From Dr. Verg Chiropractic, Vancouver, WA and Clackamas, OR
“My doctor told me I have arthritis.” I hear this from new patients almost every week, often said as if it closes the case: the joints are wearing out, and there isn’t much to be done. Sometimes it’s true. But arthritis is often only part of the story, and sometimes it isn’t the story at all.
What arthritis actually looks like
When I review X-rays with a patient, I look for two things: narrowing of the space between the bones, and bone growth (spurs) along the edges of a joint. That bone growth is arthritis. We grade it as mild, moderate, or severe, and mild arthritis usually isn’t something to worry about. Arthritis also isn’t simply wear and tear from years of use. In my experience it’s movement plus inflammation: a joint that is stuck or unstable wears faster, and inflammation in the body speeds that up.
Case: told he had arthritis, but the X-ray disagreed. A man came in after another doctor told him he had signs of arthritis. When we went through his neck X-rays together, the bones and joints looked normal. The openings for the nerves were wide open, with no bone spurs blocking them, and the disc spaces were not narrowed. As I told him, “I don’t see signs of arthritis.” What we did find was a straightened neck curve, mild instability in the lower neck, and nerve irritation. Those are things we can strengthen and treat, and he felt relief after his first treatment.
Case: “a little arthritis, not enough to explain it.” A 65-year-old man came in with a year or two of hip and knee pain. His primary doctor had seen a little arthritis on his X-ray, but not enough to explain his symptoms. On exam, his hip could barely rotate inward. The cause was a tightened joint capsule deep in the hip, an irritated sciatic nerve, and a hip flexor in spasm. Right after his first treatment, turning the hip no longer hurt. At his next visit he said the hip work had “helped a whole lot,” and the relief had lasted almost two weeks. He did have a setback after we added decompression, so we lightened his treatment. That’s normal in care: we adjust to how the body responds.
Arthritis isn’t the only thing that hurts
Arthritis describes the state of the joints and the discs, the pads between the bones of the spine. It doesn’t describe the muscles, tendons, ligaments, and nerves around them, and those are often where the pain is coming from. They are also what chiropractic and manual therapy can help most.
I explain it to patients as an order of difficulty. Muscle problems are the easiest to solve. Then come ligaments and tendons, then joints, then discs. Ligaments are the ropes of our body. Sometimes they tighten and form scar tissue, and by working on them we help the scar shrink so function and inflammation improve. And pain is usually the final stage of something that hasn’t worked well for a long time, which is why restoring it takes time.
Imaging findings and pain often don’t match. Many people who have no pain at all have all kinds of findings on an MRI. One older patient had worse arthritis in her right hip, yet her left hip hurt far more. That’s why I treat the person in front of me, not just the picture.
A few examples of what “arthritis” turned out to be in my office:
- Numbness. A patient with numb fingers asked me, “Maybe it’s arthritis?” Numbness and arthritis are not related. A nerve is like a tree branch: it can be pinched at the wrist, the elbow, the shoulder, or the neck, or it can lack nourishment. We treated the nerve at the neck and the wrist.
- A creaking knee. A patient worried about a crunching knee. Her knee joint was normal. The creaking came mostly from not enough strength in and around the knee, plus a tight tendon. Her plan was half-squats and lunges, not just walking.
- “Arthritic hips” that weren’t. A desk worker couldn’t squat deeply. Her hip tests were normal. The limit was tight calves, hamstrings, and quads and a stiff ankle. With care, her arm tingling mostly cleared, her shoulder strength returned to normal, and she had only one short back flare in two months.
- A knee that hurt from a tendon. Another patient’s knee pain came from the tendon below the kneecap; the joint itself tested normal. At her re-exam she was about 60% better, her limp was gone, and she had slept eight hours straight for the first time in a long while.
Case: arthritis on the X-ray, but the pain came from elsewhere. An active man’s X-rays showed mild arthritis in his neck and low back, with an early bone spur. At his re-exam, the pain generators we found were not the arthritic joints. They were stuck ribs at the breastbone that reproduced his chest pain, nerve tension down the arm, an inflamed elbow tendon, plantar fasciitis in both feet, and weak deep neck muscles. We treated the ribs, the elbow, and the feet with manual therapy, adjusted the spine, and added neck, core, and foot exercises. He was about 60% better, his headaches had improved significantly, and his low back moved without pain. His arthritis hadn’t changed. Everything around it had.
Case: the structure stayed, the pain didn’t. A 70-year-old woman came to us after a car accident. Her X-rays showed a forward-rounded upper back and a lost neck curve, changes that had been there for years. She had dizziness, ringing in her head, and a weak, painful shoulder. At five weeks she was about 60% better. At her final exam she described a full recovery. Her neck rotation went from 69 and 59 degrees, limited by pain, to 71 and 67 degrees with no pain. Her shoulder strength improved from 3 out of 5 to 4 out of 5 without pain, and she could squat and rise normally. She told me the ringing in her head, present for many years, had stopped. Her spine still has the same curves on X-ray. What changed was her muscles, her nerves, and how she moves.
