What is Osteoarthritis and How Can Physiotherapy Help?

Osteoarthritis (OA) is the most common type of joint disease, it is a heterogeneous group of conditions that result in common histopathologic and radiologic changes. A degenerative disorder that results from biochemical breakdown of articular cartilages in synovial joints. Although, OA is thought to be largely due to excessive wear and tear, secondary nonspecific inflammatory changes may also affect the joints.

This article will focus on OA of the knee joint. Osteoarthritis (OA) of the knee affects the bones, the cartilage, and the synovium in the knee joint.

Cartilage: Provides a smooth surface for joint motion and acts as a cushion between the bones.

Synovium: Lines the joints and produces fluid (synovial fluid) for lubrication, and it supplies nutrients and oxygen to the cartilage.

Once wear and tear happens to any of these properties of the joint, it affects the primary and major functions of the knee joint, thereby exposing the bones to damage.

While age is a major risk factor for osteoarthritis of the knee, young people can get it too. OA can develop at any age, but it most frequently develops in people aged over 50 years. According to the American Academy of Orthopedic Surgeons (AAOS), for some individuals, it may be hereditary, while for others, osteoarthritis of the knee can result from injury or infection or even from being overweight.

The Arthritis Foundation also report that half of all adults will develop OA at some time.

Causes and Risk Factors of Knee Osteoarthritis

The most common cause of osteoarthritis of the knee is advanced age. Almost everyone will eventually develop some degree of osteoarthritis. However, several factors increase the risk of developing significant arthritis at an earlier age.

Age: The ability of cartilage to heal decreases as a person gets older.
Excessive weight/Obesity: Weight increases pressure on all the joints, especially the knees.

Heredity: This includes genetic mutations that might make a person more likely to develop osteoarthritis of the knee. It may also be due to inherited abnormalities in the shape of the bones that surround the knee joint.

Gender: Women ages 55 and older are more likely than men to develop osteoarthritis of the knee.

Repetitive stress injuries: These are usually a result of the type of job a person has.

Athletics: Athletes involved in soccer, tennis, or long-distance running may be at higher risk for developing osteoarthritis of the knee.

Other illnesses: People with rheumatoid arthritis, the second most common type of arthritis, are also more likely to develop osteoarthritis. People with certain metabolic disorders, such as iron overload or excess growth hormone, also run a higher risk of osteoarthritis.

Signs and Symptoms of Knee Osteoarthritis

Knee pain and stiffness are classic signs of knee osteoarthritis. These symptoms tend to progress gradually, and many people initially attribute knee soreness or discomfort to lack of exercise or getting older. Many neglect their early knee arthritis symptoms as “no big deal” until they worsen and start to interrupt activities of daily living. Below are common signs and symptoms of knee osteoarthritis. Early recognition of symptoms and appropriate treatment can dramatically slow or eliminate progression of osteoarthritis symptoms.

Knee pain: Pain is the most commonly reported symptom of knee osteoarthritis. The description of the pain will depend on the patient’s condition and situation. The pain may be experienced as dull and aching or as sharp and intense. It usually worsens with certain activities that place additional strain on the joint, such as bending down or walking up stairs.

Knee stiffness: Bone friction and swelling in the knee joint makes the knee stiff and less flexible. This is a result of prolonged immobility of the joint.

Knee swelling: When knee cartilage wears away, the femur and tibia (and sometimes patella) bones can rub together, resulting in irritation and swelling of the knee (i.e. fluid in the knee). A swollen knee may be accompanied by a sensation of warmth, which can range from warm to burning.
Knee popping or crunching. Feeling a crunching or hearing a popping sound when bending the knee (squatting), are signs that cartilage has worn away and is not protecting the bones from friction. The medical term for this symptom is CREPITUS

Knee buckling or locking up: Some patients with moderate to advanced knee osteoarthritis feel a sensation of their knees giving way (buckling), especially when stepping down stairs. The knee also can lock up when over-stressed.

In most but not all cases, the symptoms of knee osteoarthritis come and go, becoming worse and more frequent over months or years. Knee osteoarthritis pain may flare up after high-intensity activities like jogging, playing tennis, or simple weight-bearing activities that add strain to the knee joint, such as squatting or stair climbing.

Diagnosis

The diagnosis of knee osteoarthritis will begin with taking a comprehensive medical history including the signs and symptoms that aggravates and alleviates the pain and physical examination. Diagnostic tests such as, MRI and X-ray can further help to confirm the diagnosis.

Magnetic resonance imaging (MRI) scans
MRI scans may be ordered when X-rays do not give a clear reason for joint pain or when the X-rays suggest that other types of joint tissue could be damaged. Blood tests can be used to rule out other conditions that could be causing the pain, such as rheumatoid arthritis, a different type of arthritis caused by a disorder in the immune system.

Physiotherapy Intervention

Physiotherapy is a non-pharmacological intervention for knee osteoarthritis recommended by the American College of Rheumatology and the European League Against Rheumatism. It encompasses numerous treatment modes including exercise, manual techniques, knee taping, and education to impart patient self-management strategies.

Having knee osteoarthritis can sometimes seem very controversial. Overusing the knees can worsen the joint health and knee OA, but the less movement at the knees, the weaker it can get, which may result to joint stiffness. A balance line must be drawn to keep the knee joints moving just enough so they’re strong and healthy, and physiotherapy helps you do that.

With knee OA, the muscles surrounding the knee can become weak, and the knee joints can become stiff. This makes it difficult to do everyday tasks, such as walking or getting out of bed.

Physiotherapy can help to reduce the pain, swelling, and stiffness of knee osteoarthritis, and it can help improve knee joint function. It can also make it easier for you to walk, bend, kneel, squat, and sit.

A study found that a combination of manual physiotherapy and supervised exercise has functional benefits for patients with knee osteoarthritis and may delay or prevent the need for surgery. The two main types of physiotherapy (passive and active treatments) can help make knee OA more manageable.
Passive treatments: The physiotherapist does the majority of the work.
Active treatments: The patient/client does more of the work (Home programs).

For more details, appointments and specific information, contact PCA at 08130280496.