What is Osteoarthritis (OA)?
OA is a degenerative joint disease that involves breakdown of the cartilage which can lead to joint pain stiffness. It can affect many joints but most commonly affects knees, hips, lower back, neck and small joints of the fingers and thumb.
There are many myths surrounding Osteoarthritis and we would like to debunk some of these myths…
Pain Equals Damage
Research shows that pain levels are not correlated to the natural degeneration that occurs in the joints. It has been shown that people who present with severe arthritic changes on an x-ray, may present with no pain and those with no structural changes on an x-ray can present with a lot of pain.
Pain is very complex and is not directly as a result of structural changes. OA typically presents through recurring flare ups which can involve variable symptoms, but most commonly pain and stiffness. Most of the time a flare up does not indicate that the structural changes are worsening and with some pain management strategies these flare ups will improve.
Arthritis is ‘Wear and Tear’ of the joint
Osteoarthritis is more complex than typically presented and has several contributing factors. ‘Wear and tear’ is commonly used to describe OA and is very misleading. Wear and tear insinuates that use of the joint is damaging and that the wear and tear is the cause of people’s pain. Structural changes are noted in arthritic joints from the altered healing of the cartilage in the joints. However, these changes start occurring in our late teens and are also seen in those with no symptoms.
The main risk factor which can increase the likelihood of OA symptoms is being overweight. Research has shown losing even 6% of your body weight can significantly reduce pain and improve function.
You need an x-ray
The first thing people feel they need when symptoms of pain and stiffness begin in certain joints is an x-ray to diagnose their symptoms. This is not necessary! In fact- the diagnosistic criteria does not even include an x-ray!
There is not a strong correlation between x-ray findings and pain. Studies have shown that many people with significant arthritic changes on an x-ray do not experience any symptoms and vice versa.
Osteoarthritis can be diagnosed by discussing your symptoms with a clinician, they will then guide you on the best way to manage your symptoms and improve your function.
Exercising will make it worse
Governing guidelines encourage exercise as a core treatment for OA. The type of exercises encouraged are strengthening and cardiovascular. Strengthening the surrounding structures can help support and protect the joint, whereas cardiovascular exercises can decrease general inflammation.
Lots of research studies show that an exercise program that is sustainable over time is equally as beneficial as pain medications and some surgical interventions to manage pain… without the side effects and with an improvement in function as well!
Most importantly the form of exercise should be one you enjoy and having signs of degeneration should not stop you participating in any of your normal activities.
I will need to have surgery
Many believe OA will continue to deteriorate over time and with activity. Research shows that only one third of people have worsening symptoms whereas the majority achieve improvements in both their pain and function.
There are many interventions that can help with OA and physiotherapy is recommended to help guide you on symptom management and strengthening exercises.
Every person is individual and may need a tailored programme to help them manage their symptoms and reach their goals. If you need some guidance on what you can be doing then please get in touch with one of our physiotherapists.
If you are struggling with pain related to arthritis then you have probably been told lots of things related to your issue, and probably spent some time reading Dr Google. Please see an expert physiotherapist who can give you some up-to-date knowledge, information, and strategies for your issue.
Globa, regional prevalence, incidence and risk factors of knee osteoarthritis in population-based studies. Aiyong Cui, Huizi Li, Dawel Wang Junlong Zhong, Yufeng Chen, Huading Lu
Analysis of the discordance between radiographic changes and knee pain in osteoarthritis of the knee. M T Hannan, D T Felson, T pincus