#47: Move Pain Free… Even With Arthritis

#47: Move Pain Free… Even With Arthritis

The PowerDot wireless and portable Transcutaneous Electrical Nerve Stimulation (TENS) and Neuromuscular Electrical Stimulation (NMES) device is the best TENS unit and best muscle stimulator, all in one, designed for advanced pain management and pain relief. 


Whether it’s lower back pain, shoulder pain, or any joint pain for that matter, with the combination of TENS therapy plus muscle stimulation workouts (which can be at home workouts), you are sure to become stronger and start moving pain free in no time. 


Speaking of pain, arthritis (painful inflammation and stiffness of a joint) is a major contributor to joint pain. Most prevalent being Osteoarthritis (OA) and Rheumatoid Arthritis (RA). 


Arthritis causes severe and debilitating joint pain which may lead to increased disability and loss of independence, limitations in activity participation, and increased risk of falls. This can prevent us from doing life. And if we don’t take action, there’s a good chance, based on the statistics, this could be our future. 


Over 23% of the population already suffers from some form of arthritis… and this number is not on the decline. It’s estimated that in the next 20 years approximately 78 million adults will suffer from arthritis (and that’s just those that go to the doctor to be diagnosed). The lifetime risk of developing OA… is 45%. These are not small numbers.


But what if we already have early signs and symptoms associated with arthritis like joint pain and stiffness?


PowerDot Smart TENS and Smart NMES can not only help to immediately relieve pain but also improve strength to ultimately improve, maintain, and/or restore physical function. Pain should not place limitations on living life. To combat and fight for function we have to begin with understanding how and why we may be experiencing this joint pain and swelling associated with arthritis. 


The Anatomy of Joints


Our body is full of different joints. Our joints consist of two bones that are “joined” or articulate with one another.


Joints can be classified structurally as fibrous, cartilaginous, synovial, or facet joints. Though, they may also be classified in regards to function or movement as synarthrosis, amphiarthrosis, and diarthrosis. 


Synarthrosis joints permit little or no movement, they’re immobile, and are fibrous joints. An example of this type of joint would be the skull sutures.


Amphiarthrosis joints permit minimal movement and are cartilaginous joints. This type of joint would be found at the intervertebral discs. 


Lastly, diarthrosis joints, or synovial joints, are freely moving joints. We use our synovial joints in everyday movement. From walking, to typing, to gripping, to squatting, etc. If there’s movement, there’s a good chance that movement is occuring at a synovial joint.


Synovial joints get their name because they are comprised of a synovial membrane which is a thick flexible membrane. This membrane creates a sac-like structure that contains fluid that lubricates the joint allowing for pain free and smooth movement.


As the muscle contracts and pulls on the tendon which pulls on the bone, movement occurs at the joint. As the joints move, not only does the synovial fluid within the synovium allow for smooth movement, but so does the articular cartilage that covers the end of each bone. 


For instance, the femur (thigh bone) sits on top of the tibia (shin bone). You may have guessed it, this is the knee, which is a synovial joint. The end of your femur has articular cartilage and on top of the tibia there’s articular cartilage (which works with the meniscus) to provide smooth movement and prevent bone on bone contact. 


These structures are designed to allow proper and pain free movement. However, in the case of arthritis, the structural integrity of the whole joint is compromised as these structures are attacked due to inflammatory and immune responses.


Wear and Tear Disease: Osteoarthritis


OA is prevalent in joints that have had to deal with a lot of stress over the years (knees, hips, and low back). OA is commonly referred to and known as the “wear and tear” disease. 


The constant stressors lead to the loss and damage of articular cartilage. Remember, the articular cartilage is the cartilage that covers the bones so that there is no bone on bone contact.


With OA there is also inflammation, new bone formation and changes, inflammation of the synovial membrane, and thickening of the joint capsule. All of these factors result in narrowing of the joint space eventually leading to bone on bone contact.


