OA: Challenging What You Think You Know for Better Pain Relief and Joint Health
What is Osteoarthritis?
Osteoarthritis (OA) is a chronic disease and the most common form of chronic arthritis. It is characterized by joint pain, stiffness, and swelling, predominantly affecting the hands, knees, and hips. While OA most frequently occurs in people over 55 years of age, it can also affect younger individuals.
Risk factors for OA include:
joint injury,
being overweight or obese,
older age.
genetic factors
DID YOU KNOW?
Running and past sports involvement, like playing netball on asphalt, is NOT a risk factor for developing OA later in life. In fact, research shows that the more active you are, the less likely you are to have severe OA.
Although there is no cure for OA, many treatments and approaches are available to manage the long-term symptoms.
FACT: Based on the latest evidence, arthroscopy is no longer recommended for managing OA in most cases! Your knee or hip typically does NOT need a "clean out."
How is Osteoarthritis diagnosed?
A health professional can usually diagnose Osteoarthritis (OA) based on your reported symptoms and a physical examination of the joint. Imaging tests like x-rays are generally not needed to diagnose OA or to determine the best treatments. Interestingly, changes seen on x-rays or MRIs do not always match up with the pain you feel.
Therefore, treatments should focus on the problems you are experiencing rather than relying on a scan.
FACT: Just because your scan looks bad doesn't mean you will experience pain or a lack of function! Conversely, a clean scan doesn't guarantee you won't experience pain.
Do I just need to replace my joint?
Not necessarily! Joint replacements can be fantastic for severe cases of OA once conservative management and exercise have been fully explored. In the meantime, there's plenty you can do to reduce your symptoms and improve your joint health!
Here's what you can do:
Nutrition: Ensure adequate calcium and vitamin D intake through your diet or supplements.
Regular Exercise: Engage in specific exercises that promote joint and bone health. These exercises can include muscle strengthening, walking, Tai Chi, stationary cycling, and Hatha yoga.
Avoid Smoking and Excessive Alcohol: Both smoking and excessive alcohol consumption are linked to bone loss, so it's best to avoid them.
Medications: Certain medications, like bisphosphonates, can help strengthen bones.
Remember, focusing on these lifestyle changes can significantly improve your joint health and help manage OA symptoms effectively.
How can exercise help with OA?
Pain can make people avoid activity and this can lead to muscle weakness, feelings of joint instability, more pain and other health problems, particularly in people with lower limb OA (knee, hip or ankles/feet). Staying active and keeping muscles strong can help with pain and stop the cycle of decline.
Welcome to the cycle of PAIN ->
Therefore, exercise is one of the most important treatments for OA. All OA clinical guidelines recommend exercise as an important part of keeping joints moving and healthy. Exercise can relieve OA symptoms of the knee and hip just as well as pain medications, but it is safer and has fewer side effects.
The benefits of exercise are many, including feeling less pain, maintaining a healthy weight to reduce the load on painful joints, being able to do more, and having better general health.
There is some evidence that specific hand exercises can help people with hand OA by reducing pain and finger joint stiffness and improving hand function, but the benefits have been shown to be small.
So which exercise is best for osteoarthritis?
Try to do some physical activity on most days of the week. A combination of strengthening and aerobic exercise is best but this can include a variety of activities by yourself or as part of a group.
Strengthening exercise
Can be performed at home or at the gym. The thigh, hip and calf muscles, which are important for daily tasks, are often weak in people with lower limb OA.
Strengthening these muscles can support and take pressure off sore joints, improve balance and reduce the feeling of giving way. Resistance can be applied with weights, elastic tubing or body weight.
Aerobic exercise
Is an activity that increases your pulse rate and makes you breathe harder. Regular aerobic exercise can help you sleep better, burn calories for weight management and increase your energy levels and general health. Release of pain-relieving hormones called endorphins can reduce pain as well.
Activities may include walking, swimming, cycling or using a stationary bike.
Reformer Pilates
Reformer Pilates for OA Management
Reformer Pilates is a versatile exercise method that can be highly beneficial for managing Osteoarthritis (OA). It can be done individually or in a class setting, offering flexibility to suit your needs and preferences.
Benefits of Reformer Pilates for OA:
Improved Functional Neuromuscular Control: Reformer Pilates focuses on controlled movements and exercises that enhance neuromuscular coordination. This helps improve joint stability and function, reducing the risk of injury and pain.
Low-Impact Exercise: The reformer machine provides a low-impact environment, making it easier on the joints while still offering a challenging workout. This is particularly beneficial for those with OA, as it minimizes stress on painful joints.
Enhanced Flexibility and Strength: Reformer Pilates incorporates resistance through springs, which can help build muscle strength and improve flexibility. Stronger muscles support the joints better, alleviating OA symptoms.
Other types of beneficial exercise
Include tai chi, balance exercises, and stretching and flexibility exercises to improve the range of motion of joints and muscles.
But it hurts when I exercise - should I keep going?
When starting to exercise, experiencing low-level pain (2-3/10) is normal. However, this pain should not linger or cause "hangover" pain the next day.
If your pain is higher than this, it's a good idea to check in with your physiotherapist or exercise physiologist. This doesn't mean exercise is bad for you; it simply means we haven't yet found the right level of load that your body can tolerate.
We'll work together over time to build up your load tolerance. You may be surprised that over 6-8 weeks of strength and balance training, twice a week under the guidance of a trained health professional, you can significantly lower your pain levels and improve your function!
Points to remember:
• Exercise can relieve OA symptoms of the knee and hip just as well as pain medications but is safer.
• Begin any new physical activity program slowly and progress gradually.
• You may experience some discomfort in the affected joint during exercise — this is normal. A major increase in pain or swelling can mean that changes to your exercise program are needed. A physiotherapist or accredited exercise physiologist can assist you here.
• If you are overweight, losing weight by modifying your diet can help reduce your pain and improve the outcomes of your exercise program.
• Benefits are lost if you stop exercising, so use strategies to help you continue: keep a log book or exercise diary; set achievable goals; ask a friend to join you; and vary your exercise program.
Osteoarthritis can be a challenge, but you don't have to face it alone. Exercise is a powerful tool to manage your symptoms and improve your overall well-being. If you're unsure where to begin or have questions about creating a safe and effective exercise program,
HELPFUL RESOURCES:
Melbourne Uni has a fantastic client led evidence-based course to learn more about your OA
Touch base and book with us at Move Sports Physiotherapy & Pilates. We will get to know you and your body during the sessions and help you MOVE!
For more related PHYSIO FACTS:
References and further information:
1.Fransen et al (2015) Exercise for osteoarthritis of the knee: a Cochrane systematic review. Br J Sports Med 49:1554-7.
2. Østerås et al (2017) Exercise for hand osteoarthritis. Cochrane Database of Systematic Reviews, Issue 1. Art. No.: CD010388.
3. Quicke et al (2015). Is long-term physical activity safe for older adults with knee pain? A systematic review. Osteoarthritis & Cartilage
4. Fransen et al. (2014) Exercise for osteoarthritis of the hip. Cochrane Database of Systematic Reviews, Issue 4. Art. No.: CD007912.
5. Rausch Osthoff et al (2018) 2018 EULAR recommendations for physical activity in people with inflammatory arthritis and osteoarthritis. Ann Rheum Dis 77:1251-60.
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