Case: an arthritis-type condition, and a full recovery. A mother of a young child had X-rays showing DISH, a condition where bone forms along the spine, in her mid-back, along with scoliosis. At her final exam her original complaint was completely resolved. She moved without pain, her shoulder strength was back to 5 out of 5, she was lifting weights three times a week, and she could carry her daughter. Her imaging findings are still there. Her pain is not.
The health equation
Healthy bones and joints come from several parts working together:
Diet + Sleep + Movement + Joint Health + Nervous System Balance + Proprioception
Chiropractic works directly on two of these, joint health and nervous system balance, and supports the rest. Here’s how each one shows up in my office.
- Sleep. When patients ask where to start, I often say sleep comes first. Extra weight makes breathing worse at night, stress hormones rise, and the body doesn’t recover. Sleep is also when a disc absorbs fluid and regains some of its height.
- Diet. People with higher insulin resistance tend to have more arthritis and degeneration, because blood sugar spikes drive inflammation. My usual starting point is to remove bread, pasta, potatoes, rice, sweets, and sweet drinks for a month or two and eat more meat, fish, and healthy fats.
- Movement. What does our youth depend on? Mobility. Being able to squat down and stand back up normally is one of the best markers of health I know.
- Joint health. An adjustment isn’t putting something back in place. It’s giving a stuck, compressed area more space, more movement, and more blood flow, like opening an accordion. When one vertebra doesn’t move, its neighbors compensate, friction builds, and that’s where arthritis begins.
- Nervous system balance. Nerves are often the real source of pain, numbness, or weakness. We use gentle techniques such as nerve flossing and decompression to take pressure off irritated nerves at the neck, the low back, and the limbs. Our nervous system consists of two main systems; fight and flight (sympathetic) and rest and digest (parasympathetic). Chiropractic adjustments turn on the inhibited parasympathetic system through specific adjustments to C1, C6-C7 on the side and front-side of the neck, visceral organ manipulation, and pelvic alignment.
- Proprioception. This is your body’s sense of where it is, the root of balance. The knee, the ankle, and the pelvis are a two-way street: an unstable ankle or knee affects the pelvis, and the pelvis affects the leg. Weak muscles also become tight, because they’re carrying more than their share. For balance, I often recommend standing on a vibration plate at home.
Case: balance coming back. An older patient I had been treating for balance problems told me at a follow-up visit that she could now put on her sock while standing on one foot, without falling. She was also taking her medication only when she needed it. That was a big change from the last time I’d seen her.
Case: age 72 is not too late. A 72-year-old man came in after falling backward onto concrete, with a month of severe leg pain and numbness. He also has diabetes, and his hips barely rotated. We used adjustments, spinal decompression, knee work, and massage, plus a month without carbohydrates. After about five weeks and seven visits, I documented full resolution of his symptoms and a full return to daily activities. A few days later he told me, “I feel like a hero.” Before, he couldn’t join his grandsons when they came by on bicycles. Now he rides with them. His recovery wasn’t a straight line: he had one flare after a fall and another after we increased his traction, so we adjusted his care each time.
When it really is arthritis
I’m honest with patients: we can’t grow back a joint that’s already worn down. But arthritis is also the tightening of all the tissues around the joint, and that part we can treat. The soft tissues usually respond faster than the arthritic joint itself.
Case: honest expectations with severe arthritis. A grandmother came to us after a car accident. She already had severe arthritis in the joints of her low back. At her re-exam, her shoulder, which she couldn’t move before, was about 90% better. Her mid-back was about 65% better. Her arthritic low back was about 55% better: real progress, but slower. We continued weekly visits, daily walking, and coordination with a specialist.
Sometimes arthritis behaves in a way that tells me something else is going on. When a hip goes from mild to severely worn in about a month, or the whole body seems inflamed, I suspect an inflammatory or autoimmune process and send the patient back to their medical doctor or to a rheumatologist for testing. Our care still helps those patients. It just takes longer, and the inflammation has to be addressed too.
The bottom line
If you’ve been told you have arthritis, it’s worth asking: is the arthritis really what’s causing the pain? Very often, the muscles, tendons, ligaments, and nerves around the joint are the bigger part of the problem, and those respond to care. Even when arthritis is part of the picture, diet, sleep, movement, balance, and joint care can change how you feel and how far you can go.
Dr. Verg Chiropractic offers a free consultation for new patients at both of our locations:
- Vancouver, WA — 109 SE 101st Ave — (360) 203-6000
- Portland / Clackamas, OR — 10001 SE Sunnyside Rd #120 — (503) 386-9819
This article is for general educational purposes and does not replace an individualized medical evaluation. Case examples describe individual patients; results vary. Please consult Dr. Verg or another qualified healthcare provider about your condition, and always talk with your physician before changing any prescribed medication.