What do you think about these statements on Osteoarthritis? True or False?
1. You need an Xray to diagnose Osteoarthritis, and the severity shown on the Xray determines the severity of your symptoms and pain levels.
2. Osteoarthritis is only about ageing and there is nothing you can do.
3. Osteoarthritis always progresses and you will eventually need a joint replacement.
4. Exercise makes Osteoarthritis worse. In fact exercise causes Osteoarthritis, and is only suitable for mild Osteoarthritis.
In fact they are all wrong!
Here’s the thing…
Osteoarthritis, or OA for short, is one of the commonest chronic conditions – 24% of people end up getting knee OA.
In a way OA is not a disease, but rather a way the joint compensates for some trauma. It is usually associated with thinning joint cartilage, remodelled adjacent bone, and localised inflammation. For some, OA may be no more than an altered joint, but symptom free, while for others it can cause major problems.
Why does it occur?
Yes, it may be related to your genes, possibly ageing, but most likely it is related to some JOINT TRAUMA from injury, misalignment, joint laxity, or over use. Chronic TENSION of muscles around a joint may also be an aggravating factor. This could be associated with poor posture or poor technique of action, especially something you do very often.
Being OVERWEIGHT also adds to the risk; for women it can be 6 times the risk.
What’s more the earlier you attend to osteoarthritis, the better the result. However, it is never too late to try something.
The important thing is for you learn as much as you can (from reliable sources).
Learn about all your options, so you can make choices which work for you.
A major stress with any chronic condition is the “internal conflict” which can arise with deciding what to do.
There are other factors which can also affect your symptoms, levels of pain, and how it impacts your life. These include your beliefs about OA, your “mood”, your relationships, work, quality of sleep, other pains you have, the support network you have, and your attitudes to exercise. It’s a problem which needs to be managed holistically.
Unless something unusual is happening, you don’t need invasive X-rays. The symptoms themselves tell you the story. Your doctor or health professional can help you with this.
Typical symptoms may include: morning stiffness, impaired mobility & joint stiffness, crepitus sounds from your joint, boney enlargements around the joint, & pain with activity.
Healthy Things to Do
Many people cope well with OA and science reveals 4 key factors can help you also cope well with OA.
Arthroscopic surgery is NOT the answer for most people, nor is reliance on lots of medication. There are much better healthy low cost alternatives.
1. Learn all about OA & Pain Science. Become a great Self Manager. Ask your health practitioners lots of questions. Go to reliable medical informations sites like:
Pain Science https://www.tamethebeast.org/#home
2. Make friends with EXERCISE and stay as physically active as you can. Exercise is not harmful to your joints, even if severe OA. It’s just about finding ways to move comfortably.
You may need some SPECIFIC STRENGTHENING exercise, as muscles around OA joints can become WEAK.
Include some MODERATE AEROBIC exercise like walking, cycling or water exercise.
Don’t forget pain relieving STRETCHING to aid your flexibility & reduce stiffness.
Additionally, COMPRESSION from muscle tension around a joint can be relieved through appropriate stretching and relaxation exercise.
Take time to CORRECT your posture & movement form, so your movement occurs with more ease & less strain. Yoga or Tai Chi can be a great for this…
“Become a detective and search out the unconscious, repetitive movements and positions that may be causing your muscle spasms. Be aware of how you use your body, and identify when and where one group of muscles is being used repetitiously at the expense of its opposing set.” Sandra Summerfield Kozak
* See your health practitioner. like a physiotherapist, for specific exercise guidance.
3. Manage your WEIGHT. This is a complex area with no easy solutions, but discuss options with your doctor or appropriate health provider. Generally in the long term, a combination of lifestyle, exercise & diet works best.
4. Protect your Joints:
Rest as you need, reduce load on affected joints, and use your LARGER muscles to aid movement.
Use good technique – using the whole body, not placing pressure to one area.
Use SUPPORTS or AIDS.
PACE yourself. If a task needs doing, then don’t do it all at once; spread it over a period of time.
5. Get additional HELP if required:
Emotional Support from friends, family, support groups
Sometimes there can be a role for “Hands on Therapy” for short periods eg Bowen or Manual Therapy
Short term use of medication for flare ups (see your doctor)
Self Massage – interesting that Arnica Gel has been found to be as effective as NSAID Gels.
Because Osteoarthritis is a CHRONIC condition you may find it helpful to have BOOST sessions every few months, with your physiotherapist, to help you stay on track.
A chronic condition does require one to STOP and re-evaluate one’s life. It will require CHANGE, but change can be seen as good.
There can be barriers to change. So take your time, weigh risks vs benefits, and find ways to fit with your life & values. For example if you are not an exerciser, it can take some practice to get used to becoming an exerciser. The good thing is there are many aids in the TECH world to help – Fitbit devices, phone reminders, calendars, & logs, social media support, and so forth.
The key is to make a decision, commit to it, re-evaluate & change as you need… You may have internal conflicts about what to do – get decision aids or speak with your health professionals.
Joint Replacement Surgery is a final option for pain relief, but should never be taken lightly. Consider all your options, and give them a reasonable go…
Next Month – Part 2: Consider how Yoga & Ayurveda (the health science of India) can be used to help support you with Osteoarthritis.
YOGA & AYURVEDA can offer holistic ways to reduce SUFFERING and lead a meaningful life…
• Self Management of Knee OA by Dr Rana Hinman Union Melb Physiotherapy (APA presentation)
• OA guidelines https://www.nice.org.uk/guidance/cg177 – clinical guidance from the UK
• “Yoga That’s Right for You – Pick the yoga practice that’s best for your joints” By Camille Noe Pagán and Susan Bernstein from the Yoga Foundation
• Int J Prev Med. 2013 Apr; 4(Suppl 1): S133–S138. PMCID: PMC3665019 Effects of Hata Yoga on Knee Osteoarthritis
- www.Healthwise.net – an aid to decision making
- “A Holistic approach to Relieving Osteoarthritis” Sandra Summerfield Kozak April 21 2015 Yoga International