Osteoarthritis

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Definition
osteo=bone arthron=joint itis=inflammation A chronic degenerative disease involving the joints, especially those bearing weight; its characterized by the loss of joint smoothness and range of motion.
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Facts

The most common form of arthritis Over 16 million people have OA Known as the wear and tear phenomenon Usually begins gradually and progresses slowly over many years Often confused with rheumatoid arthritis and other joint problems
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Common Misinterpretations

Osteoarthritis
Begins in cartilage

Rheumatoid Arthritis
Begins in synovial

Occurs on one side

Stiffness usually < 30

min. Determined by X-ray Non-inflammatory

membrane Occurs symmetrically Stiffness usually > 30 min. Determined by blood test Inflammatory
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Joints Affected

Most common in:

Knee Hips

Spine
Fingers

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Other Joints Affected

Can also affect:

Shoulder Elbows

Wrist
Jaw Feet

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Risk Factors
Aging Muscle weakness Trauma
Single, repetitive and excessive exercise

Genetic factors Anatomical Factors Obesity: especially involving women and knees
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Who is Affected?
Up to 85% of people over 65 years
Under 45, very uncommon More common in men under age of 45 After age 55, women are more common

Obese people Workers who repetitively kneel or squat increase chance of knee OA
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Symptoms
Aching pain in one or more joints
Like a roller coaster, worsens after exercise

Stiffness, usually after inactivity

sleeping, sitting

Loss of mobility Possible inflammation Joint deformity

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Symptoms cont.

Hips = inner thigh or groin pain, abnormal gait, loss of ROM Spine = neck or low back pain, may have numbness, weakness of arms and legs, loss of balance Knee = crepitus, pain going up and down stairs, wasting of quadriceps, buckling
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Normal Knee

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Osteoarthritic Knee

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Symptoms cont.

Fingers = pain and stiffness, boney lumpiness around joints, problems with dexterity

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Herberdens Nodes

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Bouchards Nodes

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Ways to Manage Osteoarthritis

Occupational changes
Reduce shock to affected joint; avoid repetitive

and stressful movements

Physical therapy
Facilitate exercise, help control joint symptoms Educate, motivate and help modify certain

exercise programs Have a variety of modalities

Electrical stimulation helps strengthen muscles

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Ways to Manage cont.

Weight reduction
Losing weight decreases shock on joints The greater the weight loss, greater benefit

Dietary Factors
Eating a balanced diet = optimizing weight = less bearing of large loads on joints

Heat and Ice

Heat: hot soaks or warm paraffin bath, relieves pain Ice: 20 minutes, reduces inflammation
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Exercise Programs
Stretching
Isometric

Resistance
Aerobic

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Studies Have Shown

Those who participate in physical activity report less pain, improvement of cardiovascular fitness and improvement of everyday living.

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Precautionary Measures
Avoid high-impact activities
stair climbing, jogging, running, tennis, racquetball

Avoid activities that could possibly damage menisci and supporting ligaments ( medial and lateral forces ) Avoid overstretching and hypermobility Different types of OA = different precautions
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Spine = avoid extension and weight bearing

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Ways to Manage cont.

Mechanical Aids
Supports and protects joints

Shock absorbing soles in shoes, orthopedic shoes Splints, braces Elastic supports Neck brace Firm mattress

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Ways to Manage cont.

Medication
Acetaminophen, Aspirin, IB, or NSAID Help exercise sessions, may control joint

inflammation

Exercise
Benefits: reduces pain, stiffness, flexibility,

muscle strength and endurance, ADLs, improves quality of life Undetermined which activity is most beneficial
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Ways to Manage cont.

Surgery Removes joint spurs, realigns joint, joint replacement

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