OSTEOARTHRITIS

Osteoarthritis
JordanFederer
PT/OT/SportsMedicine
April7th,2015

OSTEOARTHRITIS

Introduction
Osteoarthritisisoneofthemostcommonformsofarthritis.Itaffectsover27million
peopleintheUnitedStatesaccordingtotheCenterforDiseaseControlandPrevention2014,
May16.Itaffectsmostlycartilageandcanbeverypainful.Whilescientistsdonotknowthe
causeofthis,buttherearemanywaystohelprelievepainontheaffectedjoint.Thephysical
therapistplanofcareforanosteoarthritispatientwouldbetoprovidephysicaltherapytowork
onstrengtharoundthejointandtoimproverangeofmotiontohelprelievethepatientspain
levels(CDC2014,May16).

Description
Osteoarthritishasmanysymptomsthatpeoplemayexperiencethosesymptomsinclude
pain,tenderness,stiffness,gratingsensation,andbonespurs.Scientistsreallydontknowthe
causeofosteoarthritis,butitisadiseaseofthewholejointincludingcartilage,jointlining,
ligaments,andunderlyingbone.Alsoosteoarthritiscanbecausedbyfamilyhistory,being
overweight,aging,jointinjury,andstressonthejoint.Osteoarthritisaffectseachperson
differently.Someprogressmorequicklythanothers,somedonthaveanysymptomsatallbut
stillhaveosteoarthritis.Osteoarthritisoccursmorefrequentlyinadults,butitcanaffectyoung
peopletoo.Osteoarthritiscanleadtodepression,anxiety,feelingofhelplessness,limitationson
dailyactivities,andjoblimitations.Osteoarthritiscanaffectanyjoint,butismostcommonin
theendsofthefingers,thumbs,neck,lowerback,knees,andhips(MayoClinicStaff,2015),
(ArthritisSourcebook,AmySutton,2004).

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DifferentialDiagnosis
SinceArthritishassomanydifferentcategoriestoitmanypeoplegoosteoarthritismixed
upwithanotherarthritis.Themostcommonarthritisitgetsmistakenforisrheumatoidarthritis.
rheumatoidarthritisalsocausesswolleness,andfluidwithintheaffectedjoint.Onewayto
differentiatethetwowouldberheumatoidarthritismostlyhappensinyourwrists.

DiagnosticTests
Todiagnoseosteoarthritisdoctorscanlookatthemedicalhistory.Notestcandiagnose
osteoarthritis.Asosteoarthritisgetsworserestingwillmakeitbetter.Doctorscandetermineif
youhaveosteoarthritisbyrulingthingsout.Theydothisbyphysicalexamination,xrays,MRI,
andlabtests.Xrayswillshowthespacebetweenboneswherecartilageisntpresent.Cartilage
isntshowninanxraybutthelossofcartilagedoesshowasdecreasedjointspace,andbone
spurstoo.Physicalexamsareverycommon.Theyexaminetheaffectedjoint,tenderness,
swelling,orredness,andtheyalsoperformrangeofmotion.AnothertesttheywilldoisanMRI.
Theseprovidedetailedimagesoftheboneandsofttissueincludingcartilage.Thelastthingthey
candoisbloodtests.Thesearentverycommonbuttheycanruleoutothercausesofthejoint
painbutnotactuallydiagnoseosteoarthritis(Medlineplus,A.D.A.MEditorialTeam,2013).

Medications
Someoverthecounterantiinflammatorymedicationsaretypicallythefirsttobe
used.Thoseincludetylenol.aspirin,ibuprofen,andnaproxen.Somemildnarcoticsor
corticosteroidinjectionscouldalsorelievepain.Somenaturalanddietarysupplementsthatcould

OSTEOARTHRITIS

beusedareglucosamineandchondroitinsulfate.Thesecanbetakentogetherorseparate,andare
usedtosupportjointhealth.Dimethylsulfoxide(DMSO)andMethylsulfonylmethane(MSM)
arechemicallyrelateddietarysupplementsthatcaneitherbeappliedtoskinortakenbymouth,
andthisalsohelpstorelievepain.ThelastmedicationwouldbeSAdenosylLMethane
(SAME)whichisnaturallyproducedinthebodyandcanalsobeusedfordietarysupplements
(Medlineplus,A.D.A.MEditorialTeam,2013),(MayoClinicStaff,2015).

