What is Osteoarthritis?

Osteoarthritis is a degenerative condition in which there is progressive loss of articular cartilage of the joints in the body such as the hands, wrists, shoulders, neck, back, hips and knees. It can be primary (without underlying causes) or secondary (with underlaying cause)

It is most common in women compared to men. Typically, it presents in women 55 years and older however onset can occur at 45 years of age. There is often a history of mechanical joint injury earlier in life such as a repetitive sport, fall or other trauma. Another cause can be repetitive motions or an uncoordinated gait that causes repeated stress on the joints of the legs.

Typically, osteoarthritis presents as a gradual pain that gets worse with activity. Joints can be stiff, have decreased range of motion, be tender and have visible swelling. They are typically tender to touch. Sometimes the joint may feel like it is giving out and pain typically presents as an intense or dull ache that is worse after aggravating activity, in cold weather and with the consumption of alcohol. Arthritis pain after rest typically subsites less than 30 minutes after movement however that depends on the activity.

Co-morbidities (common disease that occur alongside osteoarthritis) include diabetes mellitus and gout. In Australia 33% of people over the age of 75 have symptomatic osteoarthritis, of which 13% of women and 10% of men have arthritic knees. Osteoarthritis affects 6% of all adults and as such is one of the most common degenerative diseases.

Assessment:

When you come to see an osteopath, we will run through an assessment that can help identify the presence of osteoarthritis if it is not already diagnosed. Visually we will look for inflammation, redness and if located in the hands Hebeden’s nodes (small bony growths). We will examine the range of motion in all of your joints and compare them to the other side to ensure that the are the same. We will listen and feel for any joint crepitus (grinding) and look to see that everything is in alignment. We may decide to refer you to your general practitioner for x-ray and a calcium scan if we think there may be any complications of osteoarthritis.

Treatment:

The best treatment outcomes have been seen to occur when there is a combination of health practitioners working together on a case. This can include a rheumatologist, PT, dietician, pain specialist, orthopaedic surgeon, pharmacist, internist and nursing staff. It is important that as a patient you understand the mechanism of osteoarthritis and as such the health professional you are seeing will educated you on the pathology of this condition.

The aim of treatment for osteoarthritis is to decrease the progression of OA, increase joint function/muscle strength, decrease pain and inflammation and increase overall patient outcomes. Common forms of treatment include mobilisation, traction, massage and acupuncture/dry needling if it is appropriate. Every patient is different and so treatment will vary.

It is important to reduce the level of inflammation as it will relieve pain levels. This can be done through lymphatic drainage to remove swelling as well as diet modification to include garlic, ginger, capsicum, turmeric, omega 3 and cacao as well as other anti-oxidants.

Other lifestyle changes include heat, improvement of cardiovascular and aerobic fitness and low stress strengthening. Corticosteroid injections can also be a form of treatment if thought appropriate. Surgical intervention through the use of arthroscopy (removal of impacted tissue), osteotomy, arthroplasty are considered if conservative treatment fails. 

If you would like to receive treatment for osteoarthritis our osteopaths at eclipse health and osteopathy have experience treating this condition and are happy to help! To book an appointment call 5613 3505 or use our website.

References

Arden, N.K., Perry, T.A., Bannuru, R.R. Bruyere, O., Cooper, C., Haugen, I.K., Hochberg, M.C., McAlindon, T.E., Mobasheri, A., Reginster, J.Y. (2021). Non-surgical management of knee osteoarthritis: comparison of ESCEO and OARSI 2019 guidelines. Nature Reviews Rheumatology, 17. pp 59-66. https://doi.org/10.1038/s41584-020-00523-9

Hsu, H. and Siwiec, R.M. (2018). Knee Osteoathritis. StatPearls Publishing. PMID: 29939661. https://europepmc.org/article/nbk/nbk507884

Katz, J.N., Arant, K.R., Loeser, R.F. (2021). Diagnosis and Treatment of Hip and Knee Osteoarthritis. JAMA, 325(6). pp 568-578. https://doi.org/10.1001/jama.2020.22171

Vizniak, N.A., (2019). Evidence-Informed Orthopaedic Conditions. 3^rd edition. Prohealthsys.