OSTEOARTHRITIS
Osteoarthritis is defined as a degenerative, non inflammatory joint disease characterised by a destruction of articular cartilage and formation of new bone at the joint surface and margins.
(OA = can also be called O- old age, A- arthritis)
Though OA can occur in all the joints due to aging, it is more commonly seen in weight bearing joints like knee hip, ankle and spine. Fingers joints are also frequently affected.
Among all the joints in the body, osteoarthritis affects the knee joints most and it could be primary or secondary.
Osteoarthritis (OA) of the knee is the most common type of arthritis and the major cause of chronic musculoskeletal pain and mobility disability in the elderly, and therefore represents a significant burden on healthcare provision.
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SIGNS AND SYMPTOMS
The symptoms of osteoarthritis can include:
- Pain
- Stiffness
- A grating or grinding sensation when the joint moves (crepitus)
- Swelling (either hard or soft). Sometimes the knee may either lock or give way when you put weight on it.
CAUSES
- Aging
- Obesity
- Trauma
- Infection
- Gender (women more affected)
- genetic
INVESTIGATION
X-rays are taken to assess the severity of the changes caused by osteoarthritis, although often they won’t be needed. They may show changes such as bony spurs or narrowing of the space between the bones where the cartilage has worn thin.
A Magnetic resonance imaging (MRI) scan of knee can be helpful. This will show the soft tissues (for example cartilage, tendons, and muscles) and changes in the bone that can’t be seen on a standard X –ray.
MANAGEMENT
MEDICAL TREATMENT:
NSAID (diclofenac or acelofenac)
Muscle relaxant (thiocholchicoside)
SURGICAL MANAGEMENT:
Arthroplasty, osteotomy, arthroscopic.
PHYSIOTHERAY TREATMENT
Various passive modalities have been used in patients with osteoarthritis, with varying degrees of support within the medical literature.
- Shortwave Diathermy (SWD)
- Paraffin Wax Bath
- Hydrocolateral Hot pack
- Cryotherapy
- Ultrasonic therapy (UST)
- Transcutaneous Electrical Nerve Stimulation (TENS).
- Range-of-motion exercises have been shown to decrease discomfort and pain, which can increase function and overall independence .
- Patients who cannot complete full range of motion, due to either motion limitation or inadequate strength, should be assisted by the therapist to complete full ROM. (Active-Assisted ROM Exercise).
- Continuous passive motion (CPM)device can also be used to mechanically facilitate ROM. The patient does not activate any muscles as the machine passively moves the joint.
- Isometric Exercises Involve contraction of muscles while they are at a fixed length, such that little or no joint motion is taking place.
- Isometric exercises are a reasonable initial approach for strengthening in patients who cannot tolerate repetitive joint motion, such as those with painful, inflamed joints.
