Arthritis is a common ailment and is especially prevalent in older people. It is currently the number one cause of disability in Australia. Arthritis is not an individual disease or disorder, but a term used to refer to the symptoms of a range of disorders. Common arthritis symptoms include:
- Joint pain
- Loss of flexibility and movement
There are more than 100 conditions which can result in arthritis, the most common forms are osteoarthritis, rheumatoid arthritis and gout.
Arthritis fast facts
- 3.9 million Australians have arthritis. That’s 1 in 6 people.
- By 2030, it is projected there will be 5.4 million Australians with arthritis.
- Around 2 million people with arthritis are of working age (15-64 years)
- Arthritis cost the health system $5.5 billion in 2015. This will rise to $7.6 billion by 2030.
- Arthritis accounts for 8% of the total burden of disease and injury in Australia
- Children get arthritis too
- Arthritis is the leading cause of chronic pain and the second most common cause of disability and early retirement due to ill health in Australia.
- 52,000 people (aged 15-64 years) unable to work due to arthritis
- Extra welfare costs and lost tax revenue due to early retirement due to arthritis cost $1.1 billion in 2015
- There are more than 100 different types of arthritis
- Osteoarthritis, rheumatoid arthritis and gout are the most common forms of arthritis
- We do know you’ve got to move it or lose it; rest can make pain and other symptoms much worse.
The most common form of arthritis is osteoarthritis (OA). It mainly affects people over the age of 40 but it can develop at any age. OA can affect any joint in the body but it usually occurs in large joints that support the weight of your body such as the hips, knees and lower back. It can also occur in the hands, particularly at the base of the thumb and the end joints of the fingers and in the big toe.
It is a condition that affects the whole joint including bone, cartilage, ligaments and muscles. Osteoarthritis may include:
- inflammation of the tissue around a joint
- damage to joint cartilage, this is the protective cushion on the ends of your bones which allows a joint to move smoothly
- bony spurs growing around the edge of a joint
- deterioration of ligaments (the tough bands that hold your joint together) and tendons (cords that attach muscles to bones).
Osteoarthritis can be a result of:
- an injury to the joint, such as a broken bone or torn cartilage. This could have happened years before arthritis appears;
- being overweight, this puts extra strain on weight-bearing joints and they may become worn under the pressure
- jobs involving repetitive movements, such as heavy lifting, kneeling and squatting
- family history, if your parents have or had arthritis, especially in the hands, you are more likely to develop it.
The symptoms of osteoarthritis vary from person to person. The most common signs are:
- joint pain and tenderness
- stiffness of the joints
- symptoms that worsen after overactivity or underactivity. For example, many people find their symptoms worsen after doing lots of activity such as walking or gardening, or after periods of inactivity such as when getting out of bed in the morning or after sitting for long periods.
- swelling of the joints
- muscle weakness, which may feel like the joint is unstable or will give way
- a grinding sensation or clicking noises in the joints
- a feeling that the joint might lock
- loss of mobility.
Hip and Knee Osteoarthritis
The knee and the hip are commonly affected by arthritis, particularly osteoarthritis (OA). With knee osteoarthritis you may notice pain and stiffness in your knee, particularly when you first get out of bed in the morning, after sitting for a long period, climbing stairs, walking, kneeling or even when you’re just sitting still. Osteoarthritis in the hip often produces pain in your hip, groin, buttock and/or thigh areas, which is felt as sharp pain or an ache. It is often most noticeably when you walk, climb stairs, stand up from a seated position, squat and/or first get out of bed in the morning.
Treatment for hip and knee osteoarthritis
Whilst there is no cure for osteoarthritis, the good news is that there are many treatments available to manage the symptoms from osteoarthritis and there is a lot you can do yourself to reduce the pain, improve your movement and function and improve the quality of your life.
Many people with osteoarthritis in the hip and knee often belief that joint replacement surgery is the only treatment option. In 2016 this resulted in nearly 100.000 Australians receiving hip or knee replacement surgery, at a total cost exceeding S2 billion. Joint replacement surgery has grown at an unsustainable rate, in the 20 years to 2014, Victoria had a 175 per cent increase in hip replacements and 285 per cent increase in knee replacements and there is no sign of demand slowing. Reports show that currently 25% of all joint replacement surgeries in Australia are inappropriate. Whilst it is undisputed that joint replacement surgery provides relief for people with advanced joint disease. For those who don’t need it, surgery can cause more problems than it solves.
