Arthritis is a very common problem that progresses as we age. According to the U.S. Centers for Disease Control and Prevention, nearly 50 percent of Americans age 65 or older have been diagnosed with it. By far the most common form is osteoarthritis, sometimes called the “wear and tear” type.

It is typical to see arthritic damage in the joint years after an injury, or with overuse; once we reach a certain age the X-ray changes are almost universal. There seems to be a genetic component to it as well — some people are more prone to this type of arthritis if there is a strong family history.

X-rays are a great way to diagnose arthritis, but they cannot tell whether it is causing any pain. The pain in an arthritic joint is not always from the arthritis itself; it is often caused by the same joint and muscle problems that cause pain in so many people without arthritis. I have seen patients with “bone on bone” arthritis have great pain relief when the joints were treated; clearly, their pain was due to something other than the arthritis seen on their X-rays.

Manipulation is the treatment that we start with for most of our arthritic patients. (This is not the case for patients with the disease type of arthritis.) Chiropractors are trained in many styles of manipulation, and we often modify our treatments for arthritic joints. There are special tables that allow us to use much less force, and no “cracking,” to get the joint working better and improve alignment, as well as handheld instruments that use even less force, perfect for the patient who has both arthritis and osteoporosis.

There are also tables that create gentle traction on the spine, which is a great relief for low back arthritis. If there is advanced arthritis, the relief may not be complete, but most patients do benefit from manipulation.

Acupuncture is also very helpful in treating arthritis. It reduces pain and inflammation, relaxes the surrounding muscles, and makes most patients feel more relaxed afterward.

These treatments are helpful in stopping or reversing the downward cycle that is common in arthritis; this is a situation where activity causes pain, so the patient does less and less until they end up sitting most of the day.

Unfortunately, inactivity is also bad for arthritic joints, so anything that improves tolerance for exercise helps prevent further damage to the joints.

Of course, any health problem can be made worse by lifestyle, and osteoarthritis is no exception. The “itis” at the end of the word means there is inflammation involved. And so often this inflammation is fueled by our diets. We eat a lot of “pro-inflammatory” foods that promote the inflammatory process. The worst offenders for many patients are grain products, with the worst of the worst being the white flour and sugar-laden foods.

Another culprit is factory-farmed beef, chicken and fish. Because they are raised on grains — which is not a natural food for any of them, especially fish — the fat content of the meat is changed, making it more pro-inflammatory.

We also consume a lot of vegetable oils, which have the same problem with the fats. These dietary imbalances have helped make anti-inflammatory drugs among the best-selling drugs today.

With many arthritic patients, the greatest difficulty is not the actual treatment; it is fighting the pessimism that has been instilled in us. We are taught there is no real treatment for arthritis other than painkillers and anti-inflammatory drugs, and then eventual joint replacement.

Getting a patient to even try an alternative treatment for arthritis (or changing their diet) can be like pulling teeth. Wellness care is not a cure for arthritis, but most patients get enough relief that they wonder why they waited so long to start.

Dr. Michael Noonan practices chiropractic, chiropractic acupuncture and other wellness therapies in Old Town. He can be reached at