I am starting second year of my Physiotherapy studies and my lecturer has tasked the cohort to revise our knowledge on Osteoarthritis (OA).
I thought this offered the perfect opportunity to share overview and at NW Sports massage I often have clients that have reduced mobility, pain and stiffness due to OA and Sports massage/ manual therapy can be a great way of easing symptoms.
OA is not as simple as wear and tear on the joints there are usually many factors at play such as metabolic, environmental and genetics, carry on reading to find out more.
WHAT IS OSTEOARTHRITIS (OA)?
OA is a common form of arthritis that can effect any joint in the body, however, is more commonly seen in the weightbearing joints such as the knees and hips. It is a degenerative joint disease and is a major cause of disability and pain in adult individuals, most cases affect adults who are 45years and older and is more severe and common in females. Obesity and being over-weight is also a important factor in causing OA especially in the weight bearing joints.
Cartilage is a strong and smooth connective tissue. Its main function is to prevent friction by covering the ends of our bones where two bones meet at a joint, therefore, allowing the joints to move more freely. When a joint develops OA the surface becomes rougher and cartilage thins meaning movement isn’t as smooth as it should be. When the cartilage becomes damaged the body initiates a repair process which may change the structure of the joint, often the joint will still work normally and without pain, however, sometimes these repair processes can cause some of the symptoms that are discussed below.
Here is a short video on What is OA? What is osteoarthritis? - YouTube
WHAT ARE THE SYMPTOMS OF OA?
Pain and stiffness and tenderness in affected joints
Pain tends to be worse at the end of the day or when you move the joint
Stiffness that usually reduces once moving
Symptoms can vary depending on what activities you are doing.
Reduced range of motion in a joint
Crepitus sounds when moving (grating or crackling)
Swelling – which may be hard and knobbly e.g. fingers due to extra bone growth OR soft caused by thickening of joint lining and extra fluid.
Muscle weakness or wasting
It is common for OA to be referred to as being caused by ‘wear and tear’ however, normally activity and exercise DO NOT cause OA.
A previous trauma or injury to a joint can lead to OA in later life.
WHAT IF I HAVE OA?
There is no definitive test to diagnose OA. However, your GP or healthcare professional can carry out a review to find out more about your symptoms and to determine if OA could be the cause.
Likely categories for diagnosis of OA are if you are over the age of 45 years and have activity related joint pain, plus, has either no morning joint-related stiffness or morning stiffness that lasts no longer than 30 minutes of being out of bed.
MANAGEMENT – (This is not a exhaustive list!!)
EXERCISE – People can worry that exercise will increase pain or cause more damage,
however, too much rest can increase joint stiffness. Nice guidelines recommend that long term adherence to an appropriate exercise plan increases its benefits by reducing pain, increasing functioning, and improving quality of life alongside behavioural changes. You should seek advice from a physiotherapist on the most helpful and beneficial ways to exercise.
TIP: Try using a hot water bottle/ warmth prior to exercise to ease the stiffness.
Types of exercises you should include will be range of motion, strength and aerobic (cardio). Hydrotherapy can also be a great form of exercise due to the water supporting weight, as can Pilates for maintaining mobility which you can read more about from my previous blog by clicking here.
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WEATHER – The weather does not cause OA but it can intensify pain, especially when it is due to rain or when cold. This sounds like a great excuse for a holiday and some winter sun!!
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DIET – Being overweight is a contributing factor to OA. Weight management and weight loss could help reduce symptoms in weight bearing joints, plus, reduce likelihood of developing OA. You may find certain foods in your diet increase or reduce symptoms. It would be worth keeping a diary of what you’re eating and how it’s made you feel to keep track of this.
PAIN MANAGEMENT – Versus arthritis recommends that if you are finding movement painful then taking paracetamol short term may help to alleviate pain. Ibuprofen or NSAID gels, creams and patches are also useful and available at pharmacies and supermarkets. These can work well on joints such as knees and hands but will likely have less effect on the hips. If you find that these methods of pain management are not working you should speak to your doctor.
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MANUAL THERAPY – This can be used alongside your exercise and other management methods to help gain and maintain mobility and ease symptoms/pain. At NW Sports massage I use a range of techniques and stretches that can aid this, also, relieving muscles that may of become tight due to protecting sore joints, reduced range of motion and stiffness. An assessment of your posture could help as good posture will put less strain on your joints. NICE guidelines do not recommend acupuncture or dry needling for treatment of OA.
You can book your appointment at NW Sports Massage here.
SURGERY – Majority of people with OA will not need surgery and it is often only done once other options have been exhausted. Options include:
Joint fusing – where the bones in the joint are surgically fixed together which prevents movement of that joint.
Joint replacement surgery (Arthroplasty) – This is major surgery in which will require a full rehab/ physiotherapy program once complete and benefit from prehab before surgery too!
Most common are knee and hip replacements and here are links for you tube videos on what happens with during the surgery.
Arthroscopic lavage (key hole surgery) Is not recommended as there is no evidence that this reduces pain or improves physical function
SUMMARY
There is so much you can write about OA and this blog is just an introduction into it. But to sum up OA develops when the cartilage which protects the ends of our bones on our joints roughens and thins which can cause both pain and stiffness. OA commonly affects more females and at over 45 years of age. It is estimated it effects over 10 million people in the UK. The plus side is there are SO many ways we can help manage symptoms including, exercise, good diet, pain management and as a later resort surgery, plus many more. We have to be looking at individual management and what works for you. OA is often a condition that often does not get steadily worse over time but instead reaches a peak (often after a few years of symptoms commencing) and then stabilises or may even improve. I hope you have found this blog both informative and helpful.
To find out a whole load more about OSTEOARTHRITIS and other arthritic conditions I would highly recommend visiting the VERSUS ARTHRITIS website here.
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