Role of physiotherapy in osteoarthritis

 

Osteoarthritis of the knee joint is one of the most common form of arthritis in Indian population.knee (o.a.) Osteoarthritis is seen radiographically in 33% of population older than 60 years of age (Felson,2004) and responsible for higher incidence of disability than any other chronic condition.

It’s important to remember that knee arthritis is also term used for some inflammatory disease of the inflammatory disease of the joint which can also cause pain and similar end result.In the knee joint as the opposing cartilage surface wear away,the knee collapses causing deformities like bow legs or knock knees.

These deformities can contribute to pain and functional losses of the knee joint. Knee osteoarthritis may occur due to previous history of injury or damage to the joint.Due to roughening of the joint along with pain there may be clicking, catching,clunking or similar symptoms.swelling is also often seen.

Risk factors and contributing to OA

Factors Causing OA
Older age Increase with age
Female sex More prevalence
Obesity Higher incidence
Osteoporosis Higher incidence
Occupation Extreme squatting
Sports activities Overuse
Previous injury Post injury
Muscle weakness Sedentary lifestyle

 

The commonly asked questions:

1) Should people with arthritis exercise?

Yes,studies have shown that exercise help people with arthritis in many ways. It will help to reduce joint pain and stiffness and increases flexibilit, muscle strength,cardiac fitness and endurance, help with weight reduction and contribute to an improved sense of well bearing.

2) How does exercise fit into a treatment plan for people with arthritis?

Exercise is one part of the treatment plan, other important aspect of the plan include rest, relaxation,diet, medication and proper Patient education about proper use of the joints to conserve energy and use pain relief methods.

3) Which exercises are most suitable for arthritis?

The Main types of exercises include:

  1.  Range of motion: to maintain and increase flexibility.
  2. Strengthening exercises: Maintain or increase muscle strength
  3. Aerobic or endurance exercises: improves cardiovascular fitness,control weight and improve overall function
  4. Balance training exercises: Improves proprioception and coordination

3) How to start the exercise?

  • Discuss with doctor.
  • Supervised exercises by physiotherapist.
  • Warm up followed by strengthening and cool down exercises.
  • Precise ergonomic plan
  • Life style modifications.
  • Choice of exercises which is enjoyable to the patient.

4) How should pain be relieved?

Physiotherapist may use the following.

  • Moist heat : for relaxation of tight structures.
  • Ice therapy : to stop pain and decrease swelling.
  • Hydrotherapy: to decrease pain
  • Mobilisation : to increase flexibility.
  • TENS : to relief pain.
  • Relaxation therapy : to relieve tension.
  • Dry needling : stimulation of deep sensory nerves.
  • Taping : support and decrease pain.
  • Exercise therapy: reconditioning the joint and weight reduction.

5) How much exercise to be done?

Exercise should not be done to level of

✓Fatigue

✓ weakness

✓ stiffness

✓ pain

✓ swelling

Moderate intensity will be the best.

6) What is the role of surgery in OA?

For advanced cases surgery in indicated when pain is unbearable and affecting the quality of life.

Post surgery physiotherapy helps restoring near normal joint function.

Patient has to follow some Do’s and Don’t s

  • Physiotherapist follow the Principe of “use it or loose it”
  •  Early diagnosis and effective treatment of injuries, complete rehabilitation should decrease the risk of osteoarthritis.

Thus holistic approach of physical therapy can be summed up in one word Oath(Oa- osteoarthritis and Th- treatment in harmony)

By

Dr. Anjali Puntambekar,

Associate Professor,

Department of Musculoskeletal Physiotherapy

K. J. Somaiya College Of Physiotherapy

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