Osteoarthritis (OA) is a degenerative joint disease that causes a breakdown in the cartilage protecting the ends of our bones. It is the most common form of arthritis, predominantly affecting older adults, and is more prevalent in women compared to men. OA may affect any joint in the body but is usually found in weight-bearing joints such as knees, hips and lower backs, or in the smaller joints of our hands.
Cartilage is a thick, smooth form of connective tissue designed to protect the ends of our bones by providing a smooth surface for joints to glide over during movement. In OA, the surface of our cartilage deteriorates, creating a lack of protective cushioning for our bone ends and resulting in pain, swelling and movement dysfunction.
There are many factors that predispose us to OA.
Age – older adults are more susceptible to OA, particularly those over 65 years.
Increased body weight and obesity – carrying extra weight places more load through our joints, particularly hips and knees. During walking alone there is 2-3 x our body weight being transferred through our knee joints. To put this into context, a person who weighs 60 kg has at least 120 kg of force transmitted through their knees with every step.
Overuse of joints – Careers that involve repetitive heavy lifting, bending, or fine-motor use of the hands, or sports that involve repetitive impact such as running, may increase the risk of OA in certain joints of the body.
Weak muscles – decreased muscle strength means our joints have to bear more load during activity.
Genetics – in some cases, a strong family history can increase our risk of developing OA.
The onset of OA is usually slow and progressive overtime. The most common signs and symptoms include: joint pain and stiffness, reduced range of motion, pain that is worse in the morning or after a period of rest, but decreases with movement and warmth, a feeling of clicking or grating during movement, and mild swelling in the joints. When joints of the lower body are affected, pain is often aggravated by weight-bearing activities such as walking, lifting, and climbing stairs. When the upper body joints are affected pain often increases during activities that involve gripping, holding objects, or delicate fine-motor tasks such as knitting.
Unfortunately we cannot heal the body of OA (without invasive surgeries such as joint replacements), however we can certainly manage and even improve the symptoms associated with it, and in turn reduce the need for such major surgeries. Research has proved that physical activity and weight loss are the most effective conservative interventions for reducing pain and improving function in OA. For the greatest benefit, exercise needs to incorporate both strength and aerobic components, and should be performed on a daily basis where possible. You might ask why ‘exercise’ is the treatment of choice in OA when it’s often physical activity (like walking) that aggravates your pain in the first place? HOWEVER, the aim of exercise in OA is to increase the strength of the muscles surrounding the affected joint and reduce and maintain a healthy body weight, hence reducing the load transferred through joints, and ultimately reducing pain and improving physical function!
If you need help finding exercises that are suitable and comfortable for you, make sure you see your Physiotherapist early as they will be able to guide you and formulate a program that will be tolerable and very helpful for managing and reducing your symptoms of OA.