and 'wear-and-tear' are quite negative ways of thinking about this process, and make us assume things are going to hurt and inevitably get worse; when a better way of putting it would perhaps be they're just wrinkles, but on your inside.
It's true that sometimes a bone spur, or osteophyte, might be in a bad place around the margin, or edge, of a joint, such that it digs into a tendon, or nerve, or other structure; or that the cartilage inside a joint has completely worn away so that the joint is 'bone-on-bone'.
This may be a problem.
However, we know from looking at thousands of scans over the years that sometimes we see very extreme examples of this, but in patients who have no pain in the involved area at all (typically, they were getting the scan done for another reason).
For another example, around 60% of 60 year-olds will have a tear in one of their shoulder tendons, and obviously shoulder pain and functional issues are not that common; so there are a lot of 60 year olds walking around with rotator cuff tears and suchlike without even knowing it!
This may be a problem.
However, we know from looking at thousands of scans over the years that sometimes we see very extreme examples of this, but in patients who have no pain in the involved area at all (typically, they were getting the scan done for another reason).
For another example, around 60% of 60 year-olds will have a tear in one of their shoulder tendons, and obviously shoulder pain and functional issues are not that common; so there are a lot of 60 year olds walking around with rotator cuff tears and suchlike without even knowing it!
Likewise, many people in quite severe pain may have no [relevant] findings on any medical imaging or investigation.
So osteoarthritis (the type of arthritis to which most people are referring when they say something like 'wear-and-tear'), tendon damage or degeneration and other issues that get more common as we age are not a simple process of 'oh, that's worn out now, that'll never be good again'.
If your joints are a bit wobbly and unhappy, we can improve the muscular support around them to help take the strain. If the muscles and tendons are tight, overworked or weak, we can do things like improve their blood supply and efficiency by stretching/lengthening them and increasing the feedback from the area (your nervous system likes information; it needs good information to make good decisions!). If the nerves are irritated from e.g. bone spurs and the like, we can mobilise and desensitise them.
So there is plenty that can be done! As with much of our management, the more you do, the less we will have to see you, so we will devote ourselves to giving the skills and knowledge needed to do that.
So osteoarthritis (the type of arthritis to which most people are referring when they say something like 'wear-and-tear'), tendon damage or degeneration and other issues that get more common as we age are not a simple process of 'oh, that's worn out now, that'll never be good again'.
If your joints are a bit wobbly and unhappy, we can improve the muscular support around them to help take the strain. If the muscles and tendons are tight, overworked or weak, we can do things like improve their blood supply and efficiency by stretching/lengthening them and increasing the feedback from the area (your nervous system likes information; it needs good information to make good decisions!). If the nerves are irritated from e.g. bone spurs and the like, we can mobilise and desensitise them.
So there is plenty that can be done! As with much of our management, the more you do, the less we will have to see you, so we will devote ourselves to giving the skills and knowledge needed to do that.
