Osteoarthritis

Osteoarthritis (OA) is thought to be the most prevalent chronic joint disease. The incidence of osteoarthritis is rising because of the ageing population and the epidemic of obesity. The primary source for diagnosing OA is through X-ray. The most common location of OA is in the joints of the body – feet / knees / hips / wrists and back.

Causes

  • Primary OA is idiopathic in that there is no known definitive cause of the disease. There are some systematic factors that place an individual at a greater risk of developing OA and these include: females, increased age, nutritional factors and certain predisposed genetic factors.

  • Secondary OA however, is identifiable due to there being a definitive cause for example trauma to single or multiple joints over a prolonged period and these are commonly referred to as intrinsic joint vulnerabilities.

Signs & Symptoms

  • There are very few signs of OA but one of the main signs that may occur is swelling around the joint

  • Pain or aching in the joint during activity, or after excessive activity

  • Joint pain when returning to activity after a prolonged layoff 

  • Joint stiffness that may occur first thing in the morning are just some of the common symptoms that tend to build over time rather than show up suddenly.

Differential Diagnosis

  • Rheumatoid arthritis


PROmotion Assessment and outcome measures

  • Subjective examination including a family history check of OA and a thorough check of when the pain occurs, how it occurs and importantly – where it occurs.

  • Moving the joint through various ranges to assess for joint mobility and strength of the surrounding musculature.

  • Completing a specific OA questionnaire known as the GLA:D (Good living with arthritis – Denmark) questionnaire to help distinguish the type and severity of the OA being presented.

  • Outcome measures are also assessed at various stages through the GLA:D exercise program to assess for progress in both a subjective and objective format

How to Manage

  • Education & advice surrounding correct loading of the joints and how to avoid overloading.

  • Joining the evidence based GLA:D program to help strengthen the surrounding musculature and promote safe and effective loading for joints affected with OA.

  • Management may include a referral to an accredited dietitian for professional and practical advice.

References

  1. Bijlsma, J. W., Berenbaum, F., & Lafeber, F. P. (2011). Osteoarthritis: an update with relevance for clinical practice. Lancet (London, England)377(9783), 2115–2126. https://doi.org/10.1016/S0140-6736(11)60243-2

  2. Vina ER, Kwoh CK. Epidemiology of osteoarthritis: literature update. Curr Opin Rheumatol. 2018;30(2):160‐167. doi:10.1097/BOR.0000000000000479

  3. Wellsandt E, Golightly Y. Exercise in the management of knee and hip osteoarthritis. Curr Opin Rheumatol. 2018;30(2):151‐159. doi:10.1097/BOR.0000000000000478