Managing Osteoarthritis; what you need to know
Have you been diagnosed with Osteoarthritis? Have you had a scan which shows degenerative changes in your joint or wear and tear in your cartilage? Are you confused about what your options are?
In this article, we explore various strategies of Osteoarthritis management and how you can improve your symptoms to continue doing the things you love.
Osteoarthritis is a common degenerative joint disease that affects millions of people worldwide. Osteoarthritis is characterized pathologically by localised loss of cartilage, remodeling of adjacent bone and associated inflammation. Osteoarthritis affects 33% of people over the age of 75 years, most commonly affecting the weight bearing knee and hip joints, however, can affect any joint in the body. Osteoarthritis can cause pain, impair mobility, limit function and can affect quality of life. The clinical presentation of Osteoarthritis varies largely between people, often presenting with a combination of pain, stiffness and gradual loss of mobility. Commonly we have patients present to Back to Bounce reporting fear and confusion after being diagnosed with Osteoarthritis. People are often led to believe that the only way to improve their pain is to get a joint replacement. However, for mild to moderate cases of Osteoarthritis, there are many effective holistic interventions that can help manage pain symptoms and improve function so you can continue doing things you love.
While there is no known cure for osteoarthritis, there are various holistic management strategies, including exercise therapy, lifestyle modification, inflammation management, healthy weight maintenance and nutritional changes that can help you manage pain and loss of function associated with osteoarthritis. This article explores these different aspects of holistic management and highlights the benefits they can provide to individuals with osteoarthritis.
Mythbusting: ‘But my Xray says my joint has degenerative change…’
An important point to recognise prior to a discussion about osteoarthritis is the fact that 76% of people who are diagnosed with osteoarthritis on an Xray or scan are asymptomatic. New research coming out indicates that scans are poorly related to pain and dysfunction. This means that structural changes on a scan do NOT equal pain, and certainly don’t tell the whole story. Cartilage loss or loss of joint space on an Xray does not necessarily mean you will have a painful joint. Whilst a scan be great to give information about bone and joint morphology, a static 2D image of a joint that moves in many directions does not tell us how the joint moves, how the joint is loaded with different movements or the strength of the surrounding muscles. Osteoarthritis affects not only the cartilage and joint surface of bones, but also the joint capsule, synovium and surrounding muscles. Symptomatic arthritis should be considered as a whole joint disease whereby the cartilage breaks down, inflammation occurs and the synovium becomes inflamed. It is not just about the ‘bone on bone’ appearance of a joint on a scan, but moreso a biological process going on within the joint. Often pain can give information about the sensitivity of the joint and surrounding structures, however pain does NOT mean structural damage.
So, before you become too overwhelmed by the fear that your ‘joint may be worn out’ or you have a serious case of ‘bone on bone,’ read on to learn more about what things you can do to self-manage your joint pain and what your options are.
Exercise Therapy: The Golden Ticket in Managing Osteoarthritis
Currently, clinical guidelines recommend exercise therapy as the main intervention and first line of treatment for osteoarthritis management. Regular physical activity can help alleviate pain, improve joint function, and enhance overall well-being. Many people diagnosed with Osteoarthritis become confused about exactly what exercise to do. Often when people believe they have ‘wear and tear’ in their joint, they become fearful of exercise. However, as osteoarthritis affects the joint surface/cartilage, moderate load and physical activity help to nourish the cartilage. It is important to engage in exercises that are suitable for the individual. Low-impact activities like swimming, cycling, aquatic therapy, yoga and range of motion exercises are great for maintaining joint range of motion and encouraging synovial fluid flow and mobilise the affected joint.
In addition to low-impact exercises, specific strength exercises targeting the affected joints can also be beneficial. Weak muscles around the affected joint can contribute to more pressure or force being placed on the joint and therefore can contribute to pain. Physiotherapy exercises, guided by a qualified professional, can help improve joint stability, increase range of motion, and promote better joint alignment and control of movement. Appropriate weight bearing exercises can also help to deliver nourishment to the joint surface/cartilage to maintain the health of the joint.
