“Is my pain due to arthritis and is there anything I can do”? This is a question we get asked a lot. There are several different types of arthritis. Wear and tear arthritis, Osteoarthritis is a process that starts before we are 30 and continues at various rates depending on many factors. It is caused by mechanical stress that occurs over time as we use our bodies. In fact many of us are walking around with changes associated with wear and tear that we are not aware of as it is not causing pain. As an osteopath with much clinical experience, it becomes clear that joint restriction (causing poor blood flow) is a much bigger determinant of pain than arthritis. For example in scans done on knees of people who have no knee pain, 68% were found to have cartilage damage and 72% were found to have osteophytes (signs of degenerative arthritis) Guermazi et al (2012) British J Sports Med. Therefore getting joints manipulated and moving again to restore blood flow often markedly reduces or removes pain in stiff joints. The knee is a hinge joint and rotation of either of the bones (the tibia, femur and patella) can cause this hinge to articulate differently, causing pain, clicking and stiffness. Treatment to restore free movement to the working parts of the hinge and get the joint fluid moving well has a positive effect on even very arthritic knees. The main aim of an osteopath is to improve fluid circulation and healing to any area in your body that needs it, including your joints. With healthy structural function, we can be pain free.