{"id":180,"date":"2015-10-20T09:24:09","date_gmt":"2015-10-20T08:24:09","guid":{"rendered":"http:\/\/us111.siteground.us\/~tlhouse0\/impossible-takes-longer.com\/blog\/?p=180"},"modified":"2015-10-20T09:25:17","modified_gmt":"2015-10-20T08:25:17","slug":"symptom-free-was-i-misdiagnosed-with-osteoarthritis-or-was-i-cured","status":"publish","type":"post","link":"https:\/\/www.impossible-takes-longer.com\/blog\/2015\/10\/20\/symptom-free-was-i-misdiagnosed-with-osteoarthritis-or-was-i-cured\/","title":{"rendered":"Symptom Free – Was I Misdiagnosed with Osteoarthritis or was I Cured?"},"content":{"rendered":"

The biggest stumbling block getting in the way of me treating and ultimately curing my hip OA was the attitude of health professionals and the public perception of what OA actually is. I believe the attitude instills learned helplessness<\/a> in us which not only reduces our chances of finding a good outcome but actually makes our symptoms worse. Nocebo effect (the opposite of placebo effect) has been researched and it is clearly shown that when told pain and dysfunction is likely we will experience exactly that. It’s known that pain is largely generated by the mind so in my opinion it’s highly irresponsible to tell people to expect it. <\/p>\n

We get very little information from our GP’s. To be fair, the likely reason that they don’t tell us much is because very little is actually known. Most of the information provided in the guidelines is educated guesses. In the case of hip OA there is very little research to guide us. The bulk of what we know comes from information leaflets and online sources such as arthritis charities. That information is based upon the official ‘educated guesses’ but over-simplified to the point of being inaccurate and for many people positively damaging. The other source of information is fellow OA sufferers. The huge problem with the latter is that it’s generally those with horror stories to tell that spend their time online talking about their disease. Most of those that have had a good outcome are out enjoying life and have forgotten about that little episode of pain and a worrying diagnosis that they had a few years back. Those that do want to share a positive story are assumed to be lying, deluded…..everyone KNOWS that OA can’t be cured so they must be wrong….right?<\/p>\n

WAS I MISDIAGNOSED OR CURED?<\/h2>\n

This simple question is proving to be controversial. For many people it\u2019s important to get a reliable answer as a good outcome for one person can provide a great deal of hope to others. My case was said to be classic and certainly when I compare symptoms and stories with other hip OA sufferers we seem to have (or had in my case) an identical condition with the same problems and symptoms.<\/p>\n

The health professionals and researchers I\u2019ve spoken to fudge around the issue by responding to my statement of \u201cI\u2019m either cured or was misdiagnosed\u201d with \u201cI\u2019m glad to hear that you\u2019re managing your symptoms\u201d. When I reiterate that I\u2019m not managing symptoms \u2013 that I no longer have any symptoms and that my joints are being well tested with extreme sporting activities they avoid the subject altogether or make a vague comment about \u201ctemporary remission\u201d. <\/p>\n

In order to clear up the confusion let\u2019s look at how OA is currently defined.<\/p>\n

THE OFFICIAL DEFINITION OF OA<\/h3>\n

The National Institute for Health and Care Excellence (NICE) provides national guidance and advice to improve health and social care in the United Kingdom. This is their definition of OA:<\/p>\n

\u201cOA refers to a clinical syndrome of joint pain accompanied by varying degrees of functional limitation and reduced quality of life.\u201d<\/em><\/p>\n

They then go on to state:<\/p>\n

\u201cOA is characterised pathologically by localised loss of cartilage, remodelling of adjacent bone and associated inflammation. A variety of traumas may trigger the need for a joint to repair itself. OA includes a slow but efficient repair process that often compensates for the initial trauma, resulting in a structurally altered but symptom-free joint. In some people, because of either overwhelming trauma or compromised repair, the process cannot compensate, resulting in eventual presentation with symptomatic OA; this might be thought of as \u2018joint failure\u2019. This in part explains the extreme variability in clinical presentation and outcome that can be observed between people, and also at different joints in the same person.\u201c<\/em><\/p>\n

Piecing together these two statements we can conclude that OA is currently viewed as joint pain that is accompanied by varying degrees of functional limitation. The root cause of symptoms is the actual joint \u2013specifically, inadequate repair of damage to the joint. As damage to the joint is for the most part irreversible, OA is considered to be incurable. <\/p>\n

This seems reasonable enough.<\/p>\n

The NICE guidelines distinguish between symptomatic OA and radiographic OA. <\/p>\n

WHAT IS RADIOGRAPHIC OA?<\/h3>\n

Radiographic OA is a term used to describe changes to joints visible on X-Rays or MRI scans. Most cases of radiographic hip OA are non-symptomatic and benign. 11% of the population are estimated to have radiographic hip OA yet only 5% are symptomatic. 6% of the population have non-symptomatic radiographic OA in hip joints.<\/p>\n

If we look again at what the NICE guideline has to say we can reasonably conclude that radiographic changes to hip joints are a normal part of the joint repair process. <\/p>\n

\u201cOA includes a slow but efficient repair process that often compensates for the initial trauma, resulting in a structurally altered but symptom-free joint.\u201d<\/em><\/p>\n

On its own, radiographic OA is normal and benign. By middle age most people will have it in at least one joint in the body.<\/p>\n

WHAT IS SYMPTOMATIC OA<\/h3>\n

Symptomatic OA is generally defined by the presence of pain, aching, or stiffness in a joint with radiographic OA. <\/p>\n

DANGERS OF ASSUMING LINK BETWEEN SYMPTOMS AND RADIOGRAPHIC OA<\/h3>\n

The assumed link between symptoms and radiographic OA can lead to a misdiagnosis of OA.<\/p>\n

NOT ALL JOINT PAIN IS CAUSED BY OA<\/h3>\n

There are numerous causes of joint pain \u2013 most of them are treatable and curable. Some specialists speculate that very early stage OA is not evident on x-ray or MRI scans. Whilst this may or may not be true, there is no test for OA so you simply cannot conclude that pain is caused by OA without ruling out all other possibilities. In practice OA tends to be a catch-all diagnosis for joint pain that has no obvious cause and is therefore frequently misdiagnosed. Interestingly, the specialist that diagnosed me with OA agreed with this point, saying:<\/p>\n

\u201cI agree OA is a blanket term and patients are often written off prematurely because this label can easily be applied.\u201d<\/em><\/p>\n

It\u2019s important to keep looking for the CAUSE of your symptoms if you are to have any hope of cure. <\/em><\/strong><\/p>\n

Correlation does not imply causation.<\/h4>\n

Even when pain and dysfunction is accompanied by radiographic OA there is no guarantee that the two are related. <\/p>\n