A clinical care standard has been developed to assist people with osteoarthritis. This clinical care standard describes the following steps:
A patient with pain and other symptoms suggestive of osteoarthritis receives a comprehensive assessment that includes a detailed history of the presenting symptoms and other health conditions, a physical examination, and a psychosocial evaluation that identifies factors that may affect their quality of life and participation in their usual activities.
A patient with knee pain and other symptoms suggestive of osteoarthritis is diagnosed as having knee osteoarthritis based on clinical assessment alone. X-rays are considered only if an alternative diagnosis is suspected (for example, insufficiency fracture, malignancy). Magnetic resonance imaging (MRI) is considered only if there is suspicion of serious pathology not detected by X-ray
Education and self-management
A patient with knee osteoarthritis receives education about their condition and treatments for it and participates in the development of an individualised self-management plan that addresses both their physical and psychosocial health needs.
Weight loss and exercise
A patient with knee osteoarthritis is offered support to lose weight, if they are overweight or obese, and advice on exercise, tailored to their needs and preferences. The patient is encouraged to set weight and exercise goals, and is referred to services to help them achieve these, as required.
Medicines used to manage symptoms
A patient with knee osteoarthritis is offered medicines to manage their symptoms. This includes consideration of the patient’s clinical condition and their preferences.
A patient with knee osteoarthritis receives planned clinical reviews at agreed intervals, and management of the condition is adjusted for any changing needs. If the patient has worsening symptoms with severe functional impairment that persists despite the best conservative management, they are referred for specialist assessment.
A patient with knee osteoarthritis who is not responding to conservative management is offered timely joint – conserving or joint replacement surgery, depending on their fitness for surgery and preferences. The patient receives information about the procedure to inform their treatment decision.
Physiotherapy treatment for Osteoarthritis
A physiotherapist has extensive knowledge regarding musculoskeletal injuries and diseases and for this reason and excellent choice of healthcare provider to assist you manage your osteoarthritis.
Your physiotherapist can help you with many aspects of your osteoarthritis management:
Learning about your arthritis as well as the symptoms, including pain, plays an important role in managing the disease. Many people with arthritis say that learning about their arthritis and what they can do about it gives them back a feeling of control over their lives and their health.
Recent research has shown that understanding how pain works and how you respond to it can help you prevent pain controlling your life. The physiotherapists at Aspire Physiotherapy Bunbury have excellent skills and qualifications to explain the pain to you and can teach you coping strategies to manage your pain better.
It is understandable that whilst someone is in pain the last thing on their mind might be exercise. Besides the discomfort, they may worry that exercising the affected joint could injure the area further and cause more pain. However, research overwhelmingly shows that people with osteoarthritis can and should exercise. Exercise is considered by far the most effective treatment besides medicine, for reducing pain and improving function in osteoarthritis.
Each of the following types of exercises plays a role in maintaining and improving the ability to move and function:
Range of motion or flexibility exercises.
Range of motion refers to the ability to move your joints through the full motion they were designed to achieve. These exercises include gentle stretching and movements that take joints through their full span. Doing these exercises regularly can help maintain and improve the flexibility in the joints.
These exercises strengthen the heart and make the lungs more efficient. This conditioning also reduces fatigue and builds stamina. Aerobic exercise also helps control weight by increasing the amount of calories the body uses. Aerobic exercises include walking, jogging, bicycling, swimming.
These exercises help maintain and improve muscle strength. Stronger muscles offer your joints more support and significantly reduce the pressure on your joints.
Hands-on treatment modalities
We use a combination of hands-on treatment modalities to help with the management of osteoarthritis. This can include:
Mobilisation of the affected joint to optimise the range of motion in the joint;
Massage of the muscles surrounding the joint to reduce any associated muscle tension;
Taping and bracing of the joint (more common for arthritis symptoms in the hand or fingers)
Ultrasound and electrotherapy, some people indicate that this can help reduce their pain in osteoarthritis.
A physiotherapist can give you advice on nutrition as well as exercise to assist in weight loss, if needed we can refer to, and closely work together with, dieticians to target weight loss.
Osteoarthritis is an extremely common condition. If you think you may be suffering from osteoarthritis, or if you are suffering from osteoarthritis, and you are not sure what to do, or where to go, get in contact with the team at Aspire Physiotherpy Bunbury and we will provide you with excellent guidance and can help you get your life back on track.