Osteoarthritis, commonly known as wear-and-tear arthritis, is a condition in which the natural cushioning between joints and cartilage wears away. When this happens, the bones of the joints rub more closely against one another with less of the shock-absorbing benefits of cartilage. The rubbing results in pain, swelling, stiffness, decreased ability to move and, sometimes, the formation of bone spurs. Knee osteoarthritis a common and growing problem. Surgery including knee replacement is an option, but whilst generally safe and successful is certainly not a first line of treatment. Before considering surgery there are a few ideas that may help reduce the pain and impact of knee osteoarthritis.
1. Weight Management
A heavier person will place more load on their joints. There is a clear link between osteoarthritis and obesity. The Obesity journal states that “Even in people without arthritic change, those who were overweight (Body mass index of 25 – 30) reported 20% higher levels of pain. For those who were obese (BMI of more than 30) the reported pain levels were 68% higher, for those with a BMI of 35 – 40 it increases to 136% higher levels of pain and those with a BMI above 40 had a shocking 254% higher level of pain.” Even moderate weight loss will make a big difference.
As well as helping with weight management, physical activity strengthens, lubricates and stabilises the joint. Your Physio can give you specific exercise that will work to strengthen the muscles around the joint providing stability.
3. Custom Knee Brace
A range of knee braces are available to help relieve pain and provide stability. The type of knee brace required depends on a number of factors including the part of the knee which is affected by arthritis.
4. Electrical Stimulation
A neuromuscular stimulator can be used to help to strengthen muscle, whist a TENS machine provides drug free pain relief. TENS is an abbreviation of Transcutaneous Electrical Nerve Stimulation. Transcutaneous means “across the skin”. In simple terms, a tens machine stimulates your nerves via an electrical current through your skin.
5. Knee Injections for Osteoarthritis
There are two types of knee injections used for osteoarthritis. A corticosteroid injection can give short term pain relief and is useful at times of flare up. Viscosupplementation injections are proven to give longer term pain relief, up to one year, in knees with mild to moderate osteoarthritis. See your practitioner to discuss this option.
Your Shelbourne Physiotherapist can help you develop a plan specific to your condition
Our joints change with time, and as we age we experience aches and pains and a gradual loss of mobility. However, osteoarthritis, one of 150 different forms of arthritis, is not simply a matter of getting older. It is a degenerative process that results in relatively rapid deterioration of a joint. Osteoarthritis generally affects people in their 60s and 70s, but can also occur among those in their 50s and younger. In most cases, a regular exercise program designed to maintain flexibility, muscle strength and endurance, will help people maintain their normal activity level. Wear and tear of your joints may occur due to aging, injury, injuries, prolonged poor posture, overuse of joints, or excess weight.
The early symptoms of osteoarthritis are recurring pain and stiffness in the joints. These symptoms are especially noticeable first thing in the morning or after sitting in one place for lengthy periods of time. Other symptoms may include swelling, obvious redness or a feeling of heat, and inability to move a joint. As the disease progresses, the damage to the joint increases. Osteoarthritis affects people in varying degrees. Despite permanent changes to the joint, some people may be pain-free, or suffer only mild or occasional pain provoked by episodes of increased use or minor trauma. For other people, symptoms can be disabling and, when the larger joints of the body are involved such as the hip or knee, the severity of the problem may require surgical treatment. The most commonly affected areas include knees, hips, hands, neck and back.
Shelbourne Physiotherapy can help
Shelbourne Physiotherapists are health professionals skilled in the assessment and treatment of the symptoms of osteoarthritis. Your individualized physiotherapy treatment program will help:
- Reduce pain;
- Improve movement and posture;
- Strengthen muscles; and
- Improve independent function.
Movement loss caused by osteoarthritis follows a predictable pattern depending upon the affected joint. A physiotherapist can diagnose the progress of the disease by measuring the mobility of the joint, the strength of the supporting muscles and the limitations on your activities. The physiotherapist will then prescribe an exercise and activity program ‘tailored’ for your individual situation. An effective exercise program may help reduce the amount of pain medication you require, as well as:
- Maintain or increase mobility;
- Improve joint lubrication and nutrition;
- Restore muscle balance and flexibility;
- Improve circulation and endurance;
- Improve strength and stability; and
- Improve poor posture.
Range-of-motion and stretching exercises will help maintain the maximum possible movement in the joint. Stretching will help maintain or restore flexibility to the joint’s muscles and tendons. Exercising in water is also beneficial as body weight is off the joints: exercising in water can also provide resistance to strengthen muscles. Other treatments provided by our Shelbourne Physiotherapists may include heat, electrical treatments, hydrotherapy, splints, and advice on preventing further joint damage. These treatments are often used in conjunction with anti-inflammatory medications that control inflammation and alleviate pain. Rest, balanced with exercise and activity, is an important part of managing your osteoarthritis. Rest is especially important when joints are hot, swollen or painful. There are several other ways to help manage your osteoarthritis:
- Always ‘respect pain’ – don’t keep ignoring the discomfort;
- Avoid overstressing joints – use proper body mechanics;
- Avoid jerky or sudden movements when possible;
- Maintain a healthy body weight;
- Use splints or walking aids if necessary; and
- Never overdo activity or exercise.
Our Victoria Physiotherapists can also provide you with suggestions on how to pace your everyday activities, so you can continue to do them in a way that causes the least problem. As a general rule, if any exercise hurts then DON’T DO IT. Sometimes, simple changes such as wearing rubber-soled shoes or sitting in a different chair may help ease your symptoms. Regular exercises like swimming, exercising in water, walking or cycling are also recommended. If your osteoarthritis affects your neck or low-back, or if any joint appears hot, swollen or painful, do not perform exercises without first consulting your physiotherapist.
Exercise and Manual Physiotherapy Arthritis Research Trial for Osteoarthritis of the Hip: A Multicentre Randomized Controlled Trial’ (2013) Archives of Physical Medicine and Rehabilitation 92(2), 302-314.
Hypoalgesic and Motor Effects of Kaltenborn Mobilisation on Elderly Patients with Secondary Thumb Carpometacarpal Osteoarthritis: A Randomized Controlled Trial’ Journal of Manipulative and Physiological Therapeutics 34, 547-556.