Chiropractic and Psoriatic Arthritis

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Introduction:

First a little history to put you in the picture. We know from ancient documents that manipu­lation has been practiced for thousands of years, for example by the Incas and the ancient Greeks. The founder of modern chiropractic was an American healer called Daniel David Palmer. Since its inception in 1895, it has grown to be the third largest healing profession in the world after medicine and dentistry. About 4 years ago an Act of Parliament was passed, which precludes anyone calling themselves a chiropractor who is not suitably qualified to the standard that the government has laid down. To become a member of the British Chiropractic Association, to which I belong, requires a full-time five year degree course and then on-going training. We also have a statutory obligation to belong to the College of Chiropractors and undergo postgraduate learning. Our educational standards and professional responsibilities are the same as you would expect from your general practitioner or hospital consultant.

The chiropractic profession specialises in the diagnosis and treatment of nerve, muscle and joint disorders. It is therefore familiar with the mechanical aspects of psoriatic arthritis. By mechanical I mean the joint pain and stiffness that sometimes accompanies the skin condition. With all forms of inflammatory arthritis, such as psoriatic arthritis, there are periods of time when the inflammation is active and aggressive and then episodes of remission when the inflammation in the joint has subsided leaving reduced symptoms. Chiropractic may be an option that could give you some symptomatic relief by caring for your joints and so allowing you to enjoy the very best quality of life possible. To enable you to do this we will look at three main topics:

  1.  What chiropractors do?
  2.  Where and why chiropractic could fit into your programme of care?
  3.  How do chiropractors treat patients with psoriatic arthritis?

What do Chiropractors do?

Chiropractors specialise in the diagnosis and treatment of conditions that are the result of mechanical joint dysfunction and the effects these dysfunc­tions have on nerves and muscles. It is most commonly spine or joint pain that bring people into our offices. We may actually diagnose your arthritis initially. If I suspect that someone has psoriatic or another inflammatory arthritis I will immediately refer that person back to their general practitioner. I do not treat as many people with psoriatic arthritis as I could because unfortunately after they return to their doctor I rarely see them again. However, from my experience, chiropractic care can actually complement the other treatments. I would recommend both sufferers and their doctors to consider it seriously as a form of care.

Chiropractors always look for the reasons for pain. We are not just interested in your symptoms. The problem is often a long way away from where they symptoms are. We will endeavor to find out which structures in your body are causing your pain. Then we treat the causes very specifically if we are able to.

When and why should chiropractic fit into your programme of care?

The when is very simple. As soon as an inflammatory episode has subsided a chiropractor may be able to help. The manual techniques that chiropractors use are contraindicated during inflammatory flare ups and should not be carried out then. The reasons that chiropractic may help between flare ups are;

  • It helps to reduce pain and stiffness. It is the joints between the bones that allow our bodies to move. During psoriatic flare ups it is not only the joints but also the ligaments that are attached to them that become inflamed. As long as the inflammation persists, the patient is unable to use the joint properly. Even when the flare up is over, the joint may remain stiff and painful. This can be due to some cartilage damage within the joint and that cannot be healed. But some of this stiffness and pan is due to muscle and ligament dysfunction and chiropractic can help.
  • It helps to remove muscle tenderness and spasm. This spasm causes muscles to be weaker than normal. This makes limbs feel weak and joints are even more unstable. Muscles provide vital protection to the joints. Correspondingly well functioning joints enable muscles to have proper tone and strength. Chiropractic helps to prevent a vicious cycle of weakness and stiffness.
  • Chiropractic may assist in reducing degenerative joint changes. Persistent joint inflammation may cause cartilage and underlying bone erosion. Where chiropractic care may help is in reducing the speed at which degenerative changes continue in people suffering with arthritis. We believe this to be due to avoiding continuing stresses on joints by encouraging more quickly the joints to function as normally as possible.

How do chiropractors treat patients with psoriatic arthritis?

  • Assessment. First we assess joint movement both individually and in the way you move, stand and sit. We do this by looking at the active range of movements to see the amount of joint and soft tissue damage. We look at the way you walk, how you move your back and at the strength and function of muscles. This will draw our attention to dysfunctioning joints which need the most help.
  • Then we gently traction each joint and mobilize it
  • We often use massage and ultrasound therapy on muscles to relieve tenderness and spasm. We also use this therapy to relieve pain and stiffness so as to reduce wear and tear on joint surfaces.
  • We are very keen on rehabilitation and preventative care. We teach patients simple exercise programmes to do at home and provide ergonomic advice. We do our best to help patients to help themselves.

Summary

I hope that this information is interesting and useful. It may give you encouragement to know that chiropractor care is a further option for treatment for your arthritis.
First published 2001 in Skin 'n' Bones Connection issue 14 page 13-14