The word arthritis means inflammation of the joint. While there are many different types of arthritis, osteoarthritis (OA) is the most prevalent form, and it affects more than three million Canadians.
In a joint affected by arthritis, the cartilage (a flexible connective tissue which covers and protects the ends of bones) begins to wear down. Cartilage is very important for a joint to function well; it helps absorb shock and allows for smooth movement between bones. When the cartilage wears down in osteoarthritis, this often results in pain, stiffness (especially in the morning), and swelling. Over time, joints affected by osteoarthritis may slowly become bigger, and in severe cases the cartilage may wear away completely and the bones may rub together causing even more pain. The symptoms of pain and stiffness associated with osteoarthritis often cause the joints to be used less often, which ultimately leads to a weakening of the muscles around the joints. This then becomes a negative cycle because if the muscles are weaker, they are less able to provide support for the joints resulting in increased pressure through the boney surfaces.
What Joints are most Commonly Affected by Osteoarthritis?
- End joints of fingers
- Middle joints of fingers
- Joint at base of thumb
- Joints at base of big toe
- Neck (cervical spine)
- Low back (lumbar spine)
What are the Signs and Symptoms of Osteoarthritis?
Osteoarthritis usually progresses slowly over a period of months to years. Below are some common symptoms you may experience.
- You may experience morning stiffness for the first 15-20 minutes after waking up
- At first, the pain may only occur with high impact activities
- As the arthritis progresses, pain may be triggered by regular daily activities
- Pain is ofter relieved by rest
- You may experience constant pain, even when you try to sleep at night
- Your joints may swell and you may lose some strength or flexibility in your joints
- You may experience locking of joints as well as a ‘creaking’ sound when you move them
- You may see a decrease in range of motion or movement in the joint
What are the Risk Factors for Developing Osteoarthritis
Some risk factors for developing osteoarthritis include:
- Age: As people age, their risk of developing OA is increased. However, this does not mean that everyone will get OA eventually just because they get older.
- Family History: Genetics plays a role in the development of OA
- Excess Weight: The more excess weight a person carries around, the more load is going through the joints of their feet, knees, hips and low back.
- Joint Injury: OA can occur in joints that have had previous injury. Sometimes an injury can damage the cartilage in a joint or affect the way the joint moves, making it more susceptible to developing OA in the future.
We do not yet know the cause of OA and there is currently no cure for this condition. However, we do know some factors that can put an individual more at risk of developing OA and some of these factors are under our control. We also have many options to help manage OA in joints that have already developed it including physiotherapy and chiropractic care. It is important to keep the muscles around the joint strong and active.
What do you do if you think you have Osteoarthritis?
If you think you might have OA, it would be a good idea to discuss this with your family doctor. They will be able to assess your symptoms and send you for any X-rays they deem appropriate to help with a diagnosis. If your doctor believes you have OA, they will educate you on treatment options including medications, physiotherapy or chiropractic care and surgery in severe cases.
How can a Physiotherapist or Chiropractor Help with Osteoarthritis?
Some of the key components of a physiotherapy or chiropractic intervention for osteoarthritis are:
Your physiotherapist and/or chiropractor will prescribe specific exercises and stretches to help maximize the range of motion and flexibility in your affected joints. They will also show you exercises to strengthen the muscles that can help protect and support your joints. Your physiotherapist may also recommend some form of low impact exercise, which can help manage your symptoms of pain and stiffness.
Other Therapeutic Modalities
Physiotherapists are skilled in the application of many other modalities which can make a big difference in reducing pain and swelling associated with arthritis. Such modalities include therapeutic ultrasound, laser, interferential current (IFC), TENS, acupuncture, dry needling and Gunn IMS.
Physiotherapists and Chiropractors are experts in using manual therapy for both joints and soft tissues to help modulate pain and increase range of motion.
Custom Knee Bracing for Osteoarthritis
Some trained physiotherapists can measure you for custom knee braces to help with osteoarthritis. We offer the DonJoy Defiance III brace which is highly effective and can help to off load the compartment of the knee affected so you can experience less pain with day to day activities. There are other off the shelf braces that can also help protect your joint and give it support it needs so that the pain can settle and you can begin to strengthen the area.
How can you Manage Osteoarthritis at Home?
Heat and Ice
Applying heat or ice to affected joints can help relieve local pain. Heat is specifically good for relieving muscles spasms and tightness, as well as promoting range of motion. Ice is specifically good for decreasing swelling and constricting blood flow to an already inflamed joint.
A physiotherapist or chiropractor will educate you about ways you can reduce the stress on your joints with daily activities. Some strategies include:
- Maintaining good posture and using good body mechanics with tasks to help protect the joints in your back and legs.
- Changing position frequently can help reduce the stiffness and pain associated with prolonged positions.
- Pacing by alternating heavy tasks with lighter tasks will help reduce stress on your joints and also conserve your energy.
- Controlling your weight helps reduce extra stress on weight bearing joints such as the back, hips, knees and feet.
- Using assistive devices can make daily activities easier and less stressful on your joints and muscles. Your physiotherapist can educate you about the different options. Some examples include grab bars near the toilet or bath tub, a reacher to pick up items from the ground, and a cane to decrease stress on hip or knee joints.
- Bracing and/or taping can be especially helpful to unload painful knee joints affected by arthritis.
Things you can do to Avoid Developing Osteoarthritis?
- If you injure a joint, be sure to seek help from a professional and complete the appropriate rehabilitation program. This should be done at any age.
- Keep your joints strong and muscles balanced with resistance training followed by a stretching regime.
- Maintain a strong core and postural awareness.
- Maintain a healthy active lifestyle. With balanced rest/activity and a healthy diet.
Written By: Reanna Montopoli, FCAMPT Physiotherapist