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Treating Chronic Pain from Osteoarthritis in Prince George

Do you suffer from chronic pain? Chronic refers to an injury that has been present for 3 months or longer. This type of injury is characterized by pain, stiffness and can be present steady or off and on. Chronic pain can be caused by an accident, poor posture, congenital abnormalities, repetitive strain or many other things. Many chronic patients have underlying conditions such as osteoarthritis, muscle disease, fibromyalgia or other problems. If you’re suffering from osteoarthritis in Prince George, please give us a call. Patients with chronic conditions can experience acute flare-ups. These can be triggered by activities, weather changes, viruses and more. With time and treatment they usually they can improve significantly. Some chronic care patients improve enough not to be considered chronic. Chronic patients see a chiropractor until they have stabilized and usually continue to see a chiropractor on a regular basis to prevent a regression of their problem.


Treatment of chronic chiropractic conditions is usually to first settle down the inflammation (if any is present) and control the pain. Then the next goal of treatment is to restore proper movement of the joints and relax the tight muscles. Muscle work, such as trigger point therapy (which is basically pressing on muscle knots to relax the muscle) and manual massage is usually done first. After the muscles relax chiropractic adjustments (adjustments are the tool chiropractors use to increase joint movement and correct joint alignment. There may be a popping sound as the joint is adjusted. This sound is caused by separating the joint slightly and causing a negative pressure in the joint. This causes the fluid to “cavitate, which means the air in the fluid separates temporarily causing a popping sound) may be made. If the condition is too tender for an adjustment, then gentle mobilizations (mobilizations are gentle repetitive movements that help increase joint movement) are made to help increase joint mobility. Ice may be used in the office if necessary. After the adjustments a massager is used to help relax the muscles more to help keep the joints moving. Therapain liniment is often used at the end of the treatment.

With the treatment, all care is taken to make sure the patient is helped as much as possible with the least amount of discomfort. If certain procedures are too painful they will be changed to lessen the pain or just not done at that point. If, at any point, you feel pain please let Dr. Warawa know. He will ask many times for you to let him know if anything is too tender or painful.

Frequency of Treatment

The amount of treatment a person will need varies. Most acute flare-ups of chronic conditions will settle in 1-8 treatments. The more the injury, the longer the treatment and healing time will be. If a full treatment can be done on the first visit, the next treatment will be 2-4 days later, then the next treatment 4-6 days later. This rate of treatment will be done until the person is back to normal. If a full treatment cannot be done on the first visit, daily treatments are done until a full treatment can be done and then the treatments are spaced out. When a patient is treated they need time to heal. When a joint is injured, there is damage to the ligaments, muscles and tendons. A chiropractor will correct the joint alignment and mobility, but the body has to heal the damaged soft tissue. If the joint is not corrected the injury will take a lot longer to heal and may not heal right and could eventually become a chronic problem. If problems such as osteoarthritis and/or degenerative changes are present, this will complicate and slow down progress. If these conditions are present, the more the patient needs chiropractic care. Proper alignment will help slow down the progression of arthritis and degeneration. Once the patient has improved, chronic patients can benefit from regular maintenance treatments which can be done every 1-4 months.

How Will I Feel After My Treatment

After the treatment you will still feel some discomfort. The movement may feel increased. Much of the pain with acute flare-ups is from the soft tissue damage. With treatment, the joints will move better but time for repair is needed. As the soft tissue settles the pain will lessen. Some patients will feel better after the treatment but may get sore later that day or the next day. This is often because the joint is moving more, the muscles react by initially tightening up. If the patient is too active or does something wrong after the treatment the condition can become aggravated, but this is different as the treatment is often undone. With an injury, the muscles want to tighten up, and when we get the joint moving properly the muscles can initially rebel by tightening up.

With chronic conditions the joints may not have moved for a long time, so there is a tendency to get sore after treatment. Treatment will be done at a rate that will minimize the post-treatment soreness. The longer the problem has been present and the older the patient the greater the risk of post-treatment soreness.

Some people can get different reactions to treatment such as headaches and/or different areas other then the area treated becoming sore. This is because as we align the spine and get joints moving, different muscles are being used in a way that is different from what they are used to. As the body adjusts to the changes the discomforts will lessen. If everything is good with the body you will not generally see reactions like this, but if the body is not correct mechanically you will not uncommonly see reactions like this. This reaction is often a good sign that changes were made and were needed. These reactions settle as treatment progresses. These reactions are more common at the beginning of treatment as the changes are greater.

Always discuss any reactions with Dr. Warawa. Understanding your condition and treatment is essential for prompt and proper healing.

Chronic pain

What to Do After Your Treatment?

With chronic conditions the best thing to do after treatment is rest. Ice helps to settle inflammation and pain. Generally, you should ice 5-10 minutes at a time and once every 1-2 hours initially and then every 2-4 after until the pain subsides. If the ice aggravates then stop. Anti-inflammatory and muscle relaxant medication may be taken as this can help. Gentle stretches may be shown to you. Please do them, but if they cause pain either slow down or stop them and let Dr. Warawa know.

  1. Stay off the couch, sit in a firm to medium chair.
  2. Watch with twisting. Twisting is the easiest way to injure the spine. Whenever you lift, always lift without twisting and with minimal bending.
  3. Cough and sneeze straight.
  4. Sleep on your side or back. Stomach sleeping should be avoided. A proper bed is essential. Arms should be below shoulder when sleeping. A proper pillow helps. A contoured cervical pillow may help.
  5. Proper posture is important. Always sit and stand straight.
  6. Always keep warm. Cold muscles strain easier.
  7. Warm up before actives. Stretching helps prevent injuries.
  8. Break up your activities. Do not spend too much time doing one thing or too long in one position.
  9. Always take your time doing stuff. Quick movements lead to injury.
  10. Avoid extreme bending of your spine in any direction. Avoid reaching or overhead work.

Maintenance Treatment

Once a person is back on track, many people do not need to return for further treatment unless they have another acute episode. When another acute episode is starting, it is best to get in for treatment ASAP. The sooner you get in, the less you suffer and the less treatments you will need. With some patients, a check-up treatment every 1-3 months may help prevent acute episodes.

If you have osteoarthritis, you have options. Contact the clinic of Dr. Warawa today.


questions answered

Dr. Warawa can assess your health, answer questions and determine the right treatment option for you.

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