Degeneration, osteoarthritis, wear and tear, we’ve all heard these words before but what is actually going on? These terms are used interchangeably and describe the process that is occurring within particular joints of our skeletal frame. Osteoarthritis is a degenerative joint condition that worsens progressively with time and affects a type of joint called synovial joints. These include the main weight-bearing joints of the body (knees, hips and ankles) as well as the hands and the spine; particularly the neck and lower back.
It is a process that affected 1 in 11 Australians in 2014-2015 and can start to be seen in individuals as young as 20-30 years old. Normally however, symptoms only start to become noticeable in the population over the age of 50.
In a normal, healthy joint, cartilage is a tissue that covers the ends of our bones and functions to protect them by reducing friction and dissipating stresses during movement. In osteoarthritis, this cartilage softens and starts to break down, exposing the bones to increased biomechanical stresses. This results in numerous changes within the joint and can lead to a variety of symptoms that slowly progress in severity including:
- Deep aching pain that originates from the joint or refers to particular surrounding areas.
- Stiffness in the joints, initially in the morning when first waking or after resting for a period of time.
- Decreased range of movement at a joint
- Swollen or enlarged joints
- Crepitus – clicking or cracking noises within the joint
Studies looking at the causes of osteoarthritis believe that alterations occur in cartilage due to excessive loading in a healthy joint or normal loading in a previously disturbed joint e.g. if a joint has experienced past injury or surgery. Although ageing is implicated, it is not the defining factor of onset. Risk factors for development of osteoarthritis include but are not limited to:
- Muscle weakness
- Previous inflammatory arthritis
- Repetitive stressful movements
The goal of conservative treatment of osteoarthritis is to alleviate pain and maintain or improve the functional state of the affected and surrounding joints. There is evidence to suggest that treatments including the following practices may be of benefit for those with osteoarthritis.
- Massage therapy
- Dry needling
- Unloading of certain joints
- Reduction of muscle contracture
- Joint mobilisation