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Osteoarthritis

Posted on 12th October 2017 by

What is Osteoarthritis?

Osteoarthritis is a condition that affects your joints, causing pain and stiffness. It’s by far the most common form of joint disease, affecting people all over the world and at least 8 million people in the UK.

What causes Osteoarthritis?

Almost anyone can get osteoarthritis but certain factors can increase your risk, for example if you’re in your late 40’s or older, you’re overweight or you’re female (for most joints, especially the knees and hands, osteoarthritis is more common and more severe in women).

What might Osteoarthritis feel like?

The main symptoms of osteoarthritis are:

Pain – The pain tends to be worse when you move your joint or at the end of the day. If you have severe osteoarthritis, you may feel pain more often.

Stiffness – Your joints may feel stiff after rest, but this usually wears off as you get moving.

A grating or grinding sensation (crepitus) – Your joint may creak or crunch as you move.

Swelling – The swelling may be hard (caused by osteophytes) or soft (caused by synovial thickening and extra fluid), and the muscles around your joint may look thin or wasted.

Not being able to use your joint normally – Your joint may not move as freely or as far as normal. Sometimes it may give way because your muscles have weakened or your joint has become less stable. Exercises to strengthen your muscles can help to prevent this.

Your symptoms will often vary for no clear reason. Some people find that changes in the weather make the pain worse, especially damp weather along with falling atmospheric pressure. Others find the pain varies depending on how active they’ve been. In more severe cases, the pain might not go away. It might stop you sleeping and cause difficulties in your daily activities.

There are some great resources on the Arthritis UK website, where these images are from. 

How do the symptoms of Osteoarthritis progress?

Symptoms of OA can vary. That may start severe but settle down or pain and stiffness can progress and worsen. What you do and how you manage your OA can really impact on the progression of symptoms. Keeping active and taking part in regular exercise is one of the best ways of helping your OA.

Possible complications of osteoarthritis include an increased risk of developing gout and chondrocalcinosis.

Gout is a common type of inflammatory arthritis, which is caused by high levels of urate that lead to sodium urate crystals forming in and around your joints. The changes that osteoarthritis causes in cartilage can encourage crystals to form within your joint. If you have both osteoarthritis and a high level of urate in your blood, you’re at an increased risk of developing gout.

Chondrocalcinosis or calcification is the formation of calcium pyrophosphate crystals in your cartilage. It can happen in any joint, with or without osteoarthritis, but it’s most likely to occur in a knee already affected by osteoarthritis, especially in older people.

How is Osteoarthritis diagnosed?

Osteoarthritis is usually diagnosed based on your symptoms and the physical signs that your doctor finds when examining your joints. this can include:

  • joint tenderness
  • creaking or grating (crepitus) sounds
  • bony swelling
  • excess fluid
  • reduced movement
  • joint instability
  • muscle thinning

X-rays are the most useful test to confirm osteoarthritis, although you probably won’t need one. They can’t really show how much pain or disability osteoarthritis is likely to cause. Some people have a lot of pain from fairly minor joint damage, while others have little pain from more severe damage.

Rarely, an MRI scan of your knee can be helpful. This will show the soft tissues (cartilage, tendons, muscles) and changes in your bone that can’t be seen on a standard x-ray

What is the best treatment for Osteoarthritis

Besides painkillers, steroid injections or surgery (when causing severe pain or mobility problems), the best treatment, according to the National Institute for Health and Care Excellence (NICE), is exercise.

NICE recommendations include:

  • advising patients to participate in exercise as a ‘core treatment’
  • offering weight loss interventions for patients who are obese or overweight
  • providing patients with holistic assessments

Exercise can help to manage some of the symptoms of arthritis. As Physiotherapists we provide advice and education on exercise, pain relief and ways to manage your condition. We can teach you how to improve your joint movement and your walking, as well as how to strengthen your muscles.

When you see us at goPhysio, we will assess your problem and give you tailored advice and a treatment programme. This may include some hands on treatments, an exercise programme and modifications to your lifestyle.

Prognosis for Osteoarthritis

It’s impossible to predict how osteoarthritis will develop for any one person. It can sometimes develop over just a year or two and cause a lot of damage to your joint, which may then cause some deformity or disability. But more often osteoarthritis is a slow process that develops over many years and results in fairly small changes in just part of your joint. This doesn’t mean it won’t be painful, but it’s less likely to cause severe deformity or disability. Sometimes the condition reaches a peak a few years after the symptoms start and then remains the same, or it may even improve.

