What is Osteoarthritis / Why does it occur?
Osteoarthritis (OA) is the most common form of arthritis and affects nearly 20 million people in the United States. Pain associated with OA stems from degeneration within joints, the site where two bones meet. Cushioned surfaces, called cartilage, cover and protect the ends of bones, allowing for friction free motion within a joint. With OA, the cartilage becomes thin and frayed, has decreased ability for friction-free movement, resulting in significant pain and joint dysfunction.
Osteoarthritis is considered a “chronic” disease meaning that it is long lasting & recurrent. Although OA can affect any joint, the joints most commonly affected are those that bear the most weight, such as the knees & hips, followed by the spine.
At this time, there are limited effective treatments to reduce pain from OA.
Injections such as Synvisc, Euflexxa, & Supartz are different synthetic forms of a substance known as hyaluronic acid which is naturally found in the joints of the body. The injections work to help re-lubricate the joint after it has lost some of its natural lubrication due to OA. Injections are not able to “cure” osteoarthritis; however, pain relief from injections can last anywhere from days to months.
A doctor may prescribe an anti-inflammatory medication to reduce OA pain. Currently, there are no medications available to reverse the effects of OA; however, there is much research exploring the potential for such medication.
Physical therapists spend 7 years of didactic and clinical medical education before obtaining their DPT (Doctor of Physical Therapy) degree. They have the expertise to design and teach an individually tailored strengthening and proprioception training program to re-educate the muscles surrounding the osteoarthritic joint without stressing the joint. Patients report a reduction in pain, decreased joint pressure and improved ability to move well within 8 weeks of starting their exercise program.
Current research supports manual techniques performed by physical therapists to reduce OA pain and improve function. Manual therapy includes Joint and Soft Tissue Mobilization. Joint mobilization helps to lubricate the joint, reduce friction between the two bones and increase joint range of motion. During joint mobilization the patient relaxes the muscles surrounding the joint while the physical therapist passively moves the joint in its full available ranges, providing a stretch to the joint capsule.
Soft tissue Mobilization reduces the tension /restrictions in soft tissues such as muscles, tendons, & ligaments. When soft tissues become chronically tight, they have the potential to disrupt the normal movement of a joint. If the hamstring/gluteus muscles are restricted, they can alter hip position and low back posture. Over time, the abnormal movement patterns of the hip and lumbar spine leads to hip/low back pain. During soft tissue mobilization, the patient is instructed to re lax their muscles as much as possible, while the therapist performs a variety of techniques including: deep tissue massage, trigger point release, positional and myofascial release to allow the muscle to reset & functional optimally.
Physical Therapy is an important part of regaining joint health and function and should be a part of every patient diagnosed with OA.