Introduction
Osteoarthritis is the most common form of arthritis, affecting millions of people worldwide. It occurs when the protective cartilage that cushions the ends of bones gradually wears down over time. Although osteoarthritis can affect any joint, it most commonly impacts the joints in the hands, knees, hips, and spine. While the joint damage caused by osteoarthritis cannot be reversed, the symptoms can usually be managed. Physiotherapy is the most effective conservative treatment for people with osteoarthritis. Physiotherapists guide patients on how to stay active, which can help slow the progression of the disease and improve pain and joint function. To begin your rehabilitation journey today, consider searching for the best physiotherapy services nearby.
What is osteoarthritis?
Osteoarthritis (OA), also known as degenerative joint disease (DJD), is the most common form of arthritis. In healthy joints, hyaline cartilage covers the ends of each bone, providing a smooth, gliding surface for joint movement and acting as a cushion between the bones. In OA, this cartilage gradually breaks down, leading to pain, swelling, and difficulty moving the joint. As OA progresses, bones may deteriorate and develop growths known as bone spurs. Fragments of bone or cartilage can break off and float within the joint. Additionally, an inflammatory process occurs in the body, causing the release of cytokines and enzymes that further damage the cartilage. In the later stages of OA, the cartilage is completely worn away, resulting in bone-on-bone contact, which leads to increased joint damage and more severe pain.
Type of OA and Risk Factors
Primary Osteoarthritis:
This form of OA occurs without any preceding injury or condition. It has a strong hereditary link and predominantly affects middle-aged women.
Secondary Osteoarthritis:
This form of OA arises due to a specific trigger that speeds up cartilage deterioration. Common triggers include:
- Injury: Bone fractures can heighten the risk of OA and may lead to its earlier onset.
- Abnormal Mechanical Forces: Factors like repetitive occupational stress or obesity can lead to OA development.
- Inactivity: A lack of physical activity can negatively impact joint health and contribute to OA.
- Inflammatory Diseases: Certain conditions, such as Perthes’ disease, Lyme disease, and chronic arthritis (e.g., costochondritis, gout, rheumatoid arthritis), can trigger secondary OA.
- Underlying Medical Conditions: A history of diseases like diabetes, Marfan syndrome, Wilson’s disease, joint infections, congenital joint disorders, Ehlers-Danlos syndrome, and hemochromatosis is linked to an increased risk of developing OA.
Symptoms of osteoarthritis (according to stages)
Osteoarthritis (OA) progresses through four distinct stages: early, mild, moderate, and severe. Additionally, there is a stage known as pre-osteoarthritis, which can also be diagnosed.
Stage 0 (Pre-Osteoarthritis):
Stage 0, or pre-osteoarthritis, represents a normal, healthy joint before any signs of the disease appear. This stage can also refer to the very early phase of OA, where cellular damage is beginning to occur, but there are no noticeable clinical signs or symptoms.
Symptoms and Signs:
At this stage, there typically aren’t any visible symptoms or detectable signs of OA. However, you may have a history of healed or healing injuries in one or more joints, or you could be overusing certain joints. Subtle changes to the joint lining that could lead to future problems may also be occurring during this stage.
Stage 1 (Early or Doubtful):
Stage 1 of osteoarthritis, known as the early or doubtful stage, involves the initial loss of cartilage between the joints. However, the joint space itself typically remains unchanged at this point. Bone spurs, which are bony growths at the ends of the bones, may begin to form during this stage.
Symptoms and Signs:
At this stage, some people may not experience any symptoms or signs. Others might start to notice mild joint pain, but it is usually minimal and may not significantly affect daily activities.
Stage 2 (Mild or Minimal):
In Stage 2 of osteoarthritis, bone spurs grow larger and may become painful. The space between joints may start to narrow slightly as enzymes begin breaking down the cartilage.
Symptoms and Signs:
Symptoms in Stage 2 can vary. Some people may experience increased pain during or after physical activity. You might also find it difficult to bend or straighten the affected joints. In some cases, pain and stiffness can begin to limit your range of motion.
Stage 3 (Moderate):
In Stage 3 of osteoarthritis, the wear on cartilage becomes more pronounced, and the joint space visibly narrows. More bone spurs may develop, and they can become larger.
Symptoms and Signs:
At this stage, most people experience frequent pain during movement, walking, or other activities that involve the affected joints. Joint stiffness may be more noticeable in the morning and after extended periods of sitting. Swelling in the joints may also be evident.
Stage 4 (Severe):
In Stage 4 of osteoarthritis, the cartilage in the affected joints is significantly reduced, and in some cases, it may be completely absent. The joint space is greatly diminished, and there is less synovial fluid to lubricate the joints. Bone spurs are much larger at this stage.
Symptoms and Signs:
At this stage, individuals often experience intense pain when using their affected joints. Daily activities may become challenging or even impossible. Stiffness, swelling, and inflammation can be severe, further impairing joint function.
Management
The primary objectives in treating osteoarthritis (OA) are to reduce pain and prevent functional decline. The management strategy includes both non-pharmacologic and pharmacologic approaches, with non-pharmacologic treatments being prioritized initially.
