Osteoarthritis

What Is Osteoarthritis?

In a healthy joint, hyaline cartilage lines the ends of bone, where bones meet to form joints. This helps create a smooth joint motion. Hyaline cartilage also acts to absorb shock and cushion the joint. Osteoarthritis is a condition where the hyaline cartilage that lines the joint surface breaks down and wears away, causing joint pain, decreased joint space, stiffness, swelling, decreased range of motion and limited joint mobility. Overtime, OA can progress until the joint cartilage is completely worn and the patient experiences complete bone on bone joint structure. Joint deformation and dysfunctional bone growth can also occur in the form of bone spurs (aka “osteophytes”), which also increases pain. These symptoms can then cause movement (bending/straightening the joint, changing positions like moving from sit to stand, walking, stairs, etc.) to become painful and difficult.

What Are The Causes Of OA?

Osteoarthritis is primarily caused by joint wear and tear, which occurs as people age. Many other factors can contribute to OA, including: genetics, inflammatory disease, previous joint injury, inactivity, obesity, joint misuse, improper muscle flexibility and support, and poor posturing can also contribute to OA occurrence.

What Are The Signs And Symptoms Of Arthritis?

Osteoarthritis symptoms include pain with movement, pain worse after inactivity/prolonged positioning or in the morning, limited range of motion, decreased joint mobility, joint crepitus (crunching sound during movement), swelling.

What Are The Risk Factors Of OA?

Some risk factors for arthritis include:

  • Advancing age
  • Being a Female
  • Obesity
  • Previous injury
  • Genetic predisposition
  • Weakness

How Is Osteoarthritis Diagnosed?

Diagnosis is obtained through imaging, most commonly x-rays. OA can also be diagnosed based on patient evaluation, commonly presenting as decreased ROM, painful passive and active range of motion, decreased joint mobility, swelling, etc.

What Are The Possible Treatments For Osteoarthritis?

Physical therapy is a safe and highly effective way to treat arthritis. Physical therapists use a variety of techniques, including manual therapy, therapeutic exercise, and neuromuscular re-education to create programs that are individualized to each patient’s specific needs. These techniques aim to decrease pain, increase joint space, improve joint mobility, increase range of motion, and increase strength and stability of muscles surrounding and supporting the joints. A focus on functional mobility addresses movement dysfunction by correcting biomechanics and form during common activities, like balancing, walking, stair climbing, and transferring positions. The physical therapist will help the patient decide if they may benefit from an assistive device (short or long term) to help offload the joint (such as a cane or walker). The PT will also work with a patient’s medical team to determine if the patient would benefit from additional examination or procedures, including further imaging, medications, injections, or in severe cases, surgical intervention.

Are There Preventative Steps To Avoid Arthritis?

Maintaining proper joint range of motion, muscle length, muscle and joint flexibility, strength, and muscular stability is key to preventing OA

What Are The Risks If OA Is Left Untreated?

Chronic pain, joint deformity, decreased range of motion, loss of end range motion, impaired mobility (changing positions, walking, stair climibing etc.)

Are There Other Related Conditions To Arthritis?

There are other forms of arthritis that may present with similar symptoms but have different underlying causes.

Key Takeaways About Osteoarthritis

  • OA is a condition where the joint’s hyaline cartilage wears away over time due to wear and tear and joint misuse. It may cause a variety of symptoms, most commonly pain, stiffness, swelling, limited motion, narrow joint space, bone on bone contact, joint deformation, osteophyte formation, poor mechanics, and impaired mobility.
  • It commonly affects individuals of advancing age and is more likely present in those with obesity, female>male, previous injury, and genetic predisposition.
  • Patient’s benefit from individualized PT programs that focus on a tailored mix of manual therapy, therapeutic exercise, and neuromuscular re-education. A holistic approach that examines a patient’s movement and biomechanics, as well as other body parts (including the foot/ankle, hip, and back, in addition to the knee) helps patient’s completely address underlying biomechanical dysfunction that may be contributing to mechanical break down and worsening knee OA.

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