Osteoarthritis (OA) is the most common form of arthritis. Categorised as mild, moderate or severe or on a numerical scale, it is a leading cause of pain in older people although it can affect much younger individuals too. It can be diagnosed without an MRI scan or an X-ray. The cases that look most severe on a scan aren’t necessarily the ones that cause most pain in patients.
Osteoarthritis is a condition that affects the joints of the body, particularly the cartilage lining of the joints which help to allow fluid smooth movement. Joints that have osteoarthritis have reduced levels of cartilage lining causing them to feel stiff and painful. This in time can lead to muscle weakness and tightness if you reduce your activity due to the arthritis symptoms.
OA affects the cartilage lining of joints that cushions bones during weight-bearing activity, causing the cartilage to become stiff and more susceptible to damage. If it persists, chemicals start to break down the cartilage, with the result that tendons and ligaments stretch and, eventually, bones rub against each other.
Symptoms include swelling, tenderness and pain, particularly after overuse of affected joints or long periods of inactivity. The severity can vary radically from person to person. Joints often affected by osteoarthritis include those in the neck, lumbar spine and wrist. It is most common in the knee, hip and in the small joints of the hand.
Several factors are thought to increase the risk of osteoarthritis including:
- family history. Some people may inherit a defect in one of the genes responsible for making cartilage, leading to more rapid joint deterioration
- abnormalities and pre-existing conditions. Osteoarthritis can occur in joints severely damaged as a result of a previous condition, such as rheumatoid arthritis or gout.
- joint injury. People who have had a broken bone near a joint are prone to developing osteoarthritis in that joint. Overusing a joint when it hasn’t had enough time to heal after an injury or operation may provoke the condition.
- excess weight. The relationship between OA and weight is not straightforward, but the reasons behind someone increasing in weight such as lack of exercise can be behind why they develop arthritis. Reducing weight may help prevent osteoarthritis occurring or decrease the rate of progression.
- age. The risk of developing osteoarthritis increases as you get older.
Osteoarthritis is aggravated when a joint is overloaded. But it is now understood that if you offload an affected joint, it can reinforce the arthritic problem by deconditioning and weakening the joint.
A happy medium must be found, which is difficult to achieve with ordinary gym equipment like a treadmill, which is 100% weight bearing, or an exercise bike which offloads weight from the knee.
Circle Rehabilitation offers an answer to this conundrum with state-of-the-art equipment which can gradually re-introduce a normal load. The NASA-inspired AlterG anti-gravity treadmill offers the most accurate “unweighting technology” around, reducing a patient’s body weight to the precision of a percentage point, by raising the air pressure around them as they exercise. The high-tech Hydro Physio works on a similar principle, with patients walking or running against the resistance of water, and also enables those whose osteoarthritis is connected with excess weight to burn lots of calories,
Other equipment at Circle which may be helpful for osteoarthritis patients includes the muscle stim neuromuscular electrical stimulator, which can be used on muscles around heavily arthritic joints that have stopped working out of pain; and 3D Gait Analysis, an accurate method of assessing the running technique of fitter patients with arthritis, looking for a return to exercise and sport.
Circle offers both rehabilitation after surgery on an arthritic joint, and rehabilitation to assist the management of osteoarthritis without the need for surgery. With a highly experienced team of physiotherapists including specialists in both upper and lower limb complaints, Circle can cater to the needs of all patients with osteoarthritis.
Patients can come and see a therapist every week, especially helpful for those with lower limb osteoarthritis who need intensive therapy at the start; we are well equipped with ultrasound, ice compressors and heat compressors.
At the same time, our approach is to get patients to understand that they are in control of their problem, and they need to engage positively with rehab, take on board exercises and pain management techniques, and modify some of the things they do on a daily basis. We can try and connect people with other health professionals in their local area who can help them with their onward rehabilitation journey.
Exercise is very important for osteoarthritis patients. They need to strike the right balance between causing pain with over-exercise and their joints stiffening up through under-exertion.
Strengthening exercises help protect the affected joint, making it more stable and reducing pain. Thigh exercises lower the chance of falling for those with knee osteoarthritis. Those with knee osteoarthritis are advised to do hip exercises, and those with hip osteoarthritis, knee exercises.
Aerobic exercise will help patients sleep better, enjoy better overall health and reduce their pain. Swimming is good for osteoarthritis, avoiding strain on the joints because the water supports the weight of the body. Tai chi has been shown to be effective at reducing pain from osteoarthritis, and can boost overall wellbeing.