What is osteoarthritis, otherwise known as OA?. In short, OA is a degenerative joint disease that affects more than 20 million people across North America. The disease gradually breaks down joint cartilage, the protective lining at the end of our bones, that provides a smooth joint surface , nutrition, and ease of range of motion. As the cartilage becomes thin, bone spurs may form and the joint surfaces rub against each other, causing pain, inflammation, stiffness and lack of mobility. This often painful cycle can impact one’s energy levels, mood, and quality of life. However, the disease is manageable once you come to understand some facts over common myths.
There are four common myths that Physio Meets Science (Brien, D.W, Chapple, C.M et al, 2019) helps to dispel. Firstly, in the case of arthritis, the joint should be protected and not loaded. It has been found that in people with knee arthritis, low activity is associated with a greater thinning of the cartilage lining shown on MRI (magnetic resonance imaging). Moderate running, for example, has been shown NOT to worsen the structural progression of OA over a 2 year period. In fact, there was a higher probability of an improvement in joint pain and function (not considering the degree of OA, genetics, and other comorbidities).
Secondly, the worse the imaging looks, the worse the joint is. Imaging diagnostics such as MRI and X-rays are standard tools for the diagnosis of OA. However, only 50% of the people with radiographic OA have clinical symptoms. The assessment of a person’s signs and symptoms may be more clinically relevant that the imaging findings, especially with regard to therapy.
Conservative treatments are ineffective and only capable to delay joint replacement surgery. It has been found that education, lifestyle, dietary changes and exercise are the cornerstone of conservative management. Exercise can positively influence pain, muscle function, body weight, cardiovascular fitness, mood and disease progression.
Lastly, is it believed that joint replacement surgery is inevitable. Disease progressions differ from person to person and are multifactorial. Many people reach the point where joint replacement surgery is not appropriate or necessary. Not everyone is suitable for surgery and it is advisable to progress through a progressive conservative management protocol in an effort to achieve the best physical function before surgery is considered.
Busting some common myths about this disease will lead to a better understanding of OA and could contribute to better lifestyle habits for people living with this disease. Physiotherapists are well equipped with the knowledge to educate patients and implement best-practice care for the ongoing management of this disease.
Jennifer Gordon (BSc.PT, AFCI, GIMS)