OSTEOARTHRITIS (OA)
Osteoarthritis is a
degenerative joint disease causing pain and inflammation in the affected
joints. Osteoarthritis involves damage
to the following:
·
Articular
cartilage (cartilage that covers the ends of long bones to minimise friction)
at the end of the long bones
·
The subchondrial
bone (the ends of bones, where the cartilage is attached)
·
The capsules that
surround the joints
·
The muscles
adjacent to the joint
This results in a
less smooth surface for the bones to glide across one another which is why OA
is associated with pain, immobility and disability.
It is common for
Osteoarthritis to affect weight-bearing joints such as the hip and knee, big
toe and on occasions the neck and spine.
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Primary OA
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Secondary QA
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|
Slow progressive
condition after age 45, due to:
·
Excessive loads
placed on normal bone tissue
·
Reasonable load
applied on inferior joint tissue
|
·
Appears before
age 40
·
Clearly defined
causes such as trauma or injury, loose joints, joint infection and metabolic
disorders (gout)
|
What are the signs and symptoms?
·
Localised joint
pain
·
Joint stiffness
in the morning lasting less than 30 minutes
·
Pain aggravated
by prolonged use of joint
·
Pain relieved by
rest
·
Fatigue may occur
from general lack of fitness that results from pain and inactivity
Who gets it and why?
It’s more common as
age progresses – many people over the age of 65 experience some form of Osteoarthritis. Unlike rheumatoid arthritis, OA is not a
systemic problem but simply degeneration of the joint actually affected. For this reason, it’s possible that one side
of the body can be affected without the other side, for example, the left knee
degenerating more than the right knee.
Causes of OA are
varied and for some people no apparent cause can be found. Causes may include:
·
Congenital (from
birth) or developmental deformity such as congenital hip dislocation
·
Joint injury such
as ligament tears
What
are the risk factors?
·
Age
·
Obesity. There is a large body of evidence that
identifies obesity as a risk factor for developing OA of the knee, particularly
in women. People in the upper BMI
quartile (> 30kg) have a 20 fold risk of developing bilateral OA of the
knee.
·
Joint injury
·
Occupational
overuse. The strongest association with
occupational activity has been shown with OA of the knee in men. It is estimated that up to 30% of all knee OA
is attributable of occupational activity that involves repeated knee bending,
kneeling, squatting or climbing.
How
OA can be treated
Treatment is usually aimed at limiting
symptoms such as pain and inflammation.
Rest and heat may help to temporarily alleviate pain. Too much pain however, can cause more stiffness.
Knee and hip replacements are one treatment
option if the Osteoarthritis is severe.
In these cases, exercise under supervision of a suitably qualified
health profession with help with pre and post operative rehabilitation.
Medications that are used in treating OA
include:
·
Paracetamol for
pain relief
·
Non-steroid anti-inflammatory
drugs (can have serious side effects such as stomach ulcers and increased
cardiovascular events (such as heart attacks).
·
Glucosamine –
made up of glucose and an amino acid glutamine.
Provides structure to bone, cartilage, skin, hair, nails. Helps to build proteins that bind water in
the cartilage matrix.
·
Chondroitin –
protects cartilage from breakdown by inhibiting destructive enzymes. Stimulates
production of collagen for building new cartilage.
·
Fish oil (likely
to have fewer side effects and decrease blood cholesterol) has possible
benefits in OA as it decreases pain and inflammation in rheumatoid arthritis.
Physical
therapy and exercise programmes
Physical therapy and exercise improve
flexibility and strengthen the muscles surrounding the joints. People who exercise regularly will typically
have less pain and better function and mobility than those who don’t.
Individualising
a programme
A pre-exercise evaluation is essential
for determining the extent of the arthritis and the presence of secondary
effects of arthritis, such as muscle weakness, joint management, joint
instability and overall deconditioning (a loss of physical fitness resulting
from inactivity).
Types
of activities
Exercise programmes are likely to be
most beneficial when they contain a combination of activities that increase
flexibility, strength and endurance.
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Suitable
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Unsuitable
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Stretching of muscles
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High impact exercise such as running
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Resistance exercises to minimise
strength losses from lack of muscles use, including:
·
Isometric –
without moving the joint
·
Isotonic –
bending and straightening the joint
|
Activity that stresses the knee such
as stair climbing
|
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Endurance exercises for increasing the
heart and breathing rate including walking, swimming and cycling
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Water based exercise – swimming, water
walking, aqua aerobics
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Support
Networks
Arthritis australia.com.au
MyJointPain.org.au
Sunshine Coast Arthritis Support Group
References
iz Gunter
ES – Task 4 – Article Submitted:5
May 2013
