Osteoarthritis and Physical Therapy
Osteoarthritis (OA) is one of the most common joint disorders, especially in adults over the age of 60. Two of the most commonly affected joints are the hip and the knee. Common symptoms are morning stiffness, where you feel like you need to get up and moving for 20 or 30 minutes before you “limber up”, creaking or popping sounds from your joint, as well as pain and swelling which is typically worse towards the end of the day.
For a lot of people, the thought of knee or hip arthritis leads right to joint replacement surgery. While total hip or knee replacement surgery is an effective treatment for severe pain and disability related to OA, it’s not for everyone and certainly shouldn’t be the first line of treatment. Hip and knee replacements are major surgical procedures and are accompanied by significant risk. On top of that, both require months of recovery and rehab, and neither is a guaranteed solution with data showing that between 1 in 5 and 1 in 10 patients are not happy with the outcome after total joint replacement.
So if replacement isn’t the first and only option, what else is there?
Many studies have shown exercise to be beneficial in reducing pain and disability resulting from OA. Exercise can help regain range of motion and reduce stiffness around the joint. It also helps strengthen the muscles surrounding the joint which reduces the stress placed on the joint during activities.
Manual therapy is a hands on approach that can including joint manipulation (a quick thrust, often accompanied by a “pop” or “crack”), joint mobilization (more gentle, graded movements of the joint), and soft tissue mobilization (various forms of massage). These techniques have been shown to be effective in treating OA, especially when combined with exercise.
Significant benefits have been shown in overweight patients with OA who have shown a 10% weight loss. We take thousands of steps in a day, and each step puts stress through our hips, knees, feet, and other joints. When you consider reducing that force by a few pounds a few thousand times a day, a little weight loss can add up to a big difference!
Equipment including custom shoe orthotics, braces, compression sleeves, and splints are some of the less aggressive ways of managing joint pain caused by osteoarthritis. Although surgery may be the end result, these pieces of equipment can help to manage pain up to the date of surgery, provide support during physical therapy, and allow for increased stabilization of the joint itself.
These are four effective and conservative treatment options that your physical therapist can use to help decrease the pain that you’re feeling from arthritis. With a through evaluation, your PT can determine which options will best help you meet your goals and get back to whatever level of activity you’re aiming for. On top of these options you PT can also consider things like bracing, and help you consider options your physician might be able to provide like injections or medications.
Just because joint pain is starting to slow you down, doesn’t mean you have to live with the pain, face surgery, or give up your independence. Conservative treatment options from your physical therapist are an effective way to treat osteoarthritis and can help get you more active with less pain!