Read more

6 Arthritis myths

Arthritis – an overview

New exercise guide for people with arthritis

How can physiotherapy help arthritis?

 


6 Arthritis Myths

Posted on 12th October 2017 by

Today is World Arthritis Day, aiming to raise awareness of the importance of early diagnosis and World arthritis day access to timely, evidence based treatment of rheumatic and musculoskeletal diseases.

Rheumatic and musculoskeletal diseases (RMDs) are commonly classified into inflammatory and non-inflammatory types:

Common non-inflammatory RMDs consist of degenerative spine diseases, osteoarthritis, osteoporosis and fibromyalgia.

Common inflammatory RMDs consist of rheumatoid arthritis, ankylosing spondylitis, reactive arthritis, connective tissue diseases and polymyalgia rheumatica.

There are many myths surrounding these conditions and to shed some light on these, Physiotherapist Gemma has explored them further.

Myth 1: There’s only one type of arthritis

There are several types of arthritis with very different causes, symptoms and treatments. Osteoarthritis is the most common form and is our normal wear and tear as we age. This can give symptoms such as pain, stiffness, and thickening around the joint and typically affects the knees, hips or spine in people over the age of 50. Rheumatoid arthritis is an inflammatory disease that typically starts in younger adults and cause redness, heat, swelling and pain often in the small joints of the hands and feet. There are many other forms including juvenile arthritis and psoriatic arthritis. If you are unsure about your symptoms check with your GP or physiotherapist.

Myth 2: My parents had arthritis so I will get it too

Whilst genetics do play a role in the development of arthritis, lifestyle has a much bigger influence. For example, if you are overweight, with a poor diet and a heavy occupation you may be more likely to develop arthritis than a sibling that is a healthy weight and has good strength in the muscles which help to support their joints.

Myth 3: You shouldn’t exercise if you have arthritis

It’s a common belief that if osteoarthritis is wear and tear in the joint, then further exercise will wear it out more. However, the reverse is actually true. By exercising we are mobilising the joint which helps to relieve stiffness, and we are strengthening the muscles around the joints which can help to support and offload the painful area. Low weight-bearing exercises such as cycling or swimming can be a great place to start if your joints are painful enough to limit the type of exercise you are able to do. Specialist classes such as clinical Pilates or our Positive Steps classes for older people are a perfect way to exercise with the right support and guidance.

Myth 4: Arthritis is always painful and will get worse as I get older

If you start noticing the symptoms of osteoarthritis there’s a lot of things you can do to help relieve and even abolish the pain yourself. Start simply by using a heat pack such as a hot water bottle or microwavable wheat pack to help ease stiffness and aches. Then begin gentle stretches of the affected joints, you need to do these little and often to be effective, but don’t push into pain.

Consider your diet and exercise levels, extra body weight puts a lot of extra stress and strain on our joints so shedding even a few pounds can help. A physiotherapist can give you personalised advice, hands-on treatment such as joint mobilisations, soft tissue massage, acupuncture and a tailored exercise prescription have all been shown to be effective in relieving the pain of arthritis. We see many patients who remain pain-free and active for years with these simple solutions.

Myth 5: If I have arthritis I will need a joint replacement

Joint replacement surgery is a major operation and always considered a last resort rather than a quick fix. Start by following the tips above and if you still find you are struggling with everyday activities seek advice from your GP. They will be able to organise an x-ray to assess the degree of wear and tear in your affected joint and ask you questions about the types of activities you are struggling with and if you have tried modifying lifestyle factors such as diet, weight and exercise. Remember some unaffected joints may show equal or even worse wear on x-ray but be completely asymptomatic. Therefore, there is no need to undergo the risks of surgery if it is not causing you any pain.

Myth 6: Supplements help

A lot of research has been conducted into supplements such as glucosamine and chrondroitin which are thought to help rebuild damage cartilage in arthritic joints. However, the vast amount of the research in this area is flawed or bias (i.e. research conducted on animals rather than humans, or conducted by the company’s manufacturing the product with a vested interest in positive results). The more recent unbiased research shows these supplements to be no better than a placebo. That said, some people do feel they get some benefit from supplements so consider trying them for up to 3 months to weigh up the cost versus the benefit yourself.

