Osteoarthritis or Internal Scar Tissue?
– Chronic joint pain isn’t always arthritis
Feeling joint pain and noticing that it is becoming more and more difficult to move around as easily as one once could is a natural part of aging. But is osteoarthritis always the cause of joint pain after a certain age?
Osteoarthritis is a common condition, especially among those over the age of 60, but the symptoms of osteoarthritis (such as joint pain, stiffness, loss of mobility, and swelling) can often overlap with other conditions which could be causing the pain. An x-ray or MRI of the joint should be able to tell us whether or not the cartilage has worn down to the point where osteoarthritis can be confirmed, but even these findings don’t always give us the full picture or can explain one’s pain. However, it’s not uncommon to hear one’s doctor suggest that osteoarthritis is the culprit of joint pain, even without much investigation or proof. This could be the reason that one is not able to find relief from common osteoarthritis treatments. I’ve found that one of the most easily confused conditions with osteoarthritis is internal scar tissue.
Many clients come to see me under the assumption that they have osteoarthritis, but have tried nearly every medication and/or treatment available to them without being able to find a solution for their discomfort. They often have the mindset that Cold Laser Therapy is their “last effort” before calling it quits and resorting to surgery. In other cases, individuals who have already had surgery on an area, but are still suffering from chronic pain, will visit me seeking a therapy that will actually work.
With many of these new clients, I like to dig a little further to understand the exact nature of the pain and the client’s health history – does the pain come and go periodically, and get worse with activity? Has there been a history of previous injury, or repetitive movement and stress placed on the joint (such as a sport or work related movement)? If the answer is yes to either or both of these questions, then internal scar tissue may be the reason (or one of the reasons) that the client is in pain.
If you would like to learn more about Internal scar tissue, visit our Internal Scar Tissue Page here
What is Internal Scar Tissue, and why can it be so confusing?
Internal scar tissue is the body’s natural emergency cellular structure. It is the body’s response to an injury that needs to be healed quickly, and it starts building as soon as an injury or physical trauma occurs (the most obvious example would be surgery, but this also occurs with repetitive injuries or stresses). Internal scar tissue is a tough, inflexible, and fibrous type of collagen that works to connect torn or damaged tissue back together. It is much more stiff and tight than healthy tissue, and it can unnecessarily attach to and pull on other surrounding structures, resulting in friction and inflammation. This is when pain and discomfort begin to occur. Internal scar tissue is initially a very helpful structure that quickly repairs damaged tissue, however, the body can have difficulty breaking it down once it is no longer needed.
Internal scar tissue can be very tricky to diagnose, because it cannot be detected by an X-Ray or MRI. However, it can sometimes be felt through the skin by touching the area affected. In addition to examining the area, I find that the best way to discover indicators of internal scar tissue are through asking my clients specific questions about the history and current state of their condition.
Below are some of the common indicators that may help me come to the conclusion that internal scar tissue is playing a role. This list can also help one determine if they might have osteoarthritis or internal scar tissue.
Indicators of Osteoarthritis or Internal Scar Tissue
- Joint stiffness is commonly felt first thing in the morning, and resolves after 10-15 minutes of moving around
- Pain and stiffness tends to temporarily improve with mild to moderate activity
- Pain and/or stiffness increases after being stationary (ie. sitting, resting) for a long time
- The condition worsens with weather changes
- May see visual changes, such as swelling and redness in the joint (more commonly in the foot and hand)
- Previous surgery or injury to the area has occurred, even if several years ago
- Periodic flare ups may occur (ie. every few weeks/months); flare ups may get more intense and last longer as time moves on
- Significant pain during or after activity
- History of repetitive use of the affected area for work, sport, etc.
- Arthritis medications don’t help
- Feels like the area is very tight
- May feel tender knots or trigger points in the surrounding muscles or soft tissue
- Pain may not correlate with findings on X-Ray, CT scan or MRI reports
- May hear or feel painless popping or crackling in the joint with movement
Another reason why internal scar tissue can be tricky is because it can actually develop from other conditions, causing additional pain and discomfort. For example, it is not uncommon for a client to have osteoarthritis (evident with an X-Ray), but also have symptoms that point towards internal scar tissue. This is yet another reason why osteoarthritis medications and/or treatments might not be fully working for an individual. The damage caused by osteoarthritis can prompt the body into building internal scar tissue in an effort to fix the damage. This can make the condition even more complicated to understand and to fix.
Many doctors are aware that internal scar tissue can be the cause of the pain, especially when it is associated with a previous injury or surgery. However, there are many different opinions when it comes to preventing and removing internal scar tissue, whether it be surgery, physiotherapy, massage or other soft tissue treatments such as Active Release Techniques and the Graston technique, dietary modifications, exercise, etc.
Finding that Cold Laser Therapy can help to relieve symptoms of both Osteoarthritis or Internal Scar Tissue
Through treating many clients at Solaj who were initially of the mindset that their pain was caused solely by osteoarthritis, I’ve found that treatment responses can commonly be very quick and quite significant. This has been an indicator to me that something else must be contributing to their pain. It takes an arthritic joint longer than just a couple of weeks to heal significantly enough to notice major changes, but most of our clients tend to feel significantly better within that short time frame. These responses have led me to believe that internal scar tissue is a significant contributor to one’s pain experience. This is because the cells can break down internal scar tissue quite efficiently and quickly, if they have the energy to do so. If we can stimulate the cells to go through the healing process and begin breaking down scar tissue immediately, then there is a profound effect on one’s pain and function.
There are instances when the source of one’s pain is not immediately evident whether it is caused by osteoarthritis or internal scar tissue. In these cases, treating the symptoms with Cold Laser Therapy can have a positive result with either condition. As an individual progresses through Cold Laser Therapy treatment, some symptoms begin to disappear. As this happens, it becomes easier to understand if the cause of their pain and restricted mobility is due to osteoarthritis or internal scar tissue, or a combination of both.
In these cases, it is important to see how one is responding to treatment, and then we can more confidently determine if the source of the problem is osteoarthritis or internal scar tissue. For example, an individual who starts to feel significantly better very quickly, likely has internal scar tissue contributing to the issue. However, they may also have the underlying issue of osteoarthritis, which is determined during the assessment, or by previous X-Ray reports. All of these factors play a role in whether or not a maintenance or preventative program will be beneficial for them in the long run.
At the end of the day, we all just want to be pain free no matter which condition we are struggling with. This is why I have found myself recommending Cold Laser Therapy for so many clients who have symptoms that could indicate osteoarthritis or internal scar tissue, because it continues to bring such long lasting results.