TherapeuticInterventions
Somesurgeriesperformedforosteoarthritisarearthroscopywhichistrimmingthetorn
cartilage,osteotomywhichischangingthealignmentofthebone,arthrodesiswhichisasurgical
fusionofthebones,andthelastonewouldbetotal/partialreplacementoftheaffectedareawith
osteoarthritis.Anotherinterventionwouldbetomakesomelifestylechanges.Someofthose
includestayingactive,eatinghealthier,gettingenoughrest,losingweightifneeded,andto
changingactivitiesthatmayinjuretheaffectedjoint.Somecomplementarymedicineyoucould
dotorelievepainwouldbeacupunturethisisgoodforseverepainanditrelievespainfora
whileandavoidssurgeryinearlierstagesofosteoarthritis.Massagesareagoodwaytoreduce
painandincreasefunction.SomepeoplerecommendTaiChiwhichoriginatedinChina,itisa
gentlewaytoreducepainandstress.TaiChialsohelpswithbalanceandflexibility.Qigongis
goodforbreathing,andmeditation.Yogaisanotherlowimpact,safe,andhealthyactivitytohelp
relievepainandimprovebalance.Bracesandsplintscanbeworntosupportandprevent
deformity(Medlineplus,A.D.A.MEditorialTeam,2013),(OsteoarthritisandComplementary

OSTEOARTHRITIS

HealthApproaches),(MayoClinicStaff,2015),(JohnHopkins,TheJohnHopkinsUniversity,
20012).

RehabilitationInterventionsofaPhysicalTherapist
Aphysicaltherapistwouldperformrangeofmotionontheaffectedjointto
examineandassessit.Theywouldalsomassagetheaffectedareathathasosteoarthritis.The
physicaltherapistwouldalsoworktoimprovemusclestrengtharoundtheaffectedjoint.An
exampleofthiswouldforosteoarthritisintheknee,walking.Thisisaverygood,lowimpact
exercisethatanyonecando.Waterwalkingisevenbetterbecausethebuoyancyofthewater
supportsthejointwhileprovidingresistance.Lastyaphysicaltherapistcouldreducepainwith
heattreatmentshotpad,ultrasound,andparaffinbath(MayoClinicStaff,2015),(Arthritis
Sourcebook,AmySutton,2004).

Prognosis
Asosteoarthritisprogressesandworsensmovementmaybecomelimited.Doing
everydaythingsmaybecomemoredifficulteachday,includingapersonsjob.Eventhough
osteoarthritisgetsworseandlimitsnormalfunctionstherearetreatmentsthatcanbedoneto
improvefunction.(ArthritisSourcebook,AmySutton,2004),(Medlineplus,A.D.A.MEditorial
Team,2013).

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Conclusion
Asaphysicaltherapist,treatingapatientwithosteoarthritiscouldrangeanywherefrom
workingwiththehands,toworkingwiththeback,knees,orevenhips.Allofthejointsareeasy
toworkwithbeingaphysicaltherapist,andtheycouldeasilyhelpreducepainandexercisethe
affectedjoint.(JohnHopkins,TheJohnHopkinsUniversity,20012),(Medlineplus,A.D.A.M
EditorialTeam,2013).

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References
MayoClinicStaff(2015,January1).OsteoarthritisRetrievedMarch10,2015,from
http://www.mayoclinic.org/diseasesconditions/osteoarthritis/basics/definition/con20014749
Sutton,AmyL.,2004,ArthritisSourcebookDetroit,Michigan,PeterE.Ruffner
Osteoarthritis.(2013,January1).RetrievedMarch7,2015,from
http://www.nlm.nih.gov/medlineplus/ency/article/000423.htm
OsteoarthritisandComplementaryHealthApproaches.(2012,January1).RetrievedFebruary
20,2015,from
https://nccih.nih.gov/health/arthritis/osteoarthritis
Stressmanagement.RetrievedFebruary16,2015,from
http://www.mayoclinic.org/healthyliving/stressmanagement/indepth/taichi/art20045184
Osteoarthritis.(2014,May16).RetrievedFebruary10,2015,from
http://www.cdc.gov/arthritis/basics/osteoarthritis.htm
Osteoarthritis.RetrievedFebruary23,2015,from
http://www.hopkinsmedicine.org/healthlibrary/conditions/adult/arthritis_and_other_rheumatic_dis
eases/osteoarthritis_85,p00061/