As mechanical factors and how the affected joint in being loaded dominates the risk of disease progression, an assessment and appropriately prescribed exercise program is essential for the treatment plan to be effective for the individual. It is essential to have your exercise program guided by an exercise professional to ensure correct technique and prevent potential injury.
Lifestyle Modification: Enhancing Overall Well-being
In addition to exercise therapy, lifestyle modification is another vital aspect of holistic management for osteoarthritis. Making certain changes in daily routines and habits can have a significant impact on reducing pain and improving joint function. Some lifestyle modifications include:
Managing stress: stress can exacerbate pain and inflammation in individuals with osteoarthritis. Engaging in stress-reducing activities like meditation, yoga, or deep breathing exercises can help manage stress levels and promote overall well-being.
Load management: structuring your week and looking at exactly how much cumulative load you are placing on your joints can be helpful. It’s important to find the balance between doing enough or doing too much and this is unique for each person.
Don’t avoid exercise: avoiding physical activity and exercise can make joint pain worse! Avoidance of activity actually leads to increasing symptoms of pain and loss of mobility in the case of osteoarthritis. It is important to understand exactly what type of physical activity is safe for you to do, so you remain confident with movement and stay active. Undergoing adequate physical activity has positive effects on mental health, cardiovascular health, metabolic and hormone regulation so don’t let your stiff and painful joints get in the way of maintaining overall health!
Sleep: a short-term loss of sleep affects inflammatory balance. More research is coming out about the positive effects of good sleep hygiene on inflammatory blood markers, which means that getting good sleep may be important for managing inflammation associated with osteoarthritis. In addition, adequate sleep helps the body’s stress response, central nervous system regulation and immune function. All the more reason to get a consistent sleep schedule!
Inflammation Management: Minimising Pain and Swelling
Inflammation is a symptom of osteoarthritis and can contribute to pain symptoms. It can be powerful to learn how you can manage inflammation as it is an essential part of holistically managing osteoarthritis. There are various strategies to reduce inflammation, including:
1. Hot and Cold Therapy: Applying heat or cold to the affected joints can help reduce pain and swelling. Heat therapy, such as warm compresses or hot packs, can help relax muscles and improve blood circulation. Cold therapy, such as ice packs or cold compresses, can help reduce inflammation and mitigate pain.
2. Medications: Over-the-counter non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, can help reduce pain and inflammation. However, it is important to consult a healthcare professional before taking any medications, as they may have potential side effects or interactions with other medications.
3. Natural Remedies: Some natural remedies, such as turmeric, ginger, and omega-3 fatty acids, have anti-inflammatory properties and can help alleviate symptoms of osteoarthritis. Recent research has shown good effect of less common supplements such as Boswellia serrata extract, pycnogenol, green-lipped mussel extract and undenatured type II collagen in the management of arthritis. Glucosamine and chondroitin have shown good clinical affect in relieving pain long term. It is essential to consult a healthcare professional such as your GP or pharmacist before incorporating any natural remedies into your management plan.
Healthy Weight: A Key Factor in Osteoarthritis Management
Maintaining a healthy weight is highly beneficial for individuals with osteoarthritis. Excess body weight puts additional stress on the joints, leading to increased pain and worsening of pain symptoms. Losing weight through a combination of healthy eating and regular exercise can help reduce joint strain and alleviate pain.
Obesity is the strongest risk factor for osteoarthritis disease onset and progression. Weight reduction could be considered as a functional treatment in knee osteoarthritis management as a 12-15% reduction in loss of body weight has been shown to significantly improve function and reduce pain.
Losing weight through a combination of healthy eating and regular exercise can significantly reduce the strain on the joints and alleviate symptoms. A registered dietitian can provide guidance on creating a balanced meal plan that supports weight loss while ensuring adequate nutrition. It is important to adopt sustainable lifestyle changes rather than resorting to fad diets, as long-term weight management is crucial for effective osteoarthritis management.
Diet and Lifestyle: Nourishing the Joints
In addition to weight management, a healthy diet and lifestyle can play a vital role in holistic management of osteoarthritis. Consuming a nutrient-rich diet can provide the necessary building blocks for joint health and reduce inflammation. Some dietary considerations include:
Omega-3 Fatty Acids: Foods rich in omega-3 fatty acids, such as fatty fish (salmon, mackerel) and flaxseeds, have anti-inflammatory properties and can help reduce joint pain and stiffness.
