Osteoarthritis (OA) is the most common musculoskeletal disorder and is the leading cause of pain and disability in the community. It increases with age and is more common in women than men.
Osteoarthritis causes changes in synovial joints, and results in a alterations to the joint surface (articular cartilage), the bone, the synovium and soft tissues surrounding the joint, the muscle and the nerves.
The most obvious finding is changes to the articular cartilage as shown in the diagram above. X-ray changes such as the knee x-ray above are obvious in the later stages of the disease. X-rays are often not sensitive to early and intermediate stage OA.
OA affects quality of life in a number of ways due to:
- Loss of physical capacity
- Effect on general health
- Social effects
- Mental health
It commonly affects the spine, hip, knee, hands and feet, although any synovial joint can be involved. The knee is the most common site comprising around 40% of cases.
Clinical examination is the cornerstone of the diagnosis. Imaging including x-rays and MRI can be used to confirm this diagnosis and exclude other problems. MRI is more sensitive than x-ray.
This is important for OA of the knee, hip and ankle. One study indicated that for every 5 kg of weight gain over the ideal weight there was a 36% increased risk of developing knee osteoarthritis. For people with a BMI over 30 there is a 20 fold increased risk of knee OA.
Activity Modification and Strengthening
Often a person’s activities need to change. This will often include substituting impact activities such as running or even walking with lower impact activities.
Strengthening the muscles around the joint can assist the joint in dealing with shock absorption.
Pharmaceutical and other options
Pain management is important. If your pain is better controlled then you will be able to increase your activity levels, which will assist with weight loss and strengthening. Your Doctor should be involved with your management. In fact optimal management may involve several different professions including:
- Medical practitioners
- Exercise Physiologists
For lower limb OA, shock-absorbing footware is important.
Later stage OA can require surgery.
The American Academy of Orthopaedic Surgeon has published a number of guidelines regarding knee OA. The website address is www.aaos.org.
Our approach to managing osteoarthritis, particularly of the knee, is based on the latest research and is an exercise-based approach. Some patients with osteoarthritis require knee replacement and we have successfully managed over 500 knee replacements. Patients have free access to our gym or can be provided programs to do outside the clinic.
An Affordable Alternative in Physiotherapy
At Advanced Physiotherapy we are aware that many patients cannot affrod extensive one-to-one treatment To provide a more affordable alternative, Advanced Physiotherapy holds six group exercise classes per week - consting only $25 per week. These programs are most suitable for patients age 60+. Each patient still completes an individually prescribes program.