Osteoarthritis (OA) refers to a painful joint condition that is the result of a number of movement, lifestyle and genetic factors that progress as you age. OA is the most common type of arthritis, affecting 56 per cent of Australian arthritis suffers. OA can develop at any age, although it is more common in people over 45 years old, and affects 48 per cent of people over 50. In the hand, the most common form of arthritis is at the base of the thumb, at the carpometacarpal joint.
What causes osteoarthritis?
OA involves changes to the whole joint, including the cartilage (the smooth layer that covers the ends of a bone), the underlying bone, the ligaments and tendons, as well as the surrounding muscles. As OA progresses, the changes to the joint can cause pain and loss of movement. The joint can also change in appearance due to swelling or the bones on each side of the joint changing shape (sometimes they may move away from their normal position).
There are a number of well-known factors that are associated with the development of OA, including smoking, obesity, physical inactivity, poor nutrition and genetics.
Arthritis can affect anyone, regardless of age, gender or nationality.
At an individual level, arthritis symptoms can greatly affect a person’s quality of life, causing disability, physical limitations and associated emotional and psychological distress. The burden on the Australian economy is also significant, with around $23.9 billion spent annually on arthritis care.
How do I know if I have osteoarthritis?
Arthritis affects each person differently and symptoms vary depending on what type of arthritis a person has and its level of severity.
The most common symptoms include:
- joint pain
- joint stiffness.
Other joint symptoms can include:
- in the latter stages, catching, clunking or grinding in the joint
- people may also feel generally fatigued or unwell because of their arthritis.
In the early stages, most people will notice joint stiffness or a mild ache, particularly in the morning. As symptoms worsen, swelling occurs with increased pain. In the late stage, joints can appear enlarged and slightly different in shape. In the fingers, bony bumps called Heberden’s nodes may develop. OA can be diagnosed by a medical professional such as a GP or physiotherapist. It involves physical examination and symptom reporting. Imaging, such as X-rays, can be helpful to check the joint space between the bones, which can indicate the amount of cartilage loss and help gauge the severity of the disease.
How can physiotherapy help with osteoarthritis?
Your physiotherapist can offer practical advice on managing the symptoms of OA, ergonomic advice and strategies for everyday activities, as well as strengthening exercises to improve pain and function. Splints can be useful to restrict movement and provide support and positioning. Heat and massage can help reduce pain and soothe sore joints and tight muscles. Strengthening exercises are added when pain is more settled, but they often need to be performed gradually to avoid irritation. An important part of management of OA is changing the way one performs a certain activity. This will reduce stress on the joints that are already sore. Your physiotherapist will be able to provide advice on everyday strategies and recommend suitable assistive equipment.
It’s important to note that not all physiotherapists are specialised in the area of hand therapy. For the best treatment outcome, find a physio who specialises in this area.
How effective is physiotherapy for osteoarthritis?
According to a recent report, there is encouraging support on conservative therapies for hand OA. A recent study showed that physiotherapy interventions were effective in reducing pain and improving function and quality of life for individuals with trapeziometacarpal (thumb) OA, and that a combination of interventions, rather than single interventions, were more effective. The low evidence on the effectiveness of hand exercises for OA is due to poor quality of the studies done.
What can I do at home?
Rest is the best treatment when a joint is painful and swollen. Apply ice on the area if it is particularly warm, swollen and sore. If the joint is achy but not warm or swollen, heat in the form of a water bath or wheat bag can be useful. Avoid activities that tend to increase your pain. When pain has improved, you can start some gentle exercises to improve your joint movement and reduce stiffness. For example, if you have OA in your finger joints, you can perform exercises for your fingers by fully straightening and then bending your fingers into a full fist, and then repeating.
Exercises should be performed in low repetitions. People can often hurt themselves more from overdoing these, thinking it will help them improve more. If you are unsure about what exercises are appropriate and how often to do them, speak to your physiotherapist.
How long until I feel better?
Treatment involves managing the condition. You should try to rest when you have pain. It can sometimes take several days to weeks to feel more comfortable. During the ‘painful’ period, take medications as prescribed by your GP and frequent rest breaks, avoid activities that increase your pain, plan your schedule ahead, and make use of your larger and unaffected joints to perform the task. If you are not getting better, see your GP and physiotherapist for further management.