Osteoarthritis (OA) is adegenerative joint diseasethat is very common, chronic in nature, and sometimes can be a disabling, depending on location and its severity.
Both men and women are affected by osteoarthritis.
It presents most commonly in middle age, with at least 20% of the elderly population suffering with severe osteoarthritis.
The causes of osteoarthritis include:
- Genetic predisposition or familial link, (family history of arthritis),
- Repetitive patterns of joint usage from heavy or generalised repetitive work causing pain and arthritis in the lower back, sacroiliac jointsand shoulder joints,
- Damage to cartilage from injury and/or trauma to a certain joints and surrounding tissues that can be caused from falls, sports injury, car accidents, and more.
- Obesity causing excess strain on weight bearing joints of the body such as in the knees and hips,
- Body compensations from other injury or strains. For example, right hip arthritis can cause strain on walking. This in turn can lead to limping or favouring weight bearing on the left side. This can then lead to left knee arthritis as a compensation of the body trying to offload the pain and compression or inflammation in the right hip.
Osteoarthritis occurs in the articular cartilage of joints. This function of the articular cartilage is to provide a smooth, lubricated area for joints to move freely and easily, as well as to distribute load across a joint surface.
Osteoarthritis is a progressive joint disease where there is a slow softening and break down of thisarticular cushioning. If there were no articular cartilage, bone would wear away very rapidly due to the friction and lack of lubrication from the joint surfaces themselves and cause bone to rub on bone – which is what occurs in late stages or severe OA.
Changes that occur in the underlying bone when the cartilage has worn away, or is actively degenerating, includes extra bony growths along the joint surfaces (which can be a reactive inflammatory response). These growths are called osteophytes and can cause further pain, restriction in movement and impingement on surrounding structures such as nerves, muscles and the joint itself. For example, osteophytes that have developed in the neck can cause restricted neck movement, pain and stiffness of the neck, but more seriously can cause irritation and nerve pain to the spinal nerves in the neck and give symptoms and pain in the hand, arm, neck and shoulder.
Osteoarthritis occurs mainly in weight bearing joints. These are joints that carry a lot of load like our hips or knees. They also occur in the joints in our hands, shoulders, neck and lower back. Unlike other types of arthritis, osteoarthritis presents asymmetrically, meaning it tends to affect one side of your body instead of both. E.g., only one knee instead of both knees. Usually many joints are affected, though not all are showing symptoms.
Common concerns and complaints include:
- Pain: Worst from extreme movements and better after rest. This pain is often worse at bedtime and slowly increases in intensity over months to years. It is a very slow progressing arthritis. It may cause local tenderness to the joint or cause referred pain – pain presenting in other areas. For example, hip osteoarthritis might also produce pain in the knee from muscle spasm, poor posture, altered walking patterns, muscle weakness and strain.
- Stiffness: occurring most frequently after inactivity – often periods of 30-60 minutes of sitting and first thing in the morning when getting out of bed.
- Swelling and deformity of the joints: This can be caused by instability of the joints – from a loss of cartilage or surrounding muscle weakness. Hard nodules can also be found on your finger joints. These are called Heberden’s nodes and Bouchard’s nodes.
- Crepitus: grating sounds of the joint, for example – in your knees when walking upstairs. This is often produced by friction between areas of exposed bone where the cartilage has worn away.
X-Rays are commonly used in the diagnosis of osteoarthritis. It will often show joints have joint space narrowing which is asymmetrical, as well as sclerosis (whiteningon the x-ray picture which indicates bony change), osteophytes, joint erosions (in certain joints such as the sacroiliac joints, shoulder joints, TMJ joints) and cyst formation as well.Like all types of imaging, findings on an X-Ray may not necessarily match with your pain.
All of these structural changes in the joint lead to a restriction in motion, thankfully not always causing pain. In fact, most commonly in the final stages there may be a loss of function and stiffness, but the joint most likely can become painless!
At St Kilda Osteopathy, we use your clinical presentation and X-Rays or other scans if you have them, and consultation with your other health practitioners to confirm your diagnosis. We also palpate (feel) what is occurring in the joints by taking them through active and passive movement tests, as well as assessing and diagnosing what is occurring in the surrounding soft tissues. From this we will be able to guide you on best management.
And…of course your Osteopath will be able to treat your joints too with “hands on” treatment!! With a focus on and improving the range of your motion andstabilisation – both by working on the joints and connecting tissues, your Osteopath will be able to help manage your Osteoarthritis.
For example, if you suffer from OA in your hip, we would do hands on work to encourage movement through your hip to reduce its stiffness and restriction. We would also work onyour lower back muscles and joints to help overall body movement and decrease overall stiffness. Massaging and mobilising tight muscles that connect from your hip to your knee, from your knee to your ankle, will also assist with the whole movement and therefore function of the hip joint itself.
If we can ensure best movement through the ankle, knee, lower back and muscles of the hip, it will help decrease tension leading into the hip joint itself. Your Osteopath will be able to determine what exercises are best suited to help stabilise and strengthen your hip and postural muscles too. These might include coordination or stretching/mobilisation exercises as well as hydrotherapy. This can include ways to decrease your pain, ideas to stay mobile in a safe manner, and ways to reduce the load on these joints.
Talk to us about your pain or arthritis, and you’ll be amazed at how we can help! Our current patients are!