Osteoarthritis

Osteoarthritis:

"Osteoarthritis is a degenerative joint condition. It causes pain, swelling and stiffness, affecting a person’s ability to move freely."

With the seasonal changes upon us, many of my clients are starting to "feel" the change is weather. It comes to all of us that have the privilege of growing old and is a normal process of aging. The phase "wear and tear" is an apt description. Just as our skin shows age, the inside of our bodies feels the age through usage. Joints are no different.  The symptoms of osteoarthritis can creep up on you slowly as it does not typically start with pain, rather stiffness,  especially after a period of rest, like early mornings or after sleeping, for getting up after sitting for a while. 

All joints in our body age, but they do not always become symptomatic. The spine, hips, knees, shoulders and ankle are the commonest. Some inflammatory arthritis conditions differ, like rheumatoid arthritis or psoriatic arthritis in presentation as they started younger and in the smaller joints too, like your hands. These conditions are not directly caused by age, rather, inflammatory,  genetic and auto immune related. Here I will focus on osteoarthritis. 

 Arthritis is confirmed with X-rays, however, they are NOT a predictor for pain or symptoms. What I mean by this is that you can have mild arthritis visible on X-ray and severe pain (usually due to soft tissue inflammation) or the most severe x-rays with no symptoms of pain. Because of this, it is usually advised to manage your symptoms and episodes or flair ups of pain.

Symptoms of osteoarthritis include:

• Pain. Affected joints might hurt during or after movement.

• Stiffness. Joint stiffness might be most noticeable upon awakening or after being inactive.

• Tenderness. Joints might feel tender when you apply light pressure to or near them.

• Loss of flexibility. You might not be able to move your joint through its full range of motion.

• Grating sensation. You might feel a grating sensation when you use the joint, and you might hear popping or crackling.

• Bone spurs. These extra bits of bone, which feel like hard lumps, can form around the affected joint.

• Swelling. This might be caused by soft tissue inflammation around the joint.

Types of management 

1. Exercise is the gold standard of medical management. Exercise is beneficial for the maintenance of general good health but more especially for joint, muscle and bone health. Movement eases stiffness and pain rapidly and if at first you can't manage exercise and walking we recommend hydrotherapy. Do what you can until you can do more. Too much will likely aggravate symptoms, so it is best done with guidance and graded exposure for those who are no longer accustomed to exercise. Clinical trials have shown that exercise programs (consisting of aerobic walking, strength training, a second aerobic phase, then a cool-down period) in combination with diet, led to significant reduction in weight, total fat mass, pain relief, and improvements in mobility.

2. Anti inflammatory medication is a common place treatment,  but because of side effects in the stomach or gut, it is not recommended for extended periods without prescription and medical guidance. 

3. Weight loss is often a first line recommendation. Increased BMI  is one of the most significant risk factors for osteoarthritis symptoms and disease progression, especially for the knee involvement. . This is not just because of added load on the joints, but also because of physiological tissue changes.

4. Heat and Ice can be very helpful in alleviating symptoms

5.  Joint Mobilisation and stretches also go a long way in the management, maintaining joint range of movement is very important.  

6. Manual therapy, including Physiotherapy techniques such as soft tissue and joint are also very beneficial when done in combination with rehabilitation, which remains thee primary focus.

7. Medical and surgical intervention may be helpful, such as a scope or joint replacement if indicated.

Osteoarthritis is a huge subject, and here I have just touched on it. There are many other less common symptoms and treatments available. If you are concerned for your joints and are having symptoms that have an impact on your quality of life, it is best to seek a medical assessment. Knowing the actual cause of a pain may change the management options and rehab program and is vital in good management.