The Importance of Blood Supply

Blood supply is terribly important for every cell of the body.  When I say that, most people would say “Duh.”  But really think about that.  When blood vessels supplying the heart muscle become clogged and the heart muscle is starved of blood, we call that condition a “heart attack.”  When blood flow to the brain is restricted, that leads to a stroke.  Blood loss to the limbs; you can guess is not good.  There are several problems when blood is subtracted from the tissues of the body.

Let’s think about the condition of arthritis for a moment.  In Latin the word “arthritis” means “joint inflammation.”   What happens in the joint to get “joint inflammation?”  The circulation through the joint has been restricted so fluid is building up in the joint area.  That introduces us to pain.  Where does the pain come from?  Pain is a nerve stretch sensor in the tissue.  You can test that for yourself by pulling your finger backwards.  You will notice pain begins when you pull it back too far.  Tissue is either stretched due to stress or stretched due to inflammation.  So the increase of fluid in the joint space stretches the tissue and sends a pain stretch signals to the brain. 

The increase of fluid over the joint space is fluid that is not circulating well.  This translates to the cell trying to survive in its own waste bi-products, and starving from the restriction of new nutrients.   After a little time the cell stops functioning.   An example of a cell that stops functioning in a joint is the “Chondroblast.”  This is a cell that builds connective tissue like cartilage.   Another cell is the “Synovial cell.”  This is a cell that produces the jelly like cushioning substance in the joint space called Synovial fluid.  No doubt those of you that have arthritis have heard the term “bone on bone.”  This is a result of the loss of Synovial fluid.  

So just how did the blood supply become restricted in and around the joint space?   This happened either through injury, repetitive use, or chronic lack of motion.   With an injury the tissue experiences little rips (sometimes big gashes) and in the repair process the subsequent split is closed and overlapped in order to secure the tissue.  The tear introduced disruption to small capillaries and the overlapping or shortening of the tissue impeded the larger capillaries.  Blood supply to the joint re-routed and often times did not supply the same tissue with new blood.  This lack of fresh blood supply or restricted blood flow led to lack of fresh nutrition to the area, inability to flush out metabolic waste, and the buildup of mineral deposits like calcium around the damaged area.  An example of what causes an injury is a car accident or a fall.  With repetitive use, small micro tears begin when the muscle over works.  The repair process for a micro tear and a larger rip is about the same leading to disturbance of the blood supply.  An example of this is like a baseball pitcher’s shoulder or a factory worker’s low back having stress on them over and over again.  With chronic lack of motion or static posture, blood circulation is reduced.  For example, constantly having your head forward with bad posture, or working long hours on the computer, or any activity that requires bending forward for an extended time leads to lack of blood flow.   The heart beats and pushes blood through the body and depends partly on the movement of muscle to help squeeze blood back to the heart.  When we take an x-ray or MRI it would reveal loss of joint space, disc degeneration, and bone spurring. 

So that is what is going on with the joint during degenerative joint disease.  You can get this in the shoulder, hands, neck, low back, hip, knees, ankles, and basically any joint area of the body.  So what is the fix?  Some elect surgery to shave off bone spurs, cut out damaged disc material, or fuse the bones.  Let’s think about that for a moment.  Since the joint has gone through a lack of circulation due to some sort of scar tissue in the joint space, does it make sense to cut the same space?  Remember that cutting in surgery is still cutting and cutting creates more scars.  Does it make sense to have the joint manipulated harshly?  Micro or Macro tears still are tears and introduce scar tissue.  I’ve found a number of ways to increase circulation to the joint and improve the normal motion of the joint without introducing scar forming trauma into the joint.

One way of increasing circulation into the joint is to increase overall circulation.  With an exercise that does not put direct pressure on the joint that is damaged, you work towards getting your heart rate to a range of 120 to 140 beats per minute for a solid five minutes per day.  That is perfect work for your heart and the rest of the body.  Next is the need to increase capillary development in the injured joint space.  This can be accomplished by stretching the joint space for 30 seconds 2 to 3 different ways about four times a day.  The stretch should not be painful but you should feel the stretch.  This will release chemicals from the tissue that will stimulate your body to build capillaries in that space. 

