Arthritis or joint pain involving the knee, hip and back are common among older people. Symptoms of arthritis like pain and swelling of the joint are often the cause of many medical consultations and increasing health care cost. Unlike rheumatoid arthritis, osteoarthritis affects single joints, often one-sided, and is not associated with other inflammatory conditions.
What is Osteoarthritis?
Osteoarthritis is a degenerative disease that involves inflammation and wearing of the cartilage of weight bearing joints and other joints of the body that are usually exposed to stress. Weight bearing joints include the hips, the knees and the spine, while other joints that may be subjected to stress and injury are the fingers, the neck and the large toe.
The cartilage is the rubbery part at the ends of bones that cushion the joint and prevent bones from rubbing into each other or causing friction during motion. It serves as a shock absorber as it changes its shape due to its elasticity during motion. When subject to constant stress or injury it can become inflamed, worn and lose its elasticity, producing the symptoms of pain, swelling and rigidity.
Factors that contribute to the development of osteoarthritis are age, overuse of a joint, obesity, heredity and previous injury.
It can usually be diagnosed by complete history, physical examination and X-ray imaging.
Treatment initially given is resting of joint, hot and cold compress and oral medications for pain. The patient is advised to reduce weight if obese, and to use supportive devices like crutches if necessary. Joint surgery may eventually be advised to repair or replace a worn out joint cartilage. However, aside from surgery, these therapeutic modalities may not slow down or completely reverse osteoarthritis, and physiotherapy may be needed to help the patient improve mobility and continue his normal activities.
Physiotherapy for Osteoarthritis
Physiotherapy or physical therapy for osteoarthritis includes a wide range of treatment modalities (except drugs) to improve the function of the joint while alleviating pain and inflammation. These are:
- The use of hot and cold therapy – the local application of heat before exercise and cold packs after exercise to reduce pain and inflammation
- The use of support devices such as splints, canes, walkers and braces – physical therapists educate the patient in the correct use of these devices to promote stability and safety in mobility
- For osteoarthritis of the hands – physical therapists advise the use of paraffin wax dips, warm water soaks and cotton gloves at night
- For osteoarthritis of the spine – patients are advised to use a firm mattress for the back, cervical collar for the neck and a lumbar corset for the lower back and hips
- Appropriate, individualized exercises that will mobilize joints without causing stress are taught to the patient such as
- Swimming, water walking and other water exercises
- Stationary cycling
- Light weight training
- Tai-chi, yoga and Pilates exercise programs
- Aerobic exercise
Occupational therapy is also recommended to teach the patient on how to do daily activities of self care, work and leisure with less stress and pain.
The advantages and benefits derived from physiotherapy for osteoarthritis include:
- Reduction of pain and inflammation
- Increased flexibility and range of motion of the joints
- Increased muscular strength and support
- Improvement of balance and support
- Weight loss and weight control
- Improvement of cardiovascular function
It is important to remember that rest and immobilization are important in the acute stages when joint pain and swelling are severe. While the physical therapy modalities work in the later stages when pain and inflammation have started to subside, they must also be carried out regularly. If osteoarthritis persists, medical and surgical therapy may be indicated.
WebMD, “The Basics of Osteoarthritis" accessed 1/18/11
Spine Health, “Specific Osteoarthritis Exercise Programs" accessed 1/18/11