Antioxidant-Rich Foods: Incorporating fruits and vegetables with high antioxidant content, such as berries, spinach, and kale, can help combat oxidative stress and reduce inflammation.
Avoiding Inflammatory Foods: Some individuals may find that certain foods, such as processed foods, refined sugars, and excessive alcohol consumption, worsen their osteoarthritis symptoms. Identifying and avoiding these trigger foods can help manage symptoms effectively.
Conservative Management vs. Surgery: Making an Informed Decision
When it comes to managing osteoarthritis, a conservative approach is usually the first line of treatment. Conservative management focuses on non-invasive strategies such as exercise therapy, lifestyle modifications, and medication. In the case that osteoarthritic pain continues to develop despite conservative management, therapeutic injections are the next line of treatment prior to surgical intervention. There are several regenerative medicine injection treatments that aim to reduce pain, improve function, and provide an environment to support tissue repair.
Hyaluronic acid injections, also known as viscosupplementation, provide lubricating fluid to the knee joint and can reduce pain.
Platelet rich therapy (PRP) injections use plasma from a patient’s blood to reduce pain, improve function and are designed to encourage tissue repair and healing.
Cortisone (steroid) injections are the most common type of joint injection used but have limited applicability as they may contribute to cartilage loss in an arthritic knee. Some doctors who treat knee arthritis will offer a steroid injection only once, while many arthritis experts have entirely stopped using steroid injections for knee arthritis. The goal of these injections is to reduce inflammation and thereby alleviate knee stiffness, swelling, and pain.
In some cases, when conservative management measures and therapeutic injections no longer provide relief, surgery may be considered. Joint replacement surgery, such as a total knee or hip replacement, can significantly improve joint function and quality of life for individuals with severe osteoarthritis. It is important to consult with a healthcare professional to assess the individual's condition and determine the most appropriate course of action.
Osteoarthritis; the facts
It’s time to change the way we think about osteoarthritis and pain. Here are some helpful facts that may help you to manage your Osteoarthritis;
Pain does not equate to structural damage, but is a reflection of the sensitivity of the knee
Rest and avoiding exercise and physical activity makes pain worse
Graded exercise guided by a health professional is safe and helpful in managing pain and function
Muscle weakness increases load on the joint, so increasing muscle mass is protective for osteoarthritic joints
Lifestyle factors such as managing sleep, staying physically active, maintaining a healthy weight and eating nutritious food can have large influences on osteoarthritic pain and dysfunction
There are many options in managing Osteoarthritis, including adjusting lifestyle factors, physiotherapy management, medication and in some cases, injection therapy, all before joint replacement surgery is considered
In conclusion, holistic management of osteoarthritis is a comprehensive approach that addresses various aspects of the condition from lifestyle through to exercise. Exercise therapy, lifestyle modification, inflammation management, healthy weight maintenance, and dietary adjustments all play crucial roles in alleviating pain, improving joint function, and enhancing overall well-being. By adopting these holistic strategies, individuals with osteoarthritis can take control and be better equipped to self-manage their condition and experience a better quality of life.
To have an individual assessment and comprehensive plan for your Osteoarthritis management, book an appointment with one of our Back to Bounce physiotherapists today to start your holistic journey towards managing osteoarthritis effectively.
At Back to Bounce, our mission is to help people get moving, achieve their goals, and BOUNCE BACK to their BEST
We are a passionate team of physiotherapists who love supporting our community on every step of their rehabilitation journey with expert knowledge, care, guidance, and support. If you need help with pain or injury, or need further information, you can call our clinic on (07) 5378 1571 or book online for an appointment here.
To learn more about our Built for Bones group classes, head to the following pages:
https://www.backtobounce.com.au/blog/built-for-bones-group-class
https://www.backtobounce.com.au/osteoporosis-osteoarthritis
https://www.backtobounce.com.au/blog/management-of-osteoarthritis
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