Osteoarthritis (knee and hip)

What it usually is

I call it wear and tear in my office. Osteoarthritis is what happens as the cartilage that lines a joint thins out and the joint changes shape a bit over the years. The truth is that if we live long enough everyone on the planet would likely have wear and tear that would show up on x-rays. I say this all the time — only the lucky ones get old.

What it often feels like

You know the stiff joints in the morning that take a while to get moving, like tin man in need of getting oiled. An ache in the knee or groin after a long walk, stairs or getting up from a low chair. Some clicking or grinding, and a joint that feels stiff after sitting.

What we look at

How your knee or hip moves and how strong the muscles around it are. How you walk, stand up from a chair and do stairs. Your feet, your back and your other hip or knee, since they all share the load. Turns out that wear and tear on joints doesn't have to equal anything. I am often surprised by how often arthritis doesn't actually hurt.

What usually helps

Exercise is the main tool, strengthening and getting the joint moving through its full range. Hands-on work, adjusting and soft tissue, to help the joint and the muscles around it move better. Orthotics, when your feet are adding to the load on your knees. Understanding pain, because "bone on bone" is a scary phrase and the joint is often tougher than the x-ray makes it sound. Pacing, so you can keep doing the things you love without paying for it for three days after.

What you can do at home

Move every day, a walk, a bike ride, the pool; motion is lotion. On a bad day, do less, not nothing. Get up from your chair without using your hands a few times a day, that's a free leg workout. And sleep, since a tired brain turns up the volume on sore joints.

When it's not a chiro problem

A hot, red, swollen joint, especially with a fever, needs a medical doctor the same day. If you fell and now can't put weight on your leg, go to emergency for an x-ray, especially if you are older. See your doctor if several joints are swollen at once or you are stiff for more than half an hour every morning, since that can be a different kind of arthritis. Unexplained weight loss or pain that is worse at night and doesn't ease with rest should be checked by your doctor too.