‘Wear and tear’. ‘Degenerative changes’. ‘Age-Related changes’. All phrases used to describe the same condition – Osteoarthritis (OA). OA is one of the leading causes of joint pain, with approximately 1 in 5 adults over 45 years old suffering from knee OA and 1 in 9 suffering with hip OA. The knee, hip, hands and feet are the most common areas to suffer with OA.
A healthy joint
What is OA?
A joint affected by Osteoarthritis
At the end of every bone is an area of articular cartilage. The role of this cartilage is to decrease friction when a joint moves, allowing smooth, gliding movement. Within OA however, this articular cartilage is degraded due to enzymes in the surrounding tissues breaking it down. This results in more friction when moving and a gradual loss of space in the joint. In some cases, small parts of bone may form in the joint space, known as osteophytes. This is due to a remodelling process . The causes of OA can vary – there can be no obvious trigger, or it can come after a trauma to the joint. Inflammatory conditions can also lead to inflammatory arthritis e.g. Psoriasis. From recent literature, risk factors include advancing age, female gender and manual occupations. The leading risk factor is obesity, making it 5x more likely to suffer from knee OA
Signs and Symptoms
The main presenting feature of OA is a gradual worsening of joint pain, which gets worse with activity and eases with rest. This activity could be a long walk, or even walking up a flight of stairs. The appearance of the joint may change, for example, the formation of nodules in the smaller finger joints, and the joint may swell. Sometimes there may be more noise (or crepitus) coming from the joint, which may or may not be painful. Over time, the range of movement in the joint will decrease and may start to affect daily tasks, such as putting on shoes and socks, standing up from a chair, or bending down to pick something up. The pain tends to be worse in the morning, with increased stiffness for the first 30 minutes – 1 hour of the day, however this will ease. There are many ways to describe the pain caused by OA – a deep ache, intense ache, occasional sharp pain. It will largely be based around the joint area, however may refer to other areas. This is known as referred pain and is due to the surrounding nerve tissues sharing the same convergence point when sending signals to the brain. The brain is then unable to identify the exact location of pain. For example, hip OA can often masquerade as knee pain.
Living with OA
Unfortunately, OA is a progressive condition, and the articular cartilage will slowly be worn away. Some may benefit from injection therapy (Steroid or Hyaluronic Acid) and ultimately joint replacement surgery is the final procedure. All is not lost however, as there are several ways to maintain independence and a happy life!
- Treat your flare ups! – Take the foot off the gas pedal for a while. Ice the swelling, reduce the aggravating activities. Ask for help from your family, friends, GP and Physiotherapist
- Pace yourself – break big tasks down into smaller more achievable tasks that won’t use up all your energy at once.
- Pain relief – Consult your GP with regards to what you are current taking and if there is anything more effective. Common medications, such as paracetamol and ibuprofen, can be escalated if needed. Take regularly for the best effects.
- Can’t go wrong with getting strong! – Strength training provides the muscles with more energy to complete day to day tasks. Even a small bit of strengthening can help with tasks such as climbing stairs and walking. If exercising on land is too painful, a slower control-based class, such as Pilates, or Hydrotherapy (which we offer at our Yateley clinic) is a great alternative! Work with a Physiotherapist to find a good balance for you that challenges you but doesn’t aggravate your pain.
- Adjusting aggravating tasks – assistance devices, such as a long shoes horn, or grabbers, can help with tasks that may be painful. Discuss with a Physiotherapist or Occupational Therapist for advice on which would be most useful.
- Alternative therapies – Mindfulness, herbal remedies and acupuncture may all be useful to relax your nervous system and improve how your brain interprets your joint pain.
- Knowledge is power! – Looking at the websites of Arthritis Charities, such as Versus Arthritis, to read a bit more about your condition and to see how others have managed.
OA is not something to be afraid of. At Thorpes, we will work with you to improve your mobility and pain so you can continue doing the activities you love.
If you are struggling with OA and would like our help then either give the clinic a call on 01276 37670 or click below to book online.
Physiotherapist at Thorpes Physiotherapy