When someone says they have “bone on bone” in their joints, it often refers to a condition where the cartilage that normally cushions the joint has worn away, leaving the bones to rub against each other. This condition is most commonly associated with osteoarthritis (OA), a degenerative joint disease that leads to pain, inflammation, and limited mobility. The phrase “bone on bone” reflects the advanced stage of OA, where cartilage has significantly deteriorated. While joint replacement surgery is sometimes recommended, there are effective conservative methods to manage symptoms and improve joint health.

What Causes “Bone on Bone”?

Cartilage acts as a shock absorber, allowing bones in a joint to glide smoothly during movement. Over time, or due to injury, this cartilage can break down, leading to friction between bones that causes pain and discomfort. Factors such as aging, obesity, previous joint injuries, and repetitive stress on the joints contribute to the development of osteoarthritis.

Symptoms of “bone on bone” arthritis often include:

• Joint stiffness
• Swelling or tenderness around the joint
• Increased pain with activity
• Reduced range of motion

While cartilage loss cannot be reversed, it’s possible to manage pain, enhance function, and slow the progression of OA with several conservative treatments. These options aim to reduce inflammation, relieve pain, and improve joint mobility.

Conservative Management of “Bone on Bone” Joints

1. Strengthening and Mobility ExercisesStrengthening the muscles surrounding the affected joint is crucial for providing additional support and reducing the load on the joint itself. For example, in knee osteoarthritis, strengthening the quadriceps, hamstrings, and gluteal muscles helps to stabilize the joint and decrease pain during movement. Likewise, exercises targeting the core and hip muscles help reduce strain on lower back and hip joints affected by OA.Key exercise approaches include:
   • Strength training: Targeted exercises using resistance bands, weights, or body weights help build muscle to support the joint.Low-impact aerobic exercise: Activities such as cycling, swimming, and walking help maintain cardiovascular health while minimizing stress on the joints.Range of motion and stretching exercises: Gentle stretching and mobility exercises improve flexibility and reduce stiffness, allowing better joint function.
   Regular exercise not only strengthens muscles but also improves circulation, reduces inflammation, and promotes joint lubrication, which can alleviate symptoms of “bone on bone” arthritis.
2. Shockwave TherapyShockwave therapy is an innovative, non-invasive treatment that uses acoustic waves to stimulate tissue regeneration and promote healing. When applied to an osteoarthritic joint, shockwave therapy helps to:
   • Reduce inflammation
   • Improve blood flow
   • Stimulate cell regeneration in surrounding tissues
   • Relieve pain
   This therapy works by breaking down scar tissue and promoting collagen production, improving the structural integrity of tendons and muscles around the joint. Although shockwave therapy doesn’t regenerate cartilage, it can be highly effective in managing pain and improving mobility in patients with “bone on bone” arthritis by enhancing soft tissue health.
3. Dry Needling for Pain ReliefDry needling involves inserting thin needles into specific points in muscles, tendons, or fascia to release tension, reduce pain, and improve function. In patients with “bone on bone” arthritis, dry needling can provide relief by targeting trigger points, reducing muscle tightness, and enhancing blood flow to the affected area.By addressing the muscular tension and imbalance often associated with joint degeneration, dry needling:
   • Improves range of motion
   • Reduces localized pain and inflammation
   • Restores normal muscle activation, which can alleviate stress on the joint
   Dry needling is particularly useful when muscle spasms and tightness contribute to joint pain, helping to restore a more balanced musculoskeletal system around the affected joint.

Holistic Approach to Managing “Bone on Bone” Arthritis

In addition to these conservative treatments, adopting a comprehensive approach to joint health is essential. Here are some additional lifestyle recommendations:

• Weight management: Reducing excess body weight lessens the mechanical load on weight-bearing joints like the knees and hips. This can help prevent further cartilage damage and alleviate symptoms.
• Dietary changes: Incorporating anti-inflammatory foods such as omega-3-rich fish, leafy greens, and antioxidants may help reduce joint inflammation.
• Manual therapy: Techniques like chiropractic adjustments or soft tissue mobilization can help improve joint alignment, reduce pain, and restore function.

When to Consider Conservative Treatment

Conservative management is ideal for individuals who want to avoid or delay surgery, particularly in the early to moderate stages of osteoarthritis. Even in advanced cases, treatments like strengthening exercises, shockwave therapy, and dry needling can help reduce symptoms and improve quality of life. Consulting with a healthcare provider to create a personalized treatment plan is crucial for managing “bone on bone” arthritis effectively.

Conclusion

“Bone on bone” arthritis doesn’t have to lead to surgery or a sedentary lifestyle. With a combination of targeted strengthening exercises, innovative therapies like shockwave and dry needling, and proactive lifestyle changes, you can manage the symptoms of osteoarthritis and maintain joint health. At Central Ohio Spine and Joint, we offer a range of treatments designed to relieve pain, enhance mobility, and help you regain control of your life without the need for invasive procedures.

If you’re experiencing joint pain and would like to explore conservative treatment options, contact us to schedule a consultation and develop a plan that works for you.