Lee-Anne Hall
OSTEOARTHRITIS (OA) is most common cause of disability in older adults.
According to the World Health Organisation (WHO) an estimated 10 percent to 15 percent of adults above the age of 60 will have some degree of OA.
The prevalence of OA is on the rise due to an increase in related factors such as obesity.
OA is defined as the deterioration of cartilage found between joints which results in bones rubbing together thus leading to stiffness, pain and decreased movement.
OA is commonly diagnosed by physical examination by either a doctor or physiotherapist and where necessary with X-ray or MRI scan.
In general the risk factors for OA include; obesity, lack of exercise, genetic predisposition, bone density, occupational injury, trauma and gender.
Aetiology
OA can affect any joint but it occurs often in knees, hips, lower back, neck, small joints of the fingers and the bases of the thumbs and big toe.
All normal joints have cartilage between them. This serves as a cushion to avoid bones rubbing against each other.
In OA the cartilage breaks down over time leaving the bones to rub on each other. This causes pain, swelling and deceased joint movement.
There are different stages of OA but over time it leads to an inflammatory process which causes more damage and pain.
Signs and Symptoms
Symptoms vary between the different joints affected but there are common symptoms in all joints.
These are;
(1) decreased joint movement
(2) stiffness that goes away after movement
(3) click or cracking sound when a joint bends
(4) mild swelling around the joint
(5) pain worse after activity or toward the end of day
Causes of OA
1 Weight — Research confirms that being overweight puts additional pressure on hips and knees.
Over time the extra weight will cause the cartilage to break down faster.
2 Injury and Overuse — Repetitive movements or high impact injuries to the joints can lead to osteoarthritis.
Athletes or sportsmen repeatedly damage joints, tendons and ligaments which can speed up the breakdown of cartilage.
Again, certain careers require long periods of standing also putting a lot of pressure on the joints.
3 Genetics — Complications of OA
OA can cause a complete breakdown of cartilage which can result in loose tissue material in the joint.
Also, it can lead to osteonecrosis which is bone death.
With repeated injury people can develop stress fractures (hairline crack in the bone).
Other people develop bleeding inside the joint and in worse cases infection in the joint.
Lastly, there can be a deterioration or rupture of the tendons and the ligaments around the joint, leading to loss of stability.
OA Treatment and Management
OA is a chronic condition with no cure. Health professionals aim to manage the symptoms such as pain, improve joint movement and flexibility, help the patient maintain a healthy weight as well as get enough exercise.
The most beneficial ways to manage OA is to have an active lifestyle with exercise.
If one is diagnosed with OA I would advise that they see a physiotherapist.
The Physio will come up with an exercise programme mainly focusing on the strengthening of the muscles around the affected joints.
This eases the burden on those joints thus reducing pain.
Next the programme will include exercises aimed at maintaining or improving joint movement to improve flexibility and reduce stiffness.
Lastly, aerobic exercise to maintain good cardiovascular fitness as well as reducing excess weight.
For people that are overweight a dietician can help plan a good diet programme to help with weight loss.
At home one can learn stretching exercises. Here you slowly and gently stretch the joints to improve flexibility, lessen stiffness and reduce pain.
Exercises like yoga and tai chi are great ways to manage stiffness. If one is interested in these exercises they can join the gym or access YouTube videos on yoga or tai chi that can also be downloaded.
Many people with OA can visit the doctor or pharmacy to get anti-inflammatory medication to help with the pain. A few examples of this medication are aspirin and ibuprofen.
Unfortunately OA can be disabling. Some people struggle to walk or stand for long periods of time due to pain and stiffness. Assistive devices are there to help with function and mobility.
Examples are cranes, walking frames, crutches and wheelchairs.
Studies have also confirmed the use of Natural and Alternative therapies to address and improve a patient’s overall well-being.
These methods include at nutritional supplements, acupuncture, massage, hydrotherapy and relaxation techniques.
In extreme cases the doctor can suggest surgery. An example is knee replacement.
An orthopedic surgeon will perform the procedure to repair or replace severely damaged joints.
In conclusion, OA is a degenerative condition that affects people over time and with increasing age. My advice is to prevent its progression. This is done by having an active lifestyle and eating the correct foods.
For more information about Osteoarthritis please email me on tsepylee@yahoo.com Or follow my blog www.healthpromotionbyleeanne.wordpress.com http://www.healthpromotionbyleeanne.wordpress.com.
Lee-Anne Hall, BSc Physiotherapy