Osteoarthritis (OA), also called osteoarthroses or degenerative joint disease, is the most common type of arthritis. OA is a chronic condition characterized by the breakdown of the joint’s cartilage. Cartilage is the part of the joint that cushions the ends of the bones and allows easy movement of joints. The breakdown of cartilage causes the bones to rub against each other, causing stiffness, pain and loss of movement in the joint. It is possible to have these degenerative changes in one or more joints and no pain. Then if the person strains some part of their body and has an x-ray which, it will show that they have osteoarthritis. However, if they had had an x-ray prior to the strain or accident, when they had no symptoms, it would have looked exactly the same. The fact is, it is much easier to strain a worn joint, and it often needs a very skilled osteopath to help them recover. 

·       OA affects nearly 135,000 Kiwis. 

·       OA typically affects only certain joints, such as the hips, hands, knees, low back and neck.

·       After age 50, women are more often affected by OA than men.   

·       Symptoms of OA typically first begin after age 40 and progress slowly. 

·       Loss of joint function as a result of OA is a major cause of work disability and reduced quality of life.   

Symptoms of Osteoarthritis: 

·       Pain or stiffness in joints after periods of inactivity or excessive use.   

·       Grating or “catching” sensation during joint movement.  

·       Bony growths at the margins of affected joints. 

The cause of OA is not yet known, but certain factors increase the risk of developing OA:  

·       Heredity  

·       Overweight 

·       Joint injury 

·       Repeated overuse of certain joints  

·       Lack of physical activity  

·       Nerve injury 

·       Aging     

·       The diagnosis of OA is typically based on a medical history and physical examination. 

·       Sometimes it is recommend that patients have X-rays or magnetic resonance imaging (MRI) to rule out other causes of pain and to determine how much joint damage has occurred.  

·       Joint aspiration, a procedure in which fluid is drained from the affected joints and examined, and blood tests also may be used to rule out other forms of arthritis in the body.   

·       Treatment plans often include a combination of rest, physical activity, supplements, medications and osteopath treatment. 

·       Osteopath treatment of OA varies with the severity of symptoms and focuses on decreasing pain and improving joint movement and reducing muscle tension. Philip uses a wide range of techniques which can be adapted to suit the individual needs of the patient and includes articulation, gentle manipulation, muscle stretching and massage. Philip will advise you on exercise, posture, lifting techniques, the use of heat and cold and the use  of joint support to prevent strain or stress on painful joints. 

·       Weight control is important for prevention of and to slow the progression of OA affecting the weight-bearing joints (knees and hips) and low back. For every one pound of weight lost, there is a four pound reduction in the load exerted on the knee for each step taken during daily activities. Losing as few as 11 pounds can cut the risk of developing knee osteoarthritis by 50 percent for some women. 

·       Physical activity such as aqua-aerobics keeps joints flexible and maintains or improves muscle strength. The buoyancy of the water supports your weight, reducing the stress on your joints and the resistance of the water gives your muscles a workout. 

·       Dietary supplements such as glucosamine and chondroitin sulfate have been shown in some studies of knee OA to relieve pain and improve joint function in severe OA. Philip can give you advice on these nutritional supplements and help you obtain them. 

·       The following herbs may help reduce inflammation:  curcuma longa (Tumeric extract),  boswellia serrate (Shallaki),  zinzibar officianale (Ginger) and  harpagophytum procumbens (Devil’s Claw). Philip can give you advice on these herbs and help you obtain them. 

·       Many people with OA use pain medications such as paracetemol or nonsteroidal anti- inflammatory drugs (NSAIDs) such as Voltaren and Nurofen to help reduce joint pain, stiffness and swelling. 

·       Corticosteroids or hyaluronic acid derivatives can be injected into joints that are unresponsive to treatment.  

·       Surgery is an important consideration in people with advanced OA associated with joint damage and/or marked limitations in joint function.    

·       Rheumatoid arthritis is a chronic disease, mainly characterized by inflammation of the lining, or synovium, of the joints. It can lead to long-term joint damage, resulting in chronic pain, loss of function and disability.   

·       Rheumatoid arthritis (RA) progresses in three stages. The first stage is the swelling of the synovial lining, causing pain, warmth, stiffness, redness and swelling around the joint. Second is the rapid division and growth of cells, or pannus, which causes the synovium to thicken. In the third stage, the inflamed cells release enzymes that may digest bone and cartilage, often causing the involved joint to lose its shape and alignment, more pain, and loss of movement. 

·       Because it is a chronic disease, RA continues indefinitely and may not go away. Frequent flares in disease activity can occur. RA is a systemic disease, which means it can affect other organs in the body. Early diagnosis and treatment of RA is critical if you want to continue living a productive lifestyle. Studies have shown that early aggressive treatment of RA can limit joint damage, which in turn limits loss of movement, decreased ability to work, higher medical costs and potential surgery. 

·       Currently, the cause of RA is unknown, although there are several theories. And while there is no cure, it is easier than ever to control RA through the use of new drugs, exercise, joint protection techniques, osteopath treatment and self-management techniques. 

Copyright © 2010 Philip Bayliss, Osteopath (Christchurch)