Osteoarthritis (OA) is a degenerative joint disorder commonly treated in physiotherapy practice and characterized by cartilage degeneration and bone overgrowth. It most commonly occurs in the weight-bearing joints of the body like hips, knees, and spine. It can also affect the fingers, thumb, neck, and large toe. It is not typically common in other joints unless prior injury or excessive stress is involved. The incidence of OA increases with age, and it is one of the most prevalent diseases in older people. OA affects about 3.3% to 3.6% of the population globally. It is the 11th most debilitating disease around the world, causing moderate to severe disability in 43 million people. According to the World Health Organization, 9.6% of men and 18.0% of women older than 60 years of age worldwide have symptomatic osteoarthritis (OA), making OA one of the most prevalent chronic diseases. In Canada there are currently more than 4.6 million people living with OA which will rise, within a generation (in 30 years) to more than 10 million (or one in four). (Christensen R, Bartels EM, Astrup A, Bliddal H.)

TYPES OF OSTEOARTHRITIS

There are 2 type of OA, primary and secondary. Both involve the breakdown of cartilage in joints, which causes bones to rub together.

Primary osteoarthritis: Wear and tear on joints as people age cause primary OA. Therefore, it starts showing up in people between the ages of 55 and 60. Theoretically, everyone experiences cartilage breakdown as they get older, but some cases are more severe than others.

Secondary osteoarthritis: Secondary OA involves a specific trigger that exacerbates cartilage breakdown. Common triggers for secondary OA include injuries like fractures, obesity, inactive lifestyle, Inflammatory Diseases and certain conditions like diabetes, Joint infections, Congenital disorders of joints also increases the chances of OA.

SIGNS AND SYMPTOMS OF OSTEOARTHRITIS TREATED IN PHYSIOTHERAPY:

The symptoms of OA include joint pain, swelling, tenderness, stiffness, and sometimes locking, which may lead to disability and severely affect the life quality of patients. The most common symptom of osteoarthritis is pain in the affected joints after repetitive use. Joint pain is usually worse later in the day. There can be swelling, warmth, and creaking of the affected joints. Pain and stiffness of the joints can also occur after long periods of inactivity, for example, sitting in a theater. In severe osteoarthritis, complete loss of cartilage causes friction between bones, causing pain at rest or pain with limited motion. (Kuttner J.H., Goldberg V.M.)

Symptoms of osteoarthritis vary greatly from patient to patient. Some patients can be debilitated by their symptoms. On the other hand, others may have remarkably few symptoms despite dramatic degeneration of the joints seen on X-rays. Symptoms also can be intermittent. It is not unusual for patients with osteoarthritis of the hands and knees to have years of pain-free intervals between symptoms.

DIAGNOSIS:

Osteoarthritis can be identified by the physical signs present around joints including swelling, warmth, crepitus or restricted range of motion of joints. There are no blood tests to diagnose the osteoarthritis, but Blood tests are performed to exclude diseases that can cause secondary osteoarthritis, as well as to exclude other arthritis conditions that can mimic osteoarthritis. For the diagnosis of the condition, X-rays of the affected joints are then main way.

The common X-ray findings of osteoarthritis include loss of joint cartilage, narrowing of the joint space between adjacent bones, and bone spur formation. Simple X-ray testing can be very helpful to exclude other causes of pain in a joint as well as assist the decision-making as to when surgical intervention should be considered.

Removal of joint fluid and injection of corticosteroids into the joints during arthrocentesis may help relieve pain, swelling, and inflammation. (Reichenbach S, Sterchi R, Scherer M, et al.)

Arthroscopy is a surgical technique whereby a doctor inserts a viewing tube into the joint space. Abnormalities of and damage to the cartilage and ligaments can be detected and sometimes repaired through the arthroscope. If successful, patients can recover from the arthroscopic surgery much more quickly than from open joint surgery.