Hip and Knee Osteoarthritis (OA) is the most common cause of hip and knee pain in the elderly. OA is commonly known to be a ‘wear and tear’ (degenerative) condition. More people are aware of OA today because we see our friends and loved ones suffer from OA as our lifespan increases.
OA affects the cartilage lining of our joints which prvides lubrication and shock absorption during our daily activities. As we age, this lining thins and wears out, resulting in symptoms of pain. swelling, and restricted movement.
Although OA is a disease of the joint, it should not be interpreted that OA needs to be cured to live well. Just like hypertension and diabetes, OA is a chronic condition and you can learn how to cope with it.
There are multiple treatment options today and exercise therapy has been proven to be the safest and most effective treatment. You may seek different methods for managing your pain but exercise should form the foundation of your plan to be successful.
Most often, individuals who understand OA cope best. There is no way you can cure OA but there are plenty of methods to assist you cope effectively.
Facts & myths about OA:
Myth: The amount of degeneration on my x-ray is indicative of how damaged my joint is.
Symptoms vary from person to person and they usually do not correlate with the advancement of degeneration. Relying on information from scans alone can be unhelpful.
Myth: Exercise is unsafe for my degenerative joint.
Not only exercise is safe, it is the best way to treat OA and this is recognised internationally.
OA is degenerative, it will just get worse.
Myth: Many people can improve their symptoms and avoid surgery with an appropriate treatment plan.
OA is a disease that only affects the elderly and it is more common as you age. However, it can and does affect younger people as well. This is especially so for those who may have suffered a joint injury in the past.
Signs and Symptons
OA presents as pain, swelling and restrictions in range of motion at the hip or knee joint. This pain usually worsens with more waightbearing activity like walking or running, and eases with rest. This pain comes and goes depending on how much activity is performed. Some patients may also have deformities at the joints which may change the alignment of the joint.
Initially pain may be less frequent, so you think less about it. Once pain occurs more often, it can affect multiple aspects of your life. Pain and joint stiffness can interfere with your social activities, climbing stairs, your work or it may even affect your ability to carry out important activities of daily living (ADL). It is also well-known that OA pain can fluctuate throughout life.
OA pain often feels better with rest. However, we know that if you do nothing about it, symptoms often return. Most people with OA are troubled when the pain is recurrent, thus becoming a persistent feature in their lives.
Why do I get osteoarthritis?
There are many factors that can increase your risk of developing hip or knee OA throughout your lifespan. While some of them are modifiable, some are not.
Modifiable
- Lifestyle: smoking, overweight, lack of, or excessive exercise.
- Strength: weak hip and knee muscles
Non-modifiable
- Trauma: previous hip/knee injuries increases your risk 3-5x
- Knee deformity: “Bow-legged” or “Knocked knee”
What are some effective treatment methods?
Effective therapy
- Strengthening exercise
- Weight loss
- Walk, cycle, swim
- Activity pacing strategies
Complementary therapy
- Pain relief: Medication, knee brace, electrical stimulation, heat/cold therapy, acupuncture, massage/ stretching, injections.
Medical treatment
- Joint Replacement Surgery is recommended only for joint deformity or if you have not responded to a sustained exercise program prescribed by a physiotherapist.
How long does it take for me to get better?
Normally, if your treatment plan is effective, you should find that your pain is well-managed and you can tell that you are getting better by the week. Some experience improvements within 4 weeks, while the average experience improvements at 2 months. Each individual is different!
As OA pain can fluctuate, you may experience ‘good’ and ‘bad’ days. ‘Bad’ periods do not mean that it is getting worse but this is just the pattern of the condition.
It is very important to learn helpful coping techniques that you can learn and apply through this journey. By doing so, you can reduce the frequency and recurrence of ‘bad’ days yet still enjoy doing activities and tasks that you value.
Activity Pacing
Slow and steady wins the race. As OA pain tends to fluctuate, you will be prone to doing more on ‘good’ days and resting on ‘bad’ days. This pattern is what physiotherapists define as “boom and bust” and usually associated with failure.
Learning how to pace your activities is a key element for all types of chronic pain management. There is a simple and effective guide to how you can do more, without worsening you condition on the whole. Speak to your physiotherapist about this.
How do I know I am getting better?
Research show that people with OA experience improvements in pain, walking speed and distance. You may also become more ‘in control’ of pain.
The longer you follow the recommended strategies, the more likely you can experience these positive effects.
How can I improve my chances of success with Physiotherapy?
Always discuss your goals with your physiotherapist in order for the treatment plan to be tailored to your goals.
Article contributed by Physiotherapy, Rehabilitation, Allied Health Services.
