Seniors Week Post 2- Osteoarthritis

Osteoarthritis (OA) is a chronic condition characterised by the breakdown of the cartilage that overlies the ends of bones in joints

• It occurs when the protective cartilage that cushions the ends of your bones wears down over time.

• Osteoarthritis affects the entire joint. It also causes:

  • Changes in the bone

  • Deterioration of the connective tissues

  • Inflammation of the joint lining.

What are some of the causes?

Osteoarthritis has no specific cause, however several factors contribute including:

• being female

• genetic factors

• excess weight

• joint misalignment

• joint injury or trauma

• repetitive joint-loading tasks (for example, kneeling, squatting and heavy lifting)

Physical inactivity is an underappreciated casual factor of most chronic diseases, including Osteoarthritis

How Common is Osteoarthritis?

• Osteoarthritis represented over half (59%) of all arthritic conditions in 2014-201

• 1 in 5 Australians (21%) over the age of 45 have osteoarthritis

• 1 in 3 Australians (35%) over the age of 80 have osteoarthritis

What are the Symptoms?

Arthritis affects people in different ways but the most common symptoms are:

• Pain

• Stiffness or reduced movement of a joint

• Swelling in a joint

• Redness and warmth in a joint

• General symptoms, such as tiredness, weight loss or feeling unwell.

What are the Lifestyle Consequences of Osteoarthritis?

What can I do about this?

Four options:

1. Improve activity levels

2. Weight loss and diet changes

3. Pain and anti-inflammatory medication

4. Surgery/injection

What should I do first?

Step 1: Discuss with your Health Professional to create an individualised plan for you.

Step 2:  Maximise the options with the least amount of health risk for you, Activity levels and Weight.

Step 3: Discuss with your Physiotherapist to Adjust Activity Levels and improve strength and ROM

Step 4: Discuss with your Dietician for Weight/Diet Management

What about my pain now though?

1. “Exercise therapy seems to be at least as effective as nonsteroidal anti-inflammatory drugs and 2 to 3 times more effective than acetaminophen (paracetamol) in reducing pain in knee osteoarthritis.”

   1. Like analgesic medication, exercise therapy needs to be taken at a sufficient dose and duration to be effective and ensure optimal and clinically relevant effects on symptoms and impairments.

   2. If your pain is strong to moderate, pain medication advised through your Doctor can be helpful.

2. Compelling evidence from more than 50 randomized controlled trials (RCTs) in knee Osteoarthritis  and 10 RCTs in hip osteoarthritis supports the efficacy of land-based exercise therapy in reducing symptoms and impairments. Compared to the two most common pharmacological pain relievers, exercise therapy seems to be at least as effective as nonsteroidal anti-inflammatory drugs and 2 to 3 times more effective than acetaminophen (paracetamol) in reducing pain in knee osteoarthritis.

What are my options with Exercise Therapy?

1. Strength Training

2. Aquatic Therapy

3. General Activity

Why is Strength Training Important for Arthritis?

• Muscle weakness and wasting is very common in arthritis, as a result of pain and difficulty moving. These factors can also contribute to lower levels of activity, poor balance and loss of independence.

• Research has shown that people with arthritis can safely participate in strength training and can prevent, and even reverse, muscle weakness.

• Regular strength training, under the supervision of a qualified health or exercise professional, is recommended as part of an exercise program for people with arthritis

What are the keys to Successful Strength Training?

To get the most benefit from strength training, you need to:

• Start with close supervision from a qualified health or exercise professional who understands arthritis, ideally a physiotherapist

• Learn the right way to do the exercises to prevent injury or making your condition worse.

• Work with your health or exercise professional to figure out how much resistance to add, and how to adapt the exercise or resistance if it is too difficult.

• Keep challenging your muscles by gradually adding more resistance, doing more repetitions (numbers) of the exercise and regularly changing the exercises in your program.

What about Aquatic Therapy?

• Benefits for symptoms and impairments from aquatic exercise therapy in the treatment of hip and knee osteoarthritis are smaller than the effects from land-based exercise therapy

• Aquatic exercise therapy may also be relevant for individuals with too much pain to exercise in a full-weight-bearing environment

General Activity

• A recent study found that walking more than 6000 steps per day protected against developing functional impairments in people with or at risk of knee osteoarthritis

• Current physical activity guidelines recommend at least 150 minutes of moderate or 75 minutes of vigorous physical activity, in bouts of at least 10 minutes duration per week

When should i consider Joint Surgery?

  Your pain and function have not responded to:

• Weight management

• Appropriate exercise therapy/strength training

• Medications

• Need for Improved movement and use of a joint

  • to walk and sit more comfortably etc

Remember to…

Contact your Health Professional if you have Osteoarthritis to get an individualised management plan

Start with the options with the least side effects: Activity Levels and Weight/Diet Planning

For more information on Senior Strength and Conditioning click here!

To book an appointment click the button below!

The Pontifex Physiotherapy Team

References

1. Physical Activity and Exercise Therapy Benefit More Than Just Symptoms and Impairments in People With Hip and Knee Osteoarthritis. JOSPT volume 48 | number 6 | june 2018

2. Chapman K & Valdes AM 2012. Genetic factors in OA pathogenesis. Bone 51:64–72.

3. Lementowski PW & Zelicof SB 2008. Obesity and osteoarthritis 2008. The American Journal of Orthopaedics 37(3):148–151.

4. Foley S, Ding C, Cicuttini F & Jones G 2007. Physical activity and knee structural change: a longitudinal study using MRI. Medicine and Science in Sports and Exercise 39:426–434.

5. AOA (Australian Orthopaedic Association) 2017. Australian Orthopaedic Association National Joint Replacement Registry Lay Summary: Hip and Knee replacement. Annual Report 2017 (supplementary report). Adelaide: AOA.

6. ABS 2015. National Health Survey: First Results, 2014–15. Canberra: ABS.