Osteoarthritis

Osteoarthritis (OA) is degeneration or wear and tear of the joint surfaces, specifically the articular cartilage (cartilage that lines all our joints acting as a shock absorber) and subchondral bone (first layer of bone directly below the cartilage). OA most commonly affects the hands, feet and spine and large weight bearing joints such as the hips and knees. OA can be divided into primary and secondary forms.

Primary OA – chronic degenerative disorder related to but not caused by age (Not all old people suffer OA). As we age the collagen fibres that makeup cartilage begin to weaken and break down. This causes a narrowing of the joint space which can lead to inflammation build up within the joint. In some cases the body responds to such changes through the growth of ‘bone spurs’ or bony outgrowths within to the joint .

Secondary OA: Caused by other factors however the patient suffers similar symptoms. Such factors include diabetes, congenital disorders, obesity, trauma (history of reconstructive surgery in that particular joint eg ACL surgery), infection, gout and several other diseases.

Signs and Symtoms:

  • Pain
  • Stiffness of the affected joint
  •  There can be associated ‘crepitus’ or creaking of the joints
  • Surrounding muscle spasm
  • Weakness of surrounding muscles
  • Symptoms often worse in cold weather

Diagnosis: Can be made by a skilled practitioner from a thorough history and physical examination. X-ray will show the narrowing and changes within the joint, however such findings may not corelate with physical symptoms.

Management: Unfortunately there is no cure for OA. One cannt reverse the degenerative changes that have already occurred, however treatment focuses on effecively controlling symptoms. Physiotherapy treatment can include:

  • Soft tissue massage to tight muscles
  • Electrophysical therapy to assist with pain and inflammation
  • Advice regarding exercise modifcation
  • Use of ice and/or heat.
  • Medications and supplements have been found to help. Discuss this with your GP.

In patients with advanced OA (cartilage has worn away completely) may need to see an orthopaedic surgeon to discuss more aggressive management strategies such as injections or surgical intervention (joint replacement)

If any of this sounds familiar and you would like to make an appointment with one of our physiotherapists please contact us on (02) 9328 3822.

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