• Dr. Karma Patel, D.C. B.Sc. (Hons)

Treating arthritis


Osteoarthritis (or arthritis) is the most common disease of joints affecting adults worldwide. Typically, arthritis affects synovial joints. These joints have cartilage lining the bone surfaces and a joint capsule filled with synovial fluid. The cartilage and synovial fluid ensure the bones can move painlessly and with low friction to each other.1


In arthritis, the cartilage decreases in thickness and eventually cracks. Once damaged, cartilage cannot recover and bone surfaces to come in contact with each other. The bones respond by expanding and forming osteophytes. Ultimately, it leads to joint pain and loss of function.1

Risk Factors 2

· Age

· Obesity

· Joint hypermobility or instability

· High-impact sports

· Repetitive knee bending

· Injury to joint

· History of immobilization

· Family history


Signs & Symptoms 2

· Pain in the joint

· Joint tenderness

· Morning stiffness

· Sensitivity when kneeling or bending

· Decrease in function

· Decrease in muscle power

· Crepitus or “cracking”

Management

Treatment options will vary depending on the stage, severity, co-morbities, age, etc. It is important to start with conservative treatment first and then progress to more invasive therapies.

1. Physical Therapy: prescribed exercises 7, hydrotherapy 3,4 (walking in the pool), manual therapy 5, ice 6, electrical stimulation 2, braces 2, kinesiotaping 3 2. Pharmaceutical: acetaminophen 8, NSAIDs 8, opioids 7,8

3. Injections 8: hyaluronic acid, corticosteroids

4. Surgery 2: arthroscopic, total knee replacement

Always consult a health care professional to assess any injuries, aches, and pains. Acute pain can progress to chronic pain if left untreated.

References:

  1. Michael, J. W. P., Schlüter-Brust, K. U., & Eysel, P. (2010). The epidemiology, etiology, diagnosis, and treatment of osteoarthritis of the knee. Deutsches Arzteblatt International, 107(9), 152.

  2. Arya, R. K., & Jain, V. (2013). Osteoarthritis of the knee joint: An overview. Journal, Indian Academy of Clinical Medicine, 14(2), 154-62.

  3. Hinman, R. S., Heywood, S. E., & Day, A. R. (2007). Aquatic physical therapy for hip and knee osteoarthritis: results of a single-blind randomized controlled trial. Physical therapy, 87(1), 32-43.

  4. Wang, T. J., Belza, B., Elaine Thompson, F., Whitney, J. D., & Bennett, K. (2007). Effects of aquatic exercise on flexibility, strength and aerobic fitness in adults with osteoarthritis of the hip or knee. Journal of advanced nursing, 57(2), 141-152.

  5. Deyle, G. D., Allison, S. C., Matekel, R. L., Ryder, M. G., Stang, J. M., Gohdes, D. D., ... & Garber, M. B. (2005). Physical therapy treatment effectiveness for osteoarthritis of the knee: a randomized comparison of supervised clinical exercise and manual therapy procedures versus a home exercise program. Physical therapy, 85(12), 1301-1317.

  6. Brosseau, L., Yonge, K. A., Welch, V., Marchand, S., Judd, M., Wells, G. A., & Tugwell, P. (2003). Thermotherapy for treatment of osteoarthritis. The Cochrane Library.

  7. Brosseau, L., Wells, G. A., Tugwell, P., Egan, M., Dubouloz, C. J., Casimiro, L., ... & Milne, S. (2005). Ottawa panel evidence-based clinical practice guidelines for therapeutic exercises and manual therapy in the management of osteoarthritis. Physical Therapy, 85(9), 907-971.

  8. Hochberg, M. C., Altman, R. D., April, K. T., Benkhalti, M., Guyatt, G., McGowan, J., ... & Tugwell, P. (2012). American College of Rheumatology 2012 recommendations for the use of nonpharmacologic and pharmacologic therapies in osteoarthritis of the hand, hip, and knee. Arthritis care & research, 64(4), 465-474.

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