Common symptoms associated with OA are joint stiffness and swelling. Joint stiffness in people with OA typically occurs going from rest to activity. For instance, pain and stiffness may occur for approximately 30 minutes after waking up from a nap or after sitting for a while. The swelling may be caused by joint effusion (an excess amount of fluid in the joint) or from the enlargement and bulging of bone.


At the end of the day, all of these factors combined, limit range of motion. Meaning, we have limited movement and can’t move our joints as well. 


Autoimmune Disorder: Rheumatoid Arthritis


RA differs from OA in that it is a progressive autoimmune disease. Just like any autoimmune disease, our immune system (B and T Cells) recognizes our normal bodily structures or proteins and begins to attack them. In the case of RA, our immune system begins to attack the joint’s synovial membrane as well as the joint’s tissue/cartilage. 


So, with RA, what causes our body’s immune system to begin attacking itself?


It all has to do with protein synthesis. There’s more to protein than post-workout shakes. Proteins are made by every one of our cells and are like the workers of the cell, they have various functions. For instance, GLUT4 is a protein found in skeletal muscle that has the responsibility of helping to take glucose into the muscle cell. But let’s get back to RA.


Now proteins are made up of long strands of amino acids called polypeptides. What happens is that at some point during protein synthesis, when the cell is making a protein, it becomes citrullinated. Citrullination is the conversion of the amino acid arginine (essential amino acid) into the amino acid citrulline (nonessential amino acid). This may not seem like a big deal, however, our body does not like proteins that have been citrullinated. So, it releases these antibodies called anti-citrullinated protein antibodies. These antibodies then begin to attack any proteins that have been citrullinated. 


As proteins that help to make-up the cartilage and other structures in the joint become citrullinated, antibodies are then released to then come and attack those structures, resulting in the degradation of the joint. 

 

Joints affected by RA begin to feel tender to the touch, painful, and stiff. The pain is caused by stimulation of nociceptors (pain receptors) due to the pressure from the swelling and later on in the disease by joint destruction. There is also stiffness, though different than OA. With RA, stiffness usually lasts for about one hour after rising in the morning. The symptoms are very similar to OA, though again, this is not from excessive wear and tear, rather an autoimmune disorder.


TENS and NMES for Arthritis


At PowerDot, we aim to improve all aspects of human performance. From the athlete striving to reach a personal record to the grandparent aiming to run around the park with their grandkids, human performance is essential. You should perform your best every day and that means moving pain free. 


The power of having a Smart TENS and Smart NMES unit all in one is that you can focus on improving strength, which ultimately improves physical function and decreases pain, as well as on just strictly pain management. Your PowerDot has numerous preset and customizable protocols to streamline improvements in human performance.


Those with arthritis tend to decrease physical activity as it becomes too painful to want to even get up… let alone go exercise. The combination of TENS and NMES can not only help to get you moving pain free but also improve physical function in the long run. 


The use of TENS therapy results in analgesia, or the inability to feel pain, and yes, this is in people with arthritis. How is this possible? TENS therapy blocks the pain signals sent to the brain. 


So, now that you can move pain free it’s time to implement NMES. If arthritis has been limiting your physical activity there’s a good chance that your muscles have atrophied (gotten smaller and weaker). This leads to even greater physical impairments. So, not only does it hurt to move, but you are weaker and so you can’t do the things you once used to be able to do. That’s where NMES comes in. NMES training in those with arthritis not only improved muscular strength and cause the muscle increase in size, but reduced pain, stiffness, and functional limitations in patients with arthritis. 


Enhancing performance is for everyone. Whether it’s for athletic endeavors like cycling or general everyday activities like walking up the stairs, pain should not be a limiting factor in your life. Grab yourself the new PowerDot 2.0, risk free, and don’t let pain limit your life.

 

Author: 

Joshua D. Dexheimer, PhD, CSCS, USAW, PES

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