Arthritis is one of the most pervasive and misunderstood conditions. Simply put, it means inflammation of a joint. Today, we will focus in on one type, osteoarthritis (OA). It is a major source of pain and disability, impacting 1 in ten Australians. It typically affects our weight bearing joint being our neck, low back, hips, knees and hands often presenting as stiffness. As common of a condition as it may be, the physiological mechanisms of its occurrence are still poorly understood. However, we are aware of the risk factors that predispose us to it:
In relation to our knee, 10-15 years after a knee cruciate (ACL or PCL) ligament rupture or meniscal tear it will lead to advanced osteoarthritis
Fat circulating molecules have inflammatory properties that affect our joint health
Increased mechanical load through our joints
50% of people with this, will develop OA in the hand joints
Operating heavy machinery, more likely to develop OA in the hand joints
Painters and carpenters, more likely to develop OA in the knee joints
Farmers, more likely to develop OA in the hip joint
With ageing it is normal to experience changes in our joint health. I think of these as “wrinkles on the inside”. In a similar way, as we get older we also have changes in our skin. It becomes less taught or shiny which can be referred to as wrinkles. We accept these changes to our skin as a normal part of ageing, however, we often reject osteoarthritic changes as normal. To manage our skin health we use moisturiser and sunscreen, keeping our skin fresh and vibrant. Likewise, with our joints, we have many interventions to that help combat the symptoms of osteoarthritis.
The focus is shifting to disease prevention and treatment of early osteoarthritis. Below is your best management plan to tackle OA head on:
First Line of Defence
See your Osteopath or health professional:
Education – often understanding something can have a big impact
Manage musculoskeletal flare ups, unfortunately these may be inevitable
Strengthening muscles around a joint provide it with stability
Aerobic conditioning specific to your capacity such as swimming, cycling, rowing or tai chi
Weight management: decrease mechanical load through joints
Medication: consult with your doctor or pharmacist regarding the benefits of non-steroidal anti-inflammatory medications. If these are not suitable, a topical cream such as Fisiocrem can be used
Third Line of Defence
Joint replacement: if you have persistent pain, night pain, and limited function and have attempted to reduce modifiable risk factors, only then are you a candidate for a joint replacement or specialist consultation. It is an effective treatment for symptomatic end stage disease, although functional outcomes and lifespan of the prostheses are highly variable.
Arthroscopy: currently no evidence to suggest any benefit
There are no quick fixes or fad diets that will resolve your symptoms arising from osteoarthritis. Rather a multifactorial approach will place you in the best position to manage your own health.