What is Osteoarthritis (OA)?

What is osteoarthritis?

Osteoarthritis (OA) is a complex degenerative non-inflammatory joint disease that affects the whole joint including subchondral bone, articular cartilage, ligaments and muscles that surround a synovial joint1 [1]. It is characterised by progressive cartilage loss, subchondral bone remodelling and formation of osteophytes narrowing the joint space [2]. Low-grade local synovial inflammation occurs believed to be a result of release of inflammatory mediators from the degradation of articular cartilage [3]. OA is the most common type of arthritis that leads to a gradual decline in health, physical function and well-being if not managed correctly [1]. Hands, hips, lower back, knees and feet are the areas that are most affected by OA.

OA is commonly referred as a “wear and tear” form of arthritis as it is thought to occur as a part of an aging process, however it has been found that aging is not a predictor of OA [1]. The aetiology of OA is however due to the result of excessive mechanical stress applied in context of susceptibility modifiable and non-modifiable factors such as age, genetics, gender, ethnicity, local mechanical factors, obesity and joint injury [2]. OA is a highly preventable and manageable disease, with 70 per cent of cases within Australia preventable by avoiding excess weight gain and joint injuries [1].

 

How common is OA?

OA currently affects one in 12 Australians and is the leading cause of chronic pain and disability world-wide [1,4]. Although the incidence of OA has been found to increase with age, osteoarthritis can occur at any stage, with more than half of the people being of working age [1 ]. It is estimated that within the next four years, the prevalence of OA will have doubled due to the higher rates of obesity also placing people at a higher risk of death compared to a general population [2].

 

Common Causes and Contributing Factors of OA

The causes of OA are not well understood however it has been shown that several biomechanical, genetic, behavioural and environmental factors contribute [1].

Person-level factors [5]

  • Genetics

  • Excess weight and obesity

  • Gender: Higher prevalence in women, incidence rates increases around menopause.

  • Age: Main risk factor however not an inevitable factor of OA

Joint- level factors

  • Abnormal joint irregularity, joint malalignment, muscle weakness and ligament rupture are some local mechanical contributing factors that increase susceptibility and progression of OA [2]

  • Joint injury and certain repetitive joint loading occupational activities [2]

 

 Common Symptoms of OA [6]:

  • Limited/reduced range of motion

  • Stiffness

  • Clicking or cracking sound

  • Mild swelling around joint

  • Pain- worse at the end of day

  • Tenderness

  • Muscle weakness

  • Mild effusion

  • Joint and limb deformity

 

How can physiotherapy help?

Currently physiotherapy treatment and management of OA is focused on reducing mechanical loads and symptom management [1]. Physiotherapy management includes the use of a variety of low impact exercise programs which has been shown to be effective [7]. Exercise based treatment approaches such as walking programs to water and land based strengthening programs have been proven to be beneficial in managing symptoms of OA [7]

Other management strategies include [4]

  • Electrical based therapy

  • Prescription equipment/aids

  • Taping

  • Weight loss program

  • Manual therapies

  • Education on pain and self-management.

Studies has found that the benefits of exercise in OA in relation to pain and physical function has a similar effect to that gained by analgesic and non-steroidal anti-inflammatory medications with fewer side effects [2] Physiotherapy treatment and management will be tailored to target each individual taking into account specific risk factors and patient characteristics.

If you have any questions regarding managing OA better, please give us a call at (02) 8411 2050. At Thornleigh Performance Physiotherapy, we can give you an accurate diagnosis and treatment, to help you get back in action as soon as possible. We are conveniently located near Beecroft, Cherrybrook, Hornsby, Normanhurst, Pennant Hills, Waitara, Wahroonga, Westleigh, West Pennant Hills, and West Pymble.

 

References:

  1. Arthritis A. Time to Move: Osteoarthrtis. http://www.arthritisaustralia.com.au/index.php/reports/time-to-move-arthritis-reports.html: Arthritis Australia;March 2014.

  2. Hunter DJ. Osteoarthritis. Best Practice & Research Clinical Rheumatology. 2011;25(6):801-814.

  3. Berenbaum F. Osteoarthritis as an inflammatory disease (osteoarthritis is not osteoarthrosis!). Osteoarthritis and Cartilage. 2013;21(1):16-21.

  4. Larmer PJ, Reay ND, Aubert ER, Kersten P. Systematic review of guidelines for the physical management of osteoarthritis. Archives of physical medicine and rehabilitation. 2014;95(2):375-389.

  5. Palazzo C, Nguyen C, Lefevre-Colau M-M, Rannou F, Poiraudeau S. Risk factors and burden of osteoarthritis. Annals of Physical and Rehabilitation Medicine. 2016;59(3):134-138.

  6. Michael JW-P, Schlüter-Brust KU, Eysel P. The epidemiology, etiology, diagnosis, and treatment of osteoarthritis of the knee. Deutsches Arzteblatt International. 2010;107(9):152.

  7. Rosedale R, Rastogi R, May S, et al. Efficacy of exercise intervention as determined by the McKenzie System of Mechanical Diagnosis and Therapy for knee osteoarthritis: a randomized controlled trial. journal of orthopaedic & sports physical therapy. 2014;44(3):173-A176.

 

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