Many of the joints in our body have articular cartilage that covers the surfaces of the bones.
This form of cartilage is like a thin layer of Teflon – it is smooth and slippery, slick and strong. The purpose of the articular cartilage is to reduce joint friction during movement, facilitate joint lubrication, and provide some shock absorption.
Joints that contain this form of cartilage include shoulders, elbows, wrists, fingers, hips, and knees, to name a few. The joints in our bodies are very hard working, performing the endless tasks of bending, moving, carrying, lifting, gripping, sitting, and walking. Over time or with trauma, the cartilage in the joints can become damaged, worn out, and thin.
What is Osteoarthritis?
As we age, there are normal, structural changes that occur to the cartilage that covers our joint surfaces. Specifically, it becomes thinner and drier with advancing age. Osteoarthritis is defined as the abnormal wearing or damage to the cartilage coupled with joint inflammation. As noted, the cartilage is present to reduce friction and lubricate the joint. Without the cartilage joints become stiff, swollen, and painful. Depending on the joint, one may find certain activities difficult such as walking, knitting, dressing, or bending.
If the cartilage becomes excessively thin, joint friction increases and lubrication decreases. Force becomes im-parted more directly at the bones of the joint, which causes the bone to create bony bumps and spurs. The irregularity of the bone surface can project within or around the joint edges, which can limit mobility and cause pain. In addition, the muscles, ligaments, and joint capsules surrounding the affected joint may become weaker and tighter if the condition is not addressed.
Osteoarthritis is a progressive condition whereby the degree of cartilage damage can gradually worsen over time. Some peoples’ joints may have mild ‘wear and tear’, while another person’s joint may be termed as having ‘bone-on-bone’ cartilage loss. The latter indicates that there is a negligible amount of cartilage remaining on the joint surfaces. The bones of the joint are essentially contacting each other without the cartilage buffer between them. This is an advanced level of osteoarthritis.
Why Does it Happen?
Osteoarthritis can occur to anyone, however, certain risk factors have been identified. The condition has a suspected hereditary component, meaning genetics likely play a role in its development. The amount of physical load a joint experiences is also correlated to osteoarthritis. Increased load through the joint causes additional compressive force which may eventually change the structure of the cartilage resulting in thinning and breaking down. An increased physical load may be from having excess body weight, occupational stressors, or abnormal joint alignment.
Certain activities have been linked to osteoarthritis, such as contact sports, prolonged sitting, and labour jobs. Other causes of osteoarthritis include direct injury or damage to a joint, joint surgery, broken bones, as well as medical conditions that cause joint inflammation. Interestingly, current research indicates recreational running, an activity some have historically considered ‘hard on the joints’, is linked to a lower incidence of hip and knee arthritis than having a sedentary lifestyle.
Do I have Osteoarthritis?
It is important to understand that as we age some joint wear and tear is normal. In fact, studies have shown that among people over 65 years of age, 50% of their knee x-rays will show signs of osteoarthritis in terms of cartilage thinning. In spite of this, the majority of these people have no symptoms of osteoarthritis. That indicates that, although degenerative changes may be present, it does not always result in pain and dysfunction.
Osteoarthritis has an inflammatory component which will begin to alter the joint structure above and beyond normal wear and tear. Symptoms of osteoarthritis include joint pain, reduced move-ment, weakness, catching or clicking of a joint, and joint stiffness, particularly in the morning. The joint may also appear swollen and feel warm. If you are experiencing symptoms of osteoarthritis it is best to speak with your physiotherapist to develop a treatment plan.
How Can Physiotherapy Help?
While there is no cure for osteoarthritis, many things can be done to help with one’s symptoms and function. Research has shown that early intervention using education, exercise, and manual therapy can reduce or eliminate pain and increase function.
Education from your physiotherapist about osteoarthritis, activity modification, and joint function are required to successfully manage joint health. Understanding the cause of the condition for each individual is imperative for developing an effective treatment plan to minimize further joint damage. Correct joint alignment, posture, and muscle length and control are important to properly support the joint. This can minimize joint stress and preserve cartilage health.
Exercise to maintain an ideal body weight, improve strength, and increase flexibility is fundamental in osteoarthritis management. Effective exercise programming is best guided by an experi-enced physiotherapist who can cater the plan to individual needs, abilities, and joint function. Additionally, hands-on manual therapy techniques provided by a physiotherapist to improve joint mobility and release muscle restrictions can reduce pain and improve range of motion.
If you think you have osteoarthritis or are experiencing joint discomfort, talk with your CAMPT certified physiotherapist about the best management strategies for your individual situation. The sooner osteoarthritis is identified and managed, the more success one will have with treatment.
About Jacqueline Henderson
Jacqueline Henderson completed a BSc.Kinesiology at the University of Victoria in 2006. From there, she obtained a Master of Science in Physical Therapy from the University of Alberta in 2009. Jacqueline has been working as an orthopedic physiotherapist in Alberta since that time and has continued her education to expand the breadth of skills used in her practice. She is trained in Gunn IMS (dry needling), acupuncture, vestibular & dizziness treatment, rehabilitation Pilates, and is a Fellow of the Canadian Academy of Manipulative Physiotherapy (FCAMPT). Jacqueline treats a wide variety of people and conditions, ranging from young to old, and acute to chronic injuries. She is experienced in treating sports injuries, headaches, dizziness, complex motor vehicle accident injuries, and ongoing aches and pains. She also has a special interest in prenatal and postnatal women and the orthopedic issues associated with pregnancy and delivery. You can find out more about Jacqueline here.