What is osteoarthritis (OA)?

Osteoarthritis (OA) is a degenerative joint disease that affects the WHOLE JOINT. Many people believe OA just affects the cartilage (layer that cushions and lines the joints). Although the main structure that’s often affected is cartilage, OA also affects the connective tissue, ligaments, and synovium surrounding the joint. Cartilage is a type of connective tissue that lines our joints and not only helps with shock/load absorption but also our ability of a joints to glide smoothly. Our articulate cartilage stores a fluid called synovial fluids his lubricates our joints and helps provide nutrients to our joints. When we move our joints, the synovial fluid is released to help lubricate. Much like a sponge – it’s full of water and when we squeeze it water releases. Similarly, if we don’t move our joints, fluid is not released and therefore lubrication and smooth/free joint play may not achieved.

OA is known as the ‘wear and tear’ condition and is generally associated with ageing. Osteoarthritis can degrade cartilage, change bone shape, cause remodelling of the underlying bone and inflammation, resulting in pain, stiffness and loss of mobility.

OA can affect any joint, but typically affects the hips, knees, spine (neck and back) and hands.

What causes osteoarthritis? (OA)

Factors that may contribute to the development of OA include

  • Age. The risk of developing OA increases with age and symptoms generally, but not always, appear in people over 50.
  • Joint injury. A bone fracture or cartilage or ligament tear can lead to OA, sometimes more quickly than in cases where there is not an obvious injury.
  • Overuse. Using the same joints over and over in a job or sport can result in OA.
  • Obesity. Excess weight adds stress and pressure on a joint, plus fat cells promote inflammation.
  • Musculoskeletal abnormalities. Malalignment of bone or joint structures can contribute to faster development of OA (example: scoliosis, knocked knee’s or bow legged)
  • Weak muscles. If muscles don’t provide adequate joint support it can result in poor positioning and control, which can lead to OA.
  • Genetics. People with family members who have OA are more likely to develop it.
  • Gender. Women are more likely to develop OA than men
  • Environmental Factors. Modifiable environmental risk factors include things like someone’s occupation, level of physical activity, quadriceps strength, presence or absence of prior joint injury, obesity, diet, sex hormones, and bone density.

What are the symptoms of OA?

Symptoms tend to build over time rather than show up suddenly. They typically affect people over the aged of 50, however OA can be seen in younger people as well. Symptoms include

  • Pain or aching in a joint during activity, after long activity or at the end of the day.
  • Joint stiffness usually occurs first thing in the morning or after resting.
  • Limited range of motion that may go away after movement.
  • Clicking or popping sound when a joint bends.
  • Swelling around a joint.
  • Muscle weakness around the joint.
  • Joint instability or buckling (as when a knee gives out).

How to diagnose OA?

We tend to diagnose OA using patient history, thorough examination and an x-ray.

Other investigations can be used to exclude differential diagnosis; routine blood tests can be useful to exclude inflammatory or infective causes. The classical x-ray features of osteoarthritis are:

  • Loss of joint space
  • Osteophytes
  • Subchondral cysts.
  • Subchondral sclerosis

Can you treat osteoarthritis (OA)?

Research demonstrates that the first line of treatment is

Education

Education around how to help manage OA, advise around lifestyle changes and how this may be influencing your pain more)

Exercise

Evidence demonstrates that exercise is the most effective, non drug treatment for reducing pain and improving movement in people who have OA. A great way to start is by adhering to the recommended weekly exercise guidelines (below).

Weight control

Being just 4.5kg puts an extra 7-20kg excess pressure on your knees. Fat is also chemically active and constantly releases inflammation causing proteins. These proteins travel through your whole body and make it a little inflamed everywhere, including in your joints. Every 5kg kg of weight gain confers a 36% increase in the risk of knee OA.

A 5.1kg reduction in weight over a 10 year period decreased the likelihood of women developing symptomatic knee OA by 50%.

Furthermore, Several studies have indicated that the ultimate goal should be an initial decrease in body weight of at least 10% in order to provide significant reductions in pain As a last result, if the above treatments fail, medications, NSAIDs, cortisone injections, PRP injections can all be exhausted prior to opting for joint replacement surgery. Here at Jannali Physiotherapy & Sports Injury Clinic, we are great at diagnosing and then implementing a thorough management plan to help reduce pain and improve functional outcomes.

 

Back to Blog