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Osteoarthritis

A young woman massaging her painful knee

A woman massaging her painful knee

Osteoarthritis (OA) affects millions of people in the united states and can cause pain in every joint in the body. However, the major joints affected the most are the hips, knees, and shoulders.  When the joint looses cartilage, the underlying osteochonral bone can become exposed. Thus, reducing the slippery surface provided by the cartilage, and now you have a bone on bone situation, which increases the friction at the joint. The most predisposing factor for OA is age. The condition primarily affects the middle-aged to elderly population, most often over 60 years (J Orthop Sports Phys Ther 2009:39 (4) A1-A25).

When the joint becomes painful and/or swollen, the person tends to reduce demand on that joint by compensating their movement.  This causes several issues: decreased mobility of the joint, decreased synovial (lubricant) production, decreased strength and stability around the joint, and decreased flexibility of surrounding musculature, all from disuse of the joint. The compensatory movements will also cause pain in other extremities and joints.

Current treatment approaches include:

Over the counter pain medications can be taken for OA pain as well as prescription strength NSAID’S (non-steroidal anti-inflammatory drugs).

Physical Therapy to regain lost movement, flexibility, strength, endurance, and return to normal functions.

Artificial synovial fluid (Synvisc) injections can be administered to provide the patient with lost lubricant in the joint, thus reducing friction from bone on bone contact.

Surgical interventions include arthroscopy for mild to moderate OA, unilateral compartment Osteotomy (removal of sub-chondral bone), unilateral joint arhroplasty (joint replacement of one compartment), and total knee replacement (arthroplasty).

 

Dr. Gary Welch PT, CFCE, CFMT, CKTP, COMT

Spectrum Physical Therapy
100 Hospital Road, Suite 112
Patchogue, NY 11772

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