In my clinic I use low level laser to stimulate circulation in the joint area.  I also use controlled microburst adjusting with an impulse instrument.  This allows me to retrain the muscles for correct motion without introducing any new rips in the muscle.  This also stimulates good blood flow and reduces the swelling of the joint.  So the name of the game is to restore great blood flow through the joints.  This, I have seen, leads to the restoration of the joint and the reduction of the degeneration. 

How does a joint form arthritis?

Several people get the diagnosis that they have arthritis and assume that is some kind of condition that they can not get help with. There are several types of arthritis.  Some are autoimmune disorders.  I am not writing about those at this time.  I am concentrating on the kind of arthritis that comes from degeneration of a joint via overuse and external damage.   The diagnosis is a little more general than specific by definition. The word arthritis comes from the Latin root "arthro" meaning joint and "itis" meaning swelling. How many people can I tell have joints that are swollen? When knees hurt after working out, could I tell a person they have arthritis? What about when someone worked hard with their hands and they hurt, can't I say they have arthritis of the hands? And what is the common medical remedy for arthritis? Isn't it an anti-inflammatory? A prescribed ibuprofen that reduces inflammation. Celebrex is an anti-inflammatory. Are anti-inflammatories all that good for the human body?

First, let's look at what is taking place in the body under normal conditions: The joint consists of two bones inter-related to form a point of movement. Covering the bones are cells called synovial cells. On the bone side of the synovial cells the blood vessels bring nutrients to the cells. On the joint side of the synovial cells, the cells produce synovial fluid (a runny jelly like substance). This synovial fluid keeps the joint connective tissue healthy and provides a cushion to the joint. Surrounding the joint and forming a capsule is connective tissue, ligamentive material that is tough and flexible. Running over the joint is tendons that attach muscle to the bones above and below the joint in order to move the joint.

In healthy conditions the muscles contract pulling on the bones and the joint flexes according to the design of the joint. Everyone has several different types of bone joints like joints that act like a hinge or a one directional mover like a Elbow joint. Some joints act like a ball and socket like the shoulder joint. Some joints are like a rotational joint that can flex a little with some pivot and side to side motion like the neck joint. Some joints allow small range of motion like the low back joints protecting us from rotational injury.  The muscles move the joint.  Blood vessels carry nutrients and oxygen to the joint.  Nerves give correct information back and forth between the brain and the body.

The muscles move the joints around.  Located throughout the muscle is blood vessels and nerves.  When the muscle strains and sprains small cellular breaks happen in the muscle.  Supportive cells lay down new connective tissue to repair the breaks.  The blood vessels may get interrupted and circulation will be altered. If this happens over and over again then the muscle's flexibility and elasticity becomes reduced.  The circulation through that same space is altered and reduced.  Nutrients and oxygen is reduced to the joint.  The synovial cells starve for nutrition and reduce synovial fluid production.  Muscles become tighter around the joint.

These things make the joint feel stiff.  When we move some, we feel pain from tighter muscles stretching.  Sometimes we feel pain from the bones of the joint pushing together.  This stretch and pain releases inflammatory chemicals to cushion the joint.  These chemicals cause more stretch of muscle, ligaments, and tendons sending more signals of stretching pain to the brain. After a while we give in and take anti-inflammatories.  These anti-inflammatories contain chemicals to stop the prostaglandin molecules and COX molecules.  Yes, this reduces the inflammation.  Guess what though..., prostaglandin is also needed to make more connective tissue.  So we stop the inflammation but also we stop the production of connective tissue like important cartilage and synovial fluid.  Oops!  Some one goofed on this one.

The better solution to arthritis is in prevention.  We need to restore the normal movement of the joint. This is done by re-aligning the bones in proper joint position, retraining the muscle to be elastic and flexible, increase the circulation through the area, and restore the nerve function.  Chiropractors are the only practitioners who are trained over four years to do exactly this type of work.  I would not trust this work to someone with a weekend seminar training, a 64 hour specialty training, or even a two year training coarse.  The best trained individual to restore normal joint movements are chiropractors who have trained four years in school for this and have lots of experience with correcting joint movement.  Now there are limitations to the joint.  If the degeneration of the joint has gone for such a long time some repair may be nearly impossible.  I say nearly because as long as you have blood moving through your body, you can make a difference to the joint.  However, saying that, I also have to note that restoration of joints takes time and effort.  Sometimes the damage is so extensive that the majority of us would not continue with the repair process.  So the best thing to do is catch things early.