Osteoarthritis

What is Osteoarthritis?

  • an inflammation (ITIS) of a joint (ARTH)
  • osteoarthritis refers to the bones versus rheumatoid arthritis which refers to the arthritic component of a system wide medical condition
  • in medical terms -- osteoarthritis is the wear and tear degeneration of the articular cartilage and subchondral bone
  • pain, deformity, and limitation of movement in joints is the result of cartilage destruction
  • articular cartilage
  • the white, smooth surface which covers the ends of the bones at the joints
  • lubricating and shock-absorbing functions
  • made of glucosaminoglycans, proteoglycans, hyaluronic acid
  • subchondral bone
  • the layer of bone underneath the articular cartilage

Where does it hurt?

  • commonly in the joints most often affected are the weight bearing joints
  • neck and low back
  • hips, knees, ankles
  • hands, feet
  • pain can be referred from these areas to others e.g. neck to shoulder and upper arm

Why does it hurt?

  • the underlying layer of bone contains many nerve fibres that convey pain

What hurts and why?

MOVEMENT

  • joint surfaces rubbing bone on bone

BEARING WEIGHT

  • compressing bone on bone

OVERUSE

  • excessive irritation of inflamed bone

REST

  • blood pooling causes aching

MORNING STIFFNESS

  • lack of joint lubrication due to prolonged rest

What shows up on x-ray?

  • narrow joint spaces
  • extra bone formation (osteophytes)
  • degrees of severity ranging from mild to severe
  • biomechanical alterations e.g. knock knees (valgus)

What causes it?

  • Cumulative effects of years of use of the joints
  • Limited ability of the body to restore articular cartilage
  • previous injury
  • poor mechanical alignment
  • excessive body weight
  • small hereditary component

How do I slow the progression?

  • you cannot reverse the degenerative process once it is seen on x-ray, but you can slow the rate of progression (early stages are reversible)
  • exercises to stretch and strengthen surrounding muscles that support and protect the injured joint are vital
  • gentle mobilizations of the joint, performed by your physiotherapist, decrease the pain associated with arthritis and stretch structures you may not be able to
  • good posture is of utmost importance – poor posture leads to increased pain levels
  • everybody is different – exercises and mobilizations for your area of arthritis are very specific for you
  • maintaining flexibility, strength and good posture can help to slow the rate of the arthritic progression
  • your physiotherapist can help you to get the most out of your exercises

Nutritional Supplements

Glucosamine

  • sold as sulfate or hydrochloride (HCl)
  • both equally effective
  • HCl less expensive and more pure
  • stimulates the manufacturing of substances necessary for joint repair
  • glycosaminoglycans & proteoglycans
  • used by the body in the manufacture of collagen, which is the protein portion of a fibrous substance that holds joints together
  • collagen is also the main component of articular cartilage
  • more glucosamine means your body has a better chance of decreasing or eliminating pain caused by insufficient lubricants and poor shock absorption
  • glucosamine is sometimes combined with Chondroitin sulfate
  • glucosamine and chondroitin are available in pharmacies and health food stores
  • typical dose of 1500 mg / day
  • effects should be noticed in three to six weeks depending upon age and severity of the condition
  • most published trials of the compound lasted only 4-8 weeks and are therefore unconvincing in the medical community although…

The Use Of Glucosamine Appears To Be Safe And Might Be Effective
For The Treatment Of Osteoarthritis”

Glucosamine for Arthritis, The Medical Letter on Drugs and Therapeutics,
Volume 39, Pages 91-92, September 26, 1997.

Chondroitin

  • acts like” liquid magnets”
  • helps attract fluid (H20)
  • sweeps nutrients into the cartilage
  • acts as a spongy shock absorber
  • maintains viscosity in joints
  • stimulates cartilage repair mechanisms
  • inhibits enzymes that break down cartilage

Caution …

  • there are no reported drug interactions
  • SIDE EFFECTS
  • Occasional digestive discomfort and nausea have been reported
  • it is derived from Chitin ~ a component of shellfish shells

** CAUTION SHELLFISH ALLERGIES **

  • some glucosamine is processed with sodium chloride (table salt), which may be restricted in some diets particularly for people with HIGH BLOOD PRESSURE
  • if you are DIABETIC or PREGNANT, it is advised that you discuss the use of glucosamine with your physician

What do you do?

  • if you feel that you can benefit from the services of a physiotherapist, consult your physician or contact us directly
  • we would be pleased to help you...

YOUR PHYSIOTHERAPIST CAN HELP YOU WITH THE REST…

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