Many people will experience joint pain to some extent at some stage during their lifetimes. Symptoms can occur without any obvious predisposing factors or history of injury or trauma. Such symptoms are often due to degenerative joint disease or osteoarthritis, OA. OA refers to mechanical abnormalities involving the degradation or degeneration of joints, including the articular (joint) capsule and the subchondral (underlying) bone. In addition to pain, other symptoms may include joint tenderness, swelling, stiffness, locking and clicking. The mechanical loading of joints that occurs in everyday activities such as jogging or lifting can cause what is often referred to as ‘wear and tear’ of the joint cartilage. Other processes may also contribute to cartilage loss, such as hereditary, metabolic or developmental factors. When the boney surfaces of a joint become less well protected by cartilage, the underlying bone may become exposed and damaged. These degenerative changes usually result in bone and joint inflammation and the development of the associated symptoms already mentioned.
Whilst it is not possible to reverse the degeneration and erosion of the joint cartilage and underlying bone, Physiotherapy can help reduce the symptoms caused by these processes. Stiffness and loss of joint movement can be minimised by joint mobilisation techniques. Pain, tenderness, inflammation and swelling can be reduced by manual therapy and the application of electrotherapy modalities, heat and ice. Weakness and wasting of the muscles adjacent to and surrounding the affected joints can be addressed by the prescription of specific strengthening exercises. Supportive splints, braces and orthoses may also be of benefit, for example prescription insoles can provide support and shock absorption to reduce pain associated with OA of the joints of the foot. Appropriate and practical advice is also an essential component of effective management of OA especially in terms of lifestyle and activities. Many patients find that with good adherence with their home exercise programmes and advice that they can self manage their condition very effectively with minimal impact on their daily lives, and that they only need to attend for treatment when they experience a flare-up, in other words on an as-required basis. Others prefer to adopt a maintenance approach to their treatment, and present at regular infrequent intervals of once every 2 to 3 months, even when they are asymptomatic. This allows us to evaluate their progress with their home exercise regime, but also to pre-empt and ‘trouble-shoot’ problems and thus prevent severe exacerbations from developing. We are happy to advise regarding the post appropriate approach to management and treatment following a thorough assessment.