Why aren't we calling wrinkles facial arthritis?
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Why aren’t we calling wrinkles facial arthritis?

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Guest Blog by: Todd E. Riddle, DC, CCSP, RKT, CSCS

I turned 44 years old the other day. To some, that makes me “old AF.” To others, I’m still a young “whipper snapper.”

I was speaking to my mother about a picture she had seen of me from my birthday festivities. She commented that I was “getting thin on top, just like your grandfather.” She was referring, of course, to my retreating hairline.

It gave me pause. Not because it causes me great shame, but because I never really noticed. Aspects of my age had been creeping up on me and I didn’t even realize it. This is, in part, due to the fact that hair loss is not painful and it doesn’t really restrict my daily activities. Perhaps it is a bit emotionally painful and a blow to the ego, but definitely not physically. But thinning hair is an expected part of the aging process and widely accepted by our society. In fact, hair loss is entirely normal.

Wrinkles are another expected part of the aging process. We get older and as our skin loses its elasticity, wrinkles appear. Recently, I have begun to notice a few wrinkles here and there. Again, not painful at all and causes me no distress. I’ve accepted that it’s time for me to start seeing age-related change.

In all of this reflecting on my personal journey through aging, I started to think about aging and expectations in regards to interactions with my patients. They say aging, death and taxes are guaranteed in this life, but how many of us stop to consider that what comes with the “age” part is more than just skin-deep? I feel confident no one would argue that wrinkles, be it on your face or anywhere else on your body, are normal and expected. You may not like it, but you know it’s a fact of life.

So, if we are willing to accept that skin sagging, thinning hair and wrinkles are the norm, why can’t we accept that there may be other age-related changes to the rest of our body? Let me give an example. I will use my whisper voice so as to avoid shaming everyone that has…osteoarthritis.

Everyone over the age of, let’s call it 40ish, has some form of it. And it’s 100% normal. Let me say that again for those of you in the back–Osteoarthritis is 100% NORMAL. Not a disease, but a normal process of aging. It’s not wear and tear or any derivative that inspires fear and caution in otherwise healthy patients. It won’t paralyze you.

And, if you want to hear something even more shocking? For many people, arthritis isn’t painful at all. Zero pain. Zilch. Nada. Nope. No pain.

For most of my fellow practitioners, I’m singing to the choir here. But do you take the time to explain this to your patient when they come in telling you about this awful diagnosis they’ve been given from another provider?

Recent research demonstrates this perfectly. In one of these studies, patients with arthritis of the knee, spine and shoulder had MRIs performed. Notice that I said these folks had arthritis of the areas that had imaging. Oddly, even though many of them had arthritis, based upon imaging, many of them had no pain. Zero pain. Zilch. Nada. They were diagnosed with arthritis of the area that was imaged, but had no pain in that area……

Based on research, I’m left to ponder; ‘Is arthritis really a diagnosis?’ Or, is it something a normal finding that average clinicians like to blame because they have no other answer.

What are your thoughts? Since wrinkles don’t hurt is it fair to say that many if not most cases of arthritis also don’t hurt?

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