The word arthritis is used to describe pain, swelling and stiffness in a joint or joints. The most common type is osteoarthritis, which affects nearly 9 million people in the UK and is the most common cause of chronic joint pain. This is diagnosed clinically based on your history and symptoms by a medical professional. It may involve imaging such as X-rays or MRIs, but these are often not required to make a diagnosis, nor are they indicative of your symptoms.
Below we will discuss what OA is, the treatment options, and provide some useful links to help you understand your condition.
Common symptoms of osteoarthritis include:
Joint stiffness
Pain
Swelling
Muscle weakness
What is osteoarthritis?
Factors influencing osteoarthritis
Age: usually over 45
Gender: more females than males
Weight
Occupation
Genetics
Joint abnormalities / anatomical differences
Previous injury or surgery
Treatment of osteoarthritis
First-line management is the initial treatment that a patient should receive after receiving a diagnosis. This is often the least invasive, most evidence-based, and typically continues as a foundational part of their ongoing care. For osteoarthritis, there are three key first-line management strategies:
Education - It is important to understand the nature of osteoarthritis, including what to expect, the benefits of movement, signs of overdoing things, and to have a good understanding of what treatment options are available and how things like diet, sleep, weather or previous experiences contribute.
Exercise - Movement is very important in managing osteoarthritis, but it can be challenging to find the right exercises for you. A combination of resistance (strength) training and aerobic exercise is best. Strengthening muscles and loading soft tissues can improve joint health and significantly improve pain and functional levels.
Weight control - Increased body weight places significant additional load on the knee joint, and weight loss is well correlated with reduced osteoarthritis symptoms and improved quality of life.
Second-line treatment is another step down the management pathway and is considered an adjunct or additional option that may not be suitable for everybody, but could be beneficial to the right person. You should continue using first-line options while exploring these options. This could include:
Walking aids, pharmacological management, non-steroidal anti-inflammatory drugs, infrequent or short-term paracetamol or weak opioids, and intra-articular corticosteroid injections. Medication and injections should be discussed and prescribed by your consultant or GP.
Surgical management is sometimes appropriate if symptoms are having a significant impact on quality of life, and first- and second-line treatment have failed. This is a decision made with your orthopaedic surgeon and could include a unicompartmental or total knee replacement.
Osteoarthritis and physiotherapy
Research shows that physiotherapy can be highly effective in the management of osteoarthritis. Our specialist physiotherapists will comprehensively assess you to provide advice and implement an individualised treatment plan. Our aim is to help you manage your condition independently with exercise, education and self-management strategies, with the aim of avoiding or delaying surgical or invasive treatments.
Exercise classes and osteoarthritis
Exercise can improve symptoms of osteoarthritis and overall health and fitness to help maintain a healthy weight. This can also help with other health conditions such as heart disease and diabetes. A graded exercise programme can be delivered by your physiotherapist in your session or within the ESCAPE-pain programme. The Nuffield Health Joint Pain Programme is a free programme designed to provide supervised exercise and gym access for patients who self-refer to their local Nuffield Health centre.
Enabling Self-management and Coping with Arthritic Pain using Exercise
The ESCAPE-pain programme is designed for people with chronic joint pain from osteoarthritis. It integrates educational self-management and coping strategies with an exercise regimen individualised for each participant. It helps you understand your condition and gives you the tools to manage and cope with pain better. Your physiotherapist will discuss a referral to this class with you, if it is appropriate.
For more information about ESCAPE-pain, visit their website where you can start a web-based version of the programme and find lots of useful information and advice on arthritis.
