Conservative Management of OA
Osteoarthritis is the most common form of arthritis and can lead to significant pain and disability. It is most common in people over 55 years and there is a 45% lifetime risk of developing Knee joint OA increasing to 65% in obese individuals.
The international guidelines for the treatment of hip and knee OA recommend exercise, education, weight management (if required) and medication if needed.
GLA: D Goodlife with osteoArthritis (Denmark) has developed an evidence based program to manage the symptoms of OA, pain and loss of function. The 8 week program has been shown to decrease the participant's pain and use of medication, increase their physical activity levels and reduce the number of days on sick leave. (Bucknor et al 2015, OARSI, "Osteoarthritis and Cartilage", 04-01, Vol 23, Issue 4, p 525-531).
Basic science and clinical studies have demonstrated that abnormal loads can alter the composition and physical properties of articular cartilage. Excessive weight gain appears to impair regulatory pathways that maintain cartilage homeostasis and increase the production of pro-inflammatory adipocytokines which contribute to cartilage degeneration. It is therefore important to educate people with OA of the importance of weight loss. For each kilogram of body weight lost, the knee experiences a 4 kilogram reduction in load per step which decreases the load on the joint and can decrease the pro inflammatory changes.
Education about arthritis, guidance regarding weight loss and exercise and timely referrals should all be part of early intervention in the conservative management of OA.
About the author:
Dr Jan Naughton received her PhD at Sydney University where she was lecturing in Sports Medicine and undergraduate physiotherapy. She specialises in shoulder injuries and has a sports physiotherapy practice in Wahroonga on Sydney's upper north shore working with two other specialist colleagues.