Arthritis is a term used a lot by different medical or health professions but what does it actually mean? Many individual’s may have the odd ache or pain in a joint and may be lead to believe they have arthritis or have concerns regarding if they should be continuing with their regular day to day activity or resting. If I’ve been told I have arthritis what can I do about it? Will it get any better? how do I manage my joint pain? These are all questions that are encountered or thought of by your everyday Australian suffering from this condition.
The musculoskeletal condition Arthritis refers to inflammation of a joint. Arthritis may present as pain, stiffness, disability and or deformity of a specific or m ultiple joints. 3.6 million or 1 in 7 Aussies deal with Arthritis, with it more common in females (18%) opposed to males (12%). There are many different types of arthritis, some of which are more common and well known are rheumatoid or psoriatic arthritis, which are autoimmune diseases; and Osteoarthritis (OA), involving the wearing of cartilage and bone of joint surfaces from mechanical stresses. The later, being the most prevalent accounting for 62% of Australian’s with arthritis having OA. In other words, OA could be the likely joint condition effecting your uncle, grandma, mum or son’s quality of life [1].
OA may effect any joint though is commonly occurring in the hips, knee’s and hands. Anybody can get it, however OA prevalence tends to increase from 40 years
of age or be more common in individuals with previous joint injury. So what causes it? Previous joint injury, altered joint alignment, family history of OA, or repetitive loaded movements and increased BMI (body mass index) can increase an individual’s risk of osteoarthritis. Chances are if you’ve done a lot of heavy lifting on the farm or worksite for your whole career you may have some OA effected joints. A lot of the time people may experience an injury or previous trauma and that alters the way they walk, stand or move; this change in their movement causes increased mechanical forces or stresses on their joints to which they are not equipped to handle [2].
Can you manage it? Absolutely. Exercise is shown to be an effective management strategy for OA. If you consider the causes for your arthritic joint pain and the current limitations that may be forced upon you as individual with OA that may hindering your lifestyle; what are the most effective ‘programs’ to help improve your quality of life? That’s our job to figure out as physio’s and guide you through your rehabilitation. Pain and weakness often correlate. Strengthening and exercise can improve function and decrease pain. The biggest hurdle for many individuals is the pain is difficult to overcome, when something hurts we want to avoid it right? Human nature. However this avoidance of activity leads to further deconditioning. Pain doesn’t always necessarily mean damage is being done. The fact that we’re avoiding moving cause of the pain means the muscles supporting the joint are getting weaker. A progressive exercise program overseen by your physiotherapist in conjunction with hands on manual therapy to decrease restrictions in range of movement can promote strengthening of musculature to support the joint. Strengthening will decrease load on directly on the affected joint/s thus help individuals manage their symptoms [3].
For lower limb OA such as hip or knee the ability of people to walk is often the biggest priority. IF your condition is affecting your gait the restoration of this is at the forefront of physiotherapy management. Therefore for most OA conditions with the lower body hands on therapy would be targeting any restrictions in flexibility or range of motion to improve an individuals ability to walk and move correctly with the appropriate pattern; and further exercise therapy strengthening of muscles around the hip and knee targeting your glutes, hamstrings and quadriceps would be incorporated. Cycling and hydrotherapy exercise are a very effective alternative to build strength and endurance in a low-impact setting [3,4].
The importance of diet, exercise and increasing activity levels to lose weight is no secret and well documented. Further pain management advice and or prescription provided via your doctor to assist participating in exercise may also be helpful. In more severe circumstances orthopaedic joint replacement surgery; or mobility aids may be used as part of a treatment plan to promote activity and offload mechanical stresses on affected joints. Your physiotherapist can work together with you to tailor a program to target your physical impairments as well as any other psychosocial factors that are effecting your OA and quality of life.
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