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DR. HOOK- Walk the walk: Arthritis event helps others in pain


Published April 23, 2009 in issue 0816 of the Hook
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the handsome doctor John Hong of Charlottesville

Talk the talk means you have to walk the walk. The 2009 Arthritis Walk is the Arthritis Foundation's national event to take the pain out of arthritis. 

Frankly, arthritis sucks. To be more refined, I'm sure the Queen of England would say that arthritis is a very unpleasant malady. (Hey, don't you just love, love, love that the Queen and First Lady Michelle Obama hugged? I wonder if they are BFFs and will text each other.)

Will you walk and raise money for the Arthritis Foundation?

I might strut vs. walk at Scott's Stadium on May 2. (I'll leave a memento there for Bono since U2 is coming in October. I love Bono! I hope he needs me when he's in town-- for something benign, of course-- let's say a dandruff attack.)

There are quite a few different types of arthritis, but the most common type that affects mega millions of Americans is osteoarthritis (OA). In OA, the cartilage wears down, and the joints don't have a cushion. So when bone touches bone, it equals "Ouch!"

The pain usually increases with more use of the joint. So pain is minimal at the beginning of they day but increases as the day goes on. And who likes pain-- well, in general, if you know what I mean?

Though pain is not bad after waking up, there's often stiffness-- a "gelling" that lasts usually less than 30 minutes. So "rise and shine" is more like, "rise and-- oooh." It takes some time to work out the kinks in the OA joints. Theater sign is when a person is sitting for a while and then their OA knees get stiff. Thank God for intermission!

Unlike rheumatoid arthritis, which affects joints symmetrically, OA can often affect only one knee or one hand. The joints most affected by OA are the spine, fingers, toes, knees, and hips. Less commonly affected are the shoulder, TMJ, ankle, wrist, and sacroiliac. 

The #1 risk factor for OA is— wait for it-- age. One of my oldest patients joked to me, "Did you hear about the old lady who died of ‘one thing after another'?" Getting older is great in many ways, but the joints can start to become arthritic. The average age of onset for OA is 40. About 80 percent of folks over 55 years old have OA, and after the age of 65 it's about— gulp— 97 percent. 

Women seem to be affected by OA about 2.6 times more than men, and their OA progresses faster. Obesity is the biggest modifiable risk factor for OA. Think about it. More weight means more stress on the joints, especially the hips and knees. 

But you know what? It seems like everything is a risk factor for development of OA: many sports, physically active occupations (especially shipyard workers, cotton workers, and carpenters), those who do a lot of prolonged knee bending (like The Bachelor?), history of injury to the joint, congenital or developmental joint disorders, osteonecrosis, gout, septic arthritis history, Paget's disease, diabetes, acromegaly, hypothyroidism, and-- frostbite!

Genetics appear to play a significant role in OA. So if you "step on a crack and break your mother's back," she might ultimately get revenge through your DNA. OA of the spine, in particular the neck and lower back, can be really a pain. If the arthritis compresses the nerves, it can be disabling. OA is a major cause of disability and costs the country millions of dollars each year.

Okay, I'm ready to walk for arthritis. I hope you make me a Jerry Lewis and pledge at this site: arthritiswalkcharlottesville.kintera.org/dearjohn

~

Dr. Hook cracks a joke or two, but he's a renowned physician with a local practice. Email him with your questions.

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Comments

                     
Brycen Hudock, D.C.4/23/2009 10:16:56 PM

I respectfully have to disagree with Dr. Hong's #1 risk factor for osteoarthritis=age. I think the more appropriate terminology for describing the cause of osteoarthritis is time. More accurately, dysfunction over a period of time. Quite different than age alone! If I can use some quirky humor as well, I'm reminded of the time a patient had arthritis present at the lowest vertebra is his back. He commented "it's just old age, doc", to which I replied "oh ya, how much older is this vertebra than the one two levels higher that looks just fine!" I've seen 30 year olds with severe osteoarthritic changes and I've seen 80 year olds with no signs of OA. Dr. Hong's thinking is typical of the traditional medical approach of removing responsibility from the patient. Blame it on genetics, age, etc. The current status of our nation's health is very poor and I believe it's this type of limited thinking that put us there. While there is no doubt things like genetics play a role in our health, current medical research in the field of epigenetics shows that our environment/lifestyle is much more of a factor in how genes are actually expressed. This model allows the individual to accept responsibility for their health. Our approach in my office is to educate patients on how to get and stay healthy and support them in their journey. Until we truly address the real causes of most disease and ill health, which is unhealthy lifestyle habits and stress, we will continually wonder how we're going to get everyone insured and pay for this terribly expensive system of health care that consistently ranks near the bottom when compared with other industrialized nations. Approximately 50% of bankruptcy in the US is due to medical expenses. I believe it was Einstein who said "You can't solve a problem with the same level of thinking which created it." More drugs aren't the answer. It's time we all question our current thinking on what health really is and what it takes to properly develop and maintain it. I welcome all questions/comments to drbrycen@truehealthva.com or (434) 975-6100

Brycen A. Hudock, D.C.

Charlottesville, VA


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