If you need any help or support then please do get in touch. Our team of Clinicians and range of services can really help educate and inform you about your condition and find ways for you to help live with your condition positively.


An Arthritis Overview

Posted on 19th May 2014 by

Arthritis means joint inflammation – arthro = joint and itis = inflammation. It’s an umbrella term used to cover many different types of joint inflammation.

Many people know they have arthritis or have heard of arthritis, but sometimes aren’t sure which one they have or what the different types are. This blog will cover the 4 most common types of arthritis and give you more information on what it is, which joints are affected and how it can be treated.

Physiotherapy has a crucial role in helping all types of arthritis by helping to maximise muscle strength, joint mobility and flexibility and supporting functional independence, so helping you to keep doing the things you enjoy.

Osteoarthritis

This is the most common type of arthritis and tends to develop gradually over time.

What Happens?

The cartilage at the joint becomes worn and rough, sometimes wearing out completely. This leads to osteophytes, or small bony growths, forming at the edges of the joint to try and replace the cartilage. The joint space becomes narrowed and tissues surrounding the joint can thicken. Often, there is inflammation making the joint stiff and painful to move.

Which Joints?

Osteoarthritis is most common in the hands, knees, hips, feet and spine.

How Is It Treated?

Medication: Analgesics for pain relief, non-steroidal anti-inflammatories for reducing inflammation and pain & steroids to reduce severe inflammation.

Surgery: Arthroscopy – to clean out the joint and remove any irritants & in more severe cases, joint replacements – most common in hips and knees.

What Can You Do To Help?

  • Keep mobile
  •  Strengthen muscles to help support joints
  • Learn to pace activities

Rheumatoid Arthritis

This is an inflammatory disease, affecting joints and tendons. It tends to present with episodes of ‘flare ups’.

What Happens?

Inflammation usually helps to heal the body, but with Rheumatoid Arthritis, prolonged inflammation causes damage. The immune system starts to attack joints, causing the prolonged inflammation. The joint capsule also becomes inflamed, leading to pain, stiffness and swelling.

Which Joints?

Rheumatoid arthritis is most common in the neck, hands and feet.

How Is It Treated?

Medication: Non-steroidal anti-inflammatories and disease modifying anti-rheumatic drugs to reduce inflammation and slow the damage being caused. Steroids may be used in severe cases of inflammation.

Surgery: Joint replacement surgery if joint function is lost or at risk.

What Can You Do To Help?

  • Learn to pace yourself and accept help on difficult tasks
  • Speak to an Occupational Therapist and Physiotherapist for help with activities of daily living.

Ankylosing Spondylitis

This is another form of inflammatory arthritis that affects the spine. Ankylosing means stiffening and spondylitis means inflammation of the spine.

What Happens?

The joints in the lower part of the spine become painful and inflamed, where the sacrum joins the pelvis. This inflammation then starts to travel up the spine, affecting vertebra at higher levels. The inflammation causes scar tissue to form in the joint spaces between the vertebra, reducing movement. Over time, the scar tissue may become calcified – turning into a bony-like tissue, which fuses the joints together and limits the available movement in the spine.

Which Joints?

Ankylosing Spondylitis mainly affects the spine, but can also affect the hips and shoulders.

How Is It Treated?

Medication: Non-steroidal anti-inflammatories and disease modifying anti-rheumatic drugs to reduce inflammation and slow the damage being caused. Steroids may be used in severe cases of inflammation.

What Can You Do To Help?

  • Keep active
  • Give up smoking – AS can lead to restrictions in rib movements and smoking will reduce lung function further

Gout

This type of arthritis responds well to treatment and further joint damage can be avoided with effective treatment.

What Happens?

Gout is caused by high levels of uric acid crystals building up in the joints. This happens when levels of uric acid are too high in the body – either because more is produced or not being effectively removed as a waste substance. Once the uric acid forms crystals around the joints, there may move into the joint space – this is when the pain, swelling and inflammation starts. It tends to last a few days and then settle, letting the joint return to normal.

Which Joints?

Most commonly affects the big toe joint, but can also affect the ankles, knees, hands, wrists and elbows.

How Is It Treated?

Severe acute attacks will be treated with non-steroidal anti-inflammatory drugs. For people affected regularly, preventative medication like allopurinol or febuxostat may be given to stop uric acid build up in the body.

What Can You Do To Help?

Drink plenty of water Avoid alcohol and red meat – these can increase uric acid levels