What is Osteoarthritis?

Sarah Cowgill (Physiotherapist – Burnie)

Most of us would have heard the word osteoarthritis. Other people may refer to it as “wearing of the cartilage”, “bone on bone”,” degeneration” but what do all these terms actually mean?

Here at Coastal Physiotherapy we see many people who are suffering from osteoarthritis and help people to manage it daily. We also find there is quite a lot confusion and many misconceptions regarding osteoarthritis.

What is it?

Osteo = relating to the bones

Arthron = joint

itis = inflammation

Osteoarthritis (OA) is a degenerative joint disease that affects 1.9 million Australians. Although often referred to as “wear and tear” arthritis, OA is a disease and not an inevitable part of the ageing process. (Arthritis Australia, 2017)

Osteoarthritis is the wearing down, and sometimes the inflammation, of the cartilage that sits between your joints. Cartilage is present in all synovial joint, e.g. hip, knee, elbow, fingers, spine and many others. The role of the cartilage is to stop the rubbing of bones from occurring and allows free flow of movement in the joint. As the cartilage wears down pain and restriction in movement can occur.

It is important not to get osteoarthritis mixed up with other conditions of the bones and joints such as rheumatoid arthritis (inflammatory autoimmune condition) and osteoporosis (decrease of bony strength/structure) and juvenile idiopathic arthritis (inflammatory autoimmune condition in children). These conditions are different and need to be managed differently.

Do I have osteoarthritis?

As we age all our joints will develop some signs of degeneration. This process can even start in adolescence. It is normal to have some level of degeneration in joints especially as we get older. As we put more load through out joints the cartilage slowly starts to wear out. If the cartilage wears out too much you can start to develop signs of osteoarthritis.

The important thing to remember is that although you may have signs of osteoarthritis (and degeneration of the cartilage) on XRAY it doesn’t necessarily have to impact you and you can be 100% symptom free.

There can however come a stage where the wearing of cartilage starts to cause painful symptoms. Some symptoms of osteoarthritis include:

• Dull pain around the joints
• Worse at end of day
• Increase load increases pain
• Tightness/restriction in movements
• Deep ache
• Inflammation
• Heat
• Worse in cold weather
• Difficulty bending joints

Everyone is different with respect to what level of degeneration starts producing symptoms.

PREVENTION:

The best ways to prevent osteoarthritis are to maintain a healthy weight and to avoid sports injuries (Arthritis Australia, 2017). It is shown that 70% of OA can be avoided if these two factors are adhered to.

Maintaining a healthy weight can help as it limits the load placed through joints and therefore the pressure placed on cartilage. It can also help to avoid secondary factors that carrying excess weight can cause, such as increased inflammation. If you would like some help with maintaining a healthy weight our Exercise Physiologists can help.

Sporting injuries can lead to wearing down of cartilage and expose bone surfaces earlier than normal. A person who suffers a knee injury is four to five times more likely to develop knee OA than someone who does not (Arthritis Australia, 2017). The best way to avoid knee injuries is to follow a sports injury prevention program. These programs focus on building strength, improving flexibility and stability and teaching correct jumping/landing strategies. Our Physiotherapists are highly skilled in providing people with preventative programs. Coastal Physiotherapy also runs a junior development program which has a strong focus on sports injury prevention techniques.

To decrease the risk of developing osteoarthritis, it is also important to be mindful of activities that we perform at work that could lead to joint injuries.

TREATMENT:

If you do suffer from osteoarthritis there are some ways to help manage and possibly eliminate the pain and disability. The best way to decrease osteoarthritis pain is to decrease the load put through the impacted joints.

This involves:

• Avoiding painful activities
• Decreasing weight put through the knee (decreasing body weight)
• Increasing muscle function to take load off knee (strength work)
• Hydrotherapy
• Decrease tightness in muscles around impacted joints
• Knee braces

Working with our Physiotherapists and Exercise Physiologists is the best way to determine how to decrease the load put through your painful joints.

It is also important to find things to manage your pain and stiffness, things like:

• Staying active: move your joints and use your muscles
• Managing tiredness
• Pacing strategies
• Looking after your joints
• Taking pain relief as required
• Heat packs/Heat creams

A lot of people with osteoarthritis can manage their condition by following the above advice. If however your osteoarthritis is still severely impacting your quality of life, sometimes your Physiotherapist or GP may recommend a joint replacement.

Joint replacements involve removing the damaged cartilage and bone and replacing them with a synthetic version. It is a big operation, but a lot of people have great results afterwards. The important thing to remember is that following a joint replacement it is very important to see a Physiotherapist or Exercise Physiologist to regain movement in your joint and improve strength and stability.

Is playing jumping sports bad for you?

While it is well known that joint injuries that occur in children and adolescents can lead to an increased risk of osteoarthritis as adults, participating in sport as children is not a bad thing. Frequency, intensity and duration of recreational physical activity appear to have a minimal effect on the development of OA (National Arthritis and Musculoskeletal Conditions Advisory Group, 2004).

The important part of participating in running and jumping sports is to ensure you are fit/capable to do so. There is a high correlation between decreased strength, balance and coordination and knee injuries and pain when participating in sport. Therefore, it is important to work on these areas to prevent injury as mentioned above.

Furthermore, not participating in sports and activity can lead to decrease strength in muscles and can increase the risk of being overweight; both of which can also lead to osteoarthritis.

If you do have an injury it is important to consult with your Physiotherapist or Exercise Physiologist before returning to any sport.

If you have any questions or think may be suffering from Osteoarthritis come in and chat to one of out Physiotherapists or Exercise Physiologists. Contact us on 64314586 for an appointment.

References:

Waller, B., Ogonowska-Slodownik, A., Vitor M., Lambeck, J., Daly, D., Kujala UM., Heinonen, A. (2014). Effect of therapeutic aquatic exercise on symptoms and function associated with lower limb osteoarthritis: systematic review with meta-analysis. Physical Therapy, Oct, 94 (10). Doi: 10.2522/ptj.20130417

Mistry, D., Chandratreya, A., Lee, PYF. (2018) An update on unloading knee braces in the treatment of unicompartmental knee osteoarthritis from the last 10 years: A literature review. Surgical Journal of New York. Jul 2: 4(3). doi: 10.1055/s-0038-1661382. eCollection 2018 Jul.

Arthritis Australia (2017). Time to move: Osteoarthritis. From https://arthritisaustralia.com.au/wordpress/wp-content/uploads/2017/09/Final_Time_to_Move_Osteoarthritis.pdf

National Arthritis and Musculoskeletal Conditions Advisory Group (NAMSCAG), 2004. Evidence to Support the National Action Plan for Osteoarthritis, Rheumatoid Arthritis and Osteoporosis: Opportunities to Improve Health-Related Quality of Life and Reduce the Burden of Disease and Disability. Australian Government Department of Health and Ageing: Canberra.