Managing Osteoarthritis with Physical Therapy

Ryan LaCorte Candice Brockel, Publications

In order for our body to move, we have bony connections called joints that are attached by tendons and ligaments. Covering the end of each bone within the joint is a smooth and flexible tissue called cartilage. This tissue provides protection, reduces shock, and decreases friction between the two bones during movement.

What Is Osteoarthritis?

Osteoarthritis is a degenerative joint disorder in which there is progressive destruction of the articular cartilage.  Due to the loss of the cartilage, the joint space becomes narrow allowing the bone ends to rub together. This creates pain and may lead to further damage such as bone deformity or bone spur formation.

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How Do I Get Osteoarthritis?

The cause of primary osteoarthritis is unknown, however, there are factors that may increase your risk for this condition. These include age, gender, past injury/ trauma, obesity/ weight gain, leg length discrepancy, and sports or occupations that place repetitive stress on the joint.  There are even theories of genetic factors leading to primary osteoarthritis. According to the Center for Disease Control and Prevention, osteoarthritis is the most common form of arthritis, and is usually more common in women than men over the age of 50.

What Are The Symptoms?

Osteoarthritis is characterized by joint stiffness and pain, generally affecting large, weight bearing joints. Typically, the joint involvement is often asymmetrical. In other words, the complaint of pain is usually worse on one side than the other.  Many people report feeling or hearing joint noises such as crunching, crackling, or clicking with movement, not always associated with pain. The stiffness is usually felt in the morning or after prolonged periods of rest, which improves with movement. Other symptoms include increased pain by the end of the day and pain during/after activity, relieved by rest. At the late stages of the disease, you may experience pain even at rest. Limitations in strength and joint range of motion become apparent as well as noticeable joint deformities due to cartilage destruction and joint space narrowing. Inflammation is not a primary characteristic of this disease but may be seen in the late stages due to bone trauma.

How is it diagnosed?

Osteoarthritis is diagnosed by X-ray results assessed by your physician.  Clinical findings of symptoms can also provide a good insight for diagnosis

How Can Physical Therapy Help?

While physical therapy cannot change the damage that has already been done, it can help manage your symptoms to improve activities of daily living. Within our joints there is a substance called synovial fluid, which lubricates and provides nutrients to our cartilage.  Because cartilage has no blood supply when it is damaged there is no way for it to regenerate. However, when we move our joints, synovial fluid is produced. Therefore, it is vital that we get our joints moving to provide extra protection and lubrication to the already damaged area, which as a result, decreases pain and improves mobility.  When coming to physical therapy your physical therapist will first perform an evaluation to get the history of your condition and identify limitations or restrictions with your movement through an objective assessment. Since the progression and symptoms of osteoarthritis are different for each person, your therapist will create an individualized exercise program specific for your needs. In general, your therapist will give you exercises in your pain free range to help promote synovial fluid production.  It is also important to decrease the stress/forces placed on your joint by increasing the strength of the surrounding muscles. Depending on the severity of the disease, activity modification and proper instruction on the use of an assistive device may also be needed for pain relief.  Along with therapeutic exercises, your therapist can provide hands-on techniques to improve joint function. In addition, certain modalities such as hot packs, cold packs, and electric stimulation can be provided to help ease your pain. You will also be given a customized home exercise program, which together with your attendance in physical therapy will become key to improving your symptoms and slowing the disease progression.

So why wait? If you are diagnosed with osteoarthritis or experiencing the symptoms described above, get up, lubricate those joints, and see what the skilled physical therapists at All-Care Physical Therapy Center can do for you.

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