I treat A LOT of people with Osteoarthritis (OA) and there are 5 Facts that I share with them that I wish I could tell everyone as a Physiotherapist.
People with OA are often told that a joint replacement surgery is inevitable. They are often told this before any conservative treatment or therapy has been attempted.
All the research as well as my own experience of treating OA patients for 30 years tells us that conservative management should be attempted before even considering surgery.
If you’re one of those people that have been told that joint replacement surgery is inevitable or that you have “bone on bone” OA then read this article and take control of your condition.
Taking control will require positive action and belief that changes can be made. Hundreds of patients that I’ve treated over the years have done this and I know that you can too.
These are The 5 Osteoarthritis facts that I wish I could tell everyone.
1. Losing Weight isn’t the Only Way to Reduce Pain
Now there is no denying that extra pressure from being overweight can contribute to increased pain and dysfunction, but a big issue with OA management is that people are told that being overweight is CAUSING their OA.
Perhaps they are even being shamed into losing weight or ridiculed for being unable to lose weight to help their own OA presentation.
We have seen in countless research articles and in my day-to-day practice as a Specialist Physiotherapist, that OA can affect any synovial joint, including the non-weight-bearing ones such as the fingers or wrists.
OA is not just a “wear and tear” disorder. Having OA in your fingers is not because you are putting too much weight through them. There are other factors at play.
Low-Grade Inflammation
Slow, low-grade inflammation in the body can lead to bone and cartilage degradation.
This can be caused by raised lipids and sugars in the blood. There can also be some genetic predisposition at play here too.
We can use this information to reduce inflammation present in our body and by doing so we can have a direct effect on the pain and dysfunction caused by OA.
You can make easy wins immediately just by making some dietary and lifestyle changes that will not only help your OA symptoms but can have other huge health benefits too.
Do not focus on weight loss initially. Focus instead on the following:
- Reduce sugar from your diet.
- Eat a diet rich in vegetables.
- Avoid processed foods and focus on whole, natural ingredients instead.
- Try to include oily fish and other sources of protein such as nuts and poultry.
By applying this, you’ll notice that if you are carrying extra weight, it will naturally start to fall and your overall health and wellbeing will increase.
2. Move your body and improve your balance
People with OA are often told to strengthen their muscles. Especially those around the affected joint.
This is good advice.
But what about the other muscles and joints? Should we move those too?
We need to move the whole body and strengthen the body globally. It is a fact that although OA can affect the younger person there is a much higher prevalence over the age of 50. Around this time we naturally start to become weaker and more deconditioned. I wrote an article on reversing muscle loss as we age. You can read it here if you would like more information.
We need to take action to reverse this decline in muscle mass and fitness levels. More than ever we need to work hard to stay fit and active and to improve the strength of ALL OF OUR MUSCLES.
Getting stronger and moving more is vital to help manage OA symptoms and improve function but also the research tells us that muscle strength is directly correlated to mortality.
Higher levels of upper and lower body strength are associated with lower risk of mortality in the adult population regardless of age.
You can start slowly, in fact I recommend that you do. Your joints will enjoy the movement and benefit from the lubricating phenomenon that gentle exercise offers. Short walks, bike rides or swims are a great start. Add in some basic bodyweight exercises for the legs, hips and upper body and all of a sudden you have a fabulous OA busting regime.
The metabolic factors we discussed earlier will also improve as the body’s function starts to improve with regular exercise.
Move little and often for the best results. Prioritise exercises that improve your balance too for added effect.
Check out my You-Tube video that will talk you through how to do this best.
3. Pain is not a direct correlation to your level of Osteoarthritis.
Pain is not an accurate measure of levels of OA.
I see patients afraid to move or exercise because of pain. They tell me they are also frightened to move in case they make their OA worse. They believe, often mistakenly that due to the nature of their pain, their OA must be severe or “bone on bone”.
OA can cause pain and stiffness but sometimes the system in our body that recognises and reacts to pain can become over sensitised making even smaller movements and activity painful. In some cases the body can even become less efficient at modulating pain. This results in the pain volume being turned up.
I ask my patients to exercise into mild discomfort but not into pain.
At the start this may mean walking for 5 minutes a day only. As the body gets used to the demands being placed upon it the sensitivity to activity drops. This results in pain reduction and an increase in the ability to exercise longer before pain kicks in.
The key here is to listen to what your body is saying to you and what signals are coming your way.
Remember, pain is not a correlation to your level of OA. Pain also does not mean joint damage.
Exercising into mild discomfort is essential for taking control of your OA.
I like to use the basic 0-10 scale for pain control where 0 = no pain and where 10 = the worst pain imaginable.
I ask my patients to exercise in the 0-4 range on this scale. There is no benefit from pushing too much further into the pain scale. If you do this consistently you will potentially increase your body’s sensitivity to pain.
By pushing into mild discomfort with exercise and activities of daily living you will take control of your sensitive OA joints.
4. Surgery isn’t always inevitable
Often people are directed to surgery off the back of an X-Ray or MRI scan.
Conservative treatment should always be the first line of OA management before surgery is ever considered. If you have been given a diagnosis of OA this does not mean that you are on a fast track to joint surgery.
In many cases, surgery can be avoided if conservative measures are implemented with consistency over time.
There is a time and a place for joint replacement surgery. I want my patients to be in control of their destinies and if surgery is warranted, to be able to decide on their terms.
Motivation to take control of pain and dysfunction is a good starting point but the strategies need to be implemented consistently over time. This means a big commitment to making changes to diet and lifestyle. Small changes here can add up to big results.
5. Osteoarthritis management takes a holistic Approach for success
We have seen in this article some of the ways that you can take control of your OA but the most effective way of managing your OA symptoms is to embrace all of them in a holistic approach to treatment.
The best results happen when you embrace all the approaches and combine them for maximum efficacy.
You need to consider the following:
- Regular remedial exercise which incorporates strengthening and cardiovascular components.
- Managing stress levels.
- Getting adequate rest.
- Eating a low-inflammatory diet
Conclusion
Embracing these changes isn’t easy.
It will take determined action to succeed, but if you do embrace them, you will reap the rewards, start taking control of your OA pain, and start living the life you want to again.
If you have any questions or would like to reach out to me you can contact me here.
Good luck!
