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OSTEOARTHRITIS
Osteoarthritis (degenerative Joint Disease) is the most common type of arthritis affecting primarily big joints where the cartilage of bone breaks down because of compromised efficacy of the musculoskeletal system resulting in biomechanical changes in the joint.
Factors
Age is the most common factor that influences OA, which is the natural degeneration of cartilage and supporting articles of joint such as ligaments, tendons, soft tissues, etc.
Other factors like injury, obesity, imbalance, compromised strength, and coordination, which may result in bad Gait (Walking pattern) and posture or occupation may worsen the speed of degeneration.
Symptoms
The primary symptom that arises due to stress on muscles is weakness followed by stiff joints and frequent crepitus (creak sound from joints)
Constant weakness in the muscles results in instability of joint resulting in soft tissue injuries and inflammation which causes pain in movement and later even in resting if inflammation become worse.
Repetitive injuries, imbalance, and prolonged stiffness of the muscles result in deformation in bone and joints which may lead to permanent deformity if untreated or limited range of motion.
Treatment
Conservative Treatment
Non-surgical methods are the most effective treatment to cure OA as these all work on the factors that directly influence arthritis.
It should be understood that the initial reason behind the OA symptoms includes weakness, stiffness, lack of strength, balance, and coordination which all together lead to instability, so it is recommended to improve all the above factors to avoid joint instability to prevent further degeneration.
Physical therapy (Physiotherapy) aims to improve Muscle flexibility, Muscle strength, Coordination, and Balance to maintain joint firmness which is sufficient to reduce the speed of degeneration.
Electrotherapy for the management such as Ultrasonic Therapy (UST), Interferential Therapy (IFT), Trans Cutaneous Electrical Nerve Stimulator (TENS), moist heat, etc, are effective with parallel practice of strength-coordination exercises and precautions.
Several other techniques and practices are there in physiotherapy to manage symptoms and delay degeneration
To improve ROM: mobilization techniques like joint mobilization, mulligans, stretching of muscles, and muscle release techniques like MFR help in improving joint ROM.
To improve muscle weakness: Strength training stepping to isotonic exercises from isometrics exercises progress gradually according to the severity of symptoms.
To improve balance and coordination: Other than the neuro-muscular coordination exercises wobble board, bosu ball, stability trainer, Bobo motion balance are effective tools to improve balance and coordination which reduces the risk of falls
Gait training:
Gait is an important aspect of osteoarthritic joint rehabilitation. The proper Gait ensures correct body weight transfers through ideal biomechanics, which reduces the chance of imbalance and excessive stress on joints.
Surgical Intervention
In case of failure of conservative management, one needs to opt surgical method which is Joint Replacement. The surgeon makes the decision to select the procedure either partial joint replacement or total joint replacement depending on the degenerated joint.
Advice
It is always advisable for the patient to practice exercises prior to replacement surgery which improves the chances of success of surgical intervention. It is very much required for the muscles to be strong enough to respond well during post-operative rehabilitation.
Post-surgery physiotherapy exercises should be performed for at least 2 months to ensure strength, coordination, balance, and fair Gait.
Aspire is equipped with a state-of-the-art unit of physiotherapy delivering the ideal protocol to improve symptoms and witnessing the effect of exercises on patients who are living pain-free lives without surgery.
By Dr. Dimple Bhardwaj (Sports Physiotherapist)