Osteoarthritis (OA)
Osteoarthritis (otherwise known as arthritis) refers to a painful joint condition that is the result of a number of movement, lifestyle and genetic factors that progress as you age. OA is the most common type of arthritis affecting 56% of Australian arthritis sufferers. It affects 48% of people over 50, but can develop at any age. Arthritis can affect anyone, regardless of age, gender or nationality. Arthritis can follow trauma or excessive loading but there are a number of well-known factors that are associated with the development of OA, including smoking, obesity, physical inactivity, poor nutrition and genetics.
Arthritis symptoms can greatly affect a person’s quality of life, causing disability, physical limitations and associated emotional and psychological distress.
In the hand, the most common form of arthritis is at the base of the thumb and the carpometacarpal joint. Other common types of osteoarthritis include OA of the knee and OA of the hip.
How do I know if I have osteoarthritis?
Arthritis involves changes to the whole joint, including the cartilage (the smooth layer covering the end of a bone), the underlying bone, the ligaments and tendons, as well as the surrounding muscles. As OA progresses, the changes to the joint can cause pain and loss of movement. Swelling and changes to the bones on each side of the joint may alter the appearance of the joint.
Some people feel generally fatigued or unwell because of their arthritis, but it affects each person differently. Symptoms will vary depending on what type of arthritis a person has and its severity.
In the early stages most people notice joint stiffness or a mild ache, particularly in the morning. As the condition worsens, pain tends to increase and there will be associated swelling, redness, warmth. In the later stages joints can appear enlarged and slightly different in shape such as the bony bumps in the fingers referred to as Heberden’s Nodes. X-rays may be helpful to check the joint space in the affected joint as this can indicate the amount of cartilage loss and help gauge the severity of the disease.
How can physio help my osteoarthritis?
Your physio will help you manage the symptoms of OA, including ergonomic advice, strategies for everyday activities and strengthening exercises to improve pain and function. Sometimes splints or brace supports can be useful to restrict movement and provide support and positioning, while heat and massage can help reduce pain and soothe sore joints and tight muscles.
Strengthening exercises are added when pain is more settled but they often need to be gradually progressed to avoid aggravation. An important part of managing OA involves changing the way activities are performed in order to reduce stress on joints, especially if they are already sore.
What is hip osteoarthritis (OA)?
Osteoarthritis of the hip joint occurs when the smooth cartilage that covers the ends of the bones becomes brittle and breaks down. This can in turn cause joint inflammation and the formation of bony spurs (bony outgrowths) as the body tries to repair the damage.
OA of the hip is not simply a matter of “wear and tear” as has previously been thought, and although the exact cause is unclear, some risk factors have been identified, including:
How do I know if I have hip osteoarthritis?
Symptoms tend to vary significantly between individuals but common symptoms include:
It is important to consult your physio or GP if you experience any of these symptoms.
How can physio help my hip osteoarthritis?
Physiotherapists can help manage hip OA with hands-on treatment, advice and education on how to manage the condition in a way that best suits you and your lifestyle. Your physio is the best person to advise you on activities to avoid and whether to continue participating in sports.
Your physio will first need to identify which of your muscles are weak and address this weakness by teaching you strengthening exercises that support and protect the hip joint. You may be given exercises to continue on your own at home or you could be referred to a group exercise class or hydrotherapy. You may also be treated with hands-on therapy such as joint mobilisation and massage as these may be of help in reducing your pain. If necessary, your physio may decide to assess your balance and walking pattern to improve the way you walk.
It is important to be aware that there is no cure for hip OA but research shows the condition can be well managed with exercise, weight loss and medications, with no need for surgery in many cases. However, if more conservative management proves to no longer be of help and your ability to perform activities of daily living is significantly limited, then you may be a candidate for a total hip replacement.
What is knee osteoarthritis (Knee OA)?
The articular cartilage of the knee is kept healthy by movement and load. OA develops when the articular cartilage is either exposed to higher loads than it can withstand, often over a long period of time, or when the cartilage itself isn’t able to withstand relatively normal loads.
Knee OA is one of the most common chronic musculoskeletal conditions seen by physios and affects a large percentage of the Australian population. It is a degenerative condition where:
These changes contribute to pain and other symptoms experienced by those with knee OA. There are a variety of predisposing factors including:
How do I know if I have knee osteoarthritis?
Knee OA can have a variety of symptoms, related to the area of the knee joint affected by OA, the severity of the OA, the amount of strength and control around the knee, and whether there are any other conditions present within the knee such as a meniscal (cartilage) tear. However, you will likely experience some or all of the following:
Symptoms of OA knee commonly fluctuate, depending on activity. Initially symptoms may only be experienced during activity but as the condition progresses pain may be experienced at rest and at night.
How can physio help my knee osteoarthritis?
While X-rays and MRIs can play a role in diagnosing knee OA it is important to note that knee symptoms may not always match the features seen on the images. Some people have considerable symptoms without much change shown on their X-rays, while others with quite advanced radiological changes may not be troubled much by pain at all.
Your physio can help in many ways with some management options being common to all people with knee OA and others specific to the individual, including:
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