- Pharmacotherapy for osteoarthritis (OA) includes oral, topical, and intra-articular options. Typically, treatment begins with acetaminophen (Panadol) and oral NSAIDs. NSAIDs can be administered orally or topically and are usually prescribed on an as-needed basis rather than on a regular schedule.
- For intra-articular injections:
- Corticosteroids: Recommended during flare-ups when patients do not respond to paracetamol or NSAIDs.
- Platelet-rich plasma (PRP).
- Hyaluronic acid.
- There are also disease-modifying osteoarthritis drugs available for treatment.
- Non-pharmacologic therapy for osteoarthritis includes physiotherapy and the use of assistive devices.
- Assistive Devices
Physiotherapists are well-equipped to recommend, fit, and instruct patients in the use of these devices. Examples of assistive devices include scooters, canes, walkers, splints, and shoe orthotics, as well as tools like jar openers, long-handled shoe horns, and steering wheel grips. Certain items, such as braces and foot orthotics, require proper fitting by a therapist.
- Physiotherapy
Physiotherapy plays a crucial role in managing osteoarthritis (OA) by teaching individuals how to use their joints properly and engage in exercises that improve motion, flexibility, and cardiovascular health. Those with OA are at higher risk for falls due to factors like decreased function, muscle weakness, and impaired balance. Additionally, side effects from pain relief medications can increase the likelihood of falls. Therefore, fall prevention strategies are an essential component of therapy.
- Range of Motion (ROM): Range of motion refers to the ability to move joints through their full, natural span of movement. ROM exercises, such as gentle stretching and movements for arthritic shoulders, are designed to take joints through their complete range. Performing these exercises regularly helps maintain and improve joint flexibility.
- Strengthening Exercises: Strengthening exercises involve using weights, resistance bands, or even your own body weight against gravity to build muscle strength. Strong muscles are crucial for supporting and protecting joints affected by osteoarthritis (OA).
- Aerobic Exercises: Aerobic activities, like walking, bicycling, swimming, and using an elliptical machine, improve cardiovascular health by strengthening the heart and lungs. These exercises also reduce fatigue, build stamina, and help manage body weight, which in turn decreases pressure on the joints.
- Strengthening Exercises: Strengthening exercises involve using weights, resistance bands, or even your own body weight against gravity to build muscle strength. Strong muscles are crucial for supporting and protecting joints affected by osteoarthritis (OA).
- Aquatic Exercise: Aquatic exercises, performed in shoulder-height water, provide a low-impact way to strengthen muscles and relieve joint pressure, particularly in the hips and knees. The water’s buoyancy reduces the strain on affected joints while providing resistance to help build strength. Regular participation in aquatic exercise can significantly reduce pain and improve daily functioning in individuals with hip and knee OA.
Frequently Asked Questions (FAQs)
Physiotherapy helps manage osteoarthritis by teaching proper joint use and movement techniques. It also includes exercises that enhance strength, flexibility, and mobility, reducing pain and improving function.
Physiotherapy is highly effective for OA, often as beneficial as medications for pain relief and long-term joint health. While medications reduce pain, physiotherapy strengthens joints, promotes flexibility, and supports functional improvements.
Physiotherapists typically recommend a combination of range-of-motion exercises, strengthening activities, aerobic exercises, and low-impact options like aquatic therapy to protect joints and alleviate OA symptoms.
Yes, physiotherapy can slow OA progression. By strengthening the muscles around joints and improving movement patterns, physiotherapy helps maintain joint health, which may reduce further cartilage wear and tear.
Frequency varies depending on individual needs, but many patients with OA benefit from 1-3 sessions per week, especially during initial treatment. Ongoing sessions or home exercises can support long-term results.
Conclusion
In conclusion, starting your rehabilitation during the early stages of osteoarthritis is essential to minimizing the loss of functional ability. You can receive your treatment at Synapse Physiotherapy, where early intervention can help preserve joint function, reduce pain, and improve your overall quality of life.
Produced by MYSense
Tags :
Back & Neck Pain
- Spine & Core Rehabilitation
- Strength & Conditioning Programme
- Pain Management
- Biomechanical Assessment
- Sports Physiotherapy
- Group Class
Sports Injuries
- Strength & Conditioning Programme
- Pain Management
- Biomechanical Assessment
- Sports Physiotherapy
- Shockwave Therapy
- Group Class
Work Desk Injuries
Pre-Post-Surgical Conditions
Scoliosis & Postural Abnormalities
Neurological Conditions
Osteoarthritis & Rheumatism
Joint degeneration and inflammation happens as the human body grows older, but that does not mean our way of life degenerates as well. Relief your joint pains with a joint effort together with your physiotherapist, who will provide pain-relief treatments and prescribe exercises for your wellbeing.
Conditions Relating To Elderly
Common conditions in the older age population include hips & knee pain, back & neck pain, osteoarthritis, rheumatism, fear of falling and many more. Aging and degeneration of bodily function is inevitable, but here at Synapse, we will help you live the best of your life.