Osteoarthritis

More than 7 million adults in the UK (15% of the population) have long-term health problems due to arthritis and related conditions. 25% of people over the age of 50 report long term knee pain, and in one quarter of these the pain is disabling.

There are a number of ways in which physiotherapy can help you reduce the symptoms of osteoarthritis and improve your quality of life.

Treatment will include:

  • Manual treatment to reduce stiffness in your joints and remedial massage to reduce chronic muscle pain and help restore normal muscle function
  • A rehabilitation program to strengthen the muscles around the painful joint
  • Assessment of your biomechanics; often changing the position or stiffness in a remote joint can reduce the forces acting through a painful joint
  • Specific taping techniques to reduce the pressure on painful structures
  • Lifestyle advice
  • Discussion of dietary supplements and different forms of pain relief
  • Dietary advice and weight loss.

State of the Evidence:

A recent study conducted in 5 GP practices in Nottingham and published in The British Medical Journal (BMJ) supports the use of simple home-based exercises to strengthen the knee musculature as the first-line treatment of knee pain in osteoarthritis. Exercises significantly reduced the experience of knee pain and improved mobility, and the improvement was maintained over 24 months. Dietary interventions and weight loss, in contrast, did not improve knee pain or mobility but did reduce levels of depression.

Another study from the USA looked at the value of quadriceps strength in preventing knee pain. The study followed over 3000 subjects aged 50–79 for 30 months looking to see whether quadriceps strength (or lack of) could predict the development of osteoarthritis symptoms and changes on x-ray. They found that the strongest knees were associated with the lowest incidence of symptomatic osteoarthritis, suggesting that there is good value of strong knees is in preventing symptoms. Interestingly this benefit was much stronger in women than men.

References

1. Jenkinson CM, Doherty M, Avery AJ et al. Effects of dietary intervention and quadriceps strengthening exercises on pain and function in overweight people with knee pain: randomised controlled trial. BMJ 2009 Aug 18;339:b3170.

2. Segal NA, Torner JC, Felson D et al. Effect of thigh strength on incident radiographic and symptomatic knee osteoarthritis in a longitudinal cohort. Arthritis Rheum 2009 Sep 15;61(9):1210-7.

For more information, visit http://www.arthritisresearchuk.org/health-professionals-and-students/reports/topical-reviews/topical-reviews-autumn-2010.aspx

Physiotherapy can be extremely effective at reducing pain and stiffness in the knee, hip, back, neck and shoulder.