By Zeinah Keen, Osteopath
This degenerative disease of the joints is a major cause of disability and chronic pain in Australia, with 3.85 million Australians affected at a cost to our economy of more than $23.9 billion each year in medical care and indirect costs such as loss of earnings and lost production. 2.4 million of those people are of working age, it is not a disease of the aging. It is the most common condition of the joints and most people have degenerative changes by the time they turn 40 (usually asymptomatic).
OA usually affects the weight bearing joints such as the hips and knees but is also common in other joints;
• Fingers
• Vertebrae (cervical and lumbar spine)
• Big toe
• Hips
• Knees
Why do people get OA?
Sedentary lifestyle and subsequent inactivity is the main cause as is poor nutrition and obesity. Secondary OA can occur whereby the internal environment of the joints is altered due to disease (Rheumatoid arthritis, congenital abnormalities, infections, metabolic, endocrine and neuropathic diseases), past trauma, repetitive use of the joints.
Signs and Symptoms
• Gradual onset involving usually 1 joint but can be more.
• Pain aggravated by exercise and relieved by rest.
• Morning stiffness easing after 15-30 mins when moving.
• Reduced range of motion in the joints
• Crepitus.
• Flexion contractures
• Joint enlargement (proliferation of soft tissue structures and joint effusion).
• Heat
OA in particular joints also has its own set of signs and symptoms;
Hips-groin pain and limping.
Spine-neurological symptoms.
Knees-locking, instability.
Diagnosis
Based on signs and symptoms.
X-ray-shows narrowing of the joint space, increased density of subchondral bone, formation of osteopathytes and pseudocytes.
Blood tests-help to rule out secondary causes of OA (RA, gout).
Synovial fluid analysis-clear and viscous.
Osteopathic Treatment of OA
Focuses on pain relief and prevention of further deterioration of the affected joints.
Giving a muscle strengthening program is very important in order to help stabilize and strengthen the affected joints.
Important to educate clients about exercise and weight loss.
Stretches and muscle strengthening
Supplements
Analgesia if required
Steroid injections popular at the moment
