Osteoarthritis, Exercise and Physiotherapy
What is Osteoarthritis?
Osteoarthritis is a condition where joints can become painful, stiff and swollen. It is a very common condition and is likely to affect most of us, as we get older. It tends to affect older adults but can also affect younger people too.
It can affect any joint in the body, most commonly weight bearing joints such as hips, knees and feet; and joints that we tend to get a lot of use out of such as fingers.
A healthy joint has a tough coating of cartilage, which helps bone ends (joints) move freely against each other. With osteoarthritis this cartilage becomes thin and the surface becomes rough. This wear on the cartilage encourages your immune system to become more active in order to try and repair the damage, a process that can change the structure of the joint in order to allow the joint to work normally without pain or stiffness. Sometimes the repair process doesn’t work properly and these changes in the joint can cause or worsen pain, swelling or joint stiffness.
The exact cause of osteoarthritis is unknown, however there are lifestyle and genetic factors that can contribute to the condition. Lifestyle factors can include being sedentary, injury to a joint, poor diet or being overweight.
Genetic factors can include a family history of osteoarthritis, increasing age and being female.
There are some factors that you cannot control, however there are things that you do to potentially change the course of the condition.
How can I manage my symptoms?
Exercise & Physiotherapy
Exercise is an excellent way to manage symptoms of osteoarthritis and to keep yourself physically and mentally healthy. A combination of strengthening exercises, cardiovascular exercises and stretching are recommended – this does not necessarily mean that you have to join a gym, you can do these at home or outdoors for example.
In general, it is advised that you:
- aim to be physically active every day
- do strengthening activities that work all of the major muscle groups (legs, hips, abdomen, chest, shoulders and arms).
- do at least 150minutes of more vigorous activity every week.
You should also reduce the amount of time spent sitting or lying down and break up long periods of not moving with some activity.
For more information on physical activity guidelines please visit www.nhs.uk/live-well/exercise/
A Physiotherapist can assess your joint movement, strength and flexibility in order to provide advice and education on exercise, pain relief and other ways to manage your symptoms.
Being active can really you stay mobile and independent.
Graded exercise & pacing
Osteoarthritis symptoms can be variable, which means lots of people experience good days and bad days. It is important to recognise this and to try and come up with a plan to manage the ‘bad days’ as well as you can.
If you are not used to exercising, doing a small amount of exercise and building up slowly is recommended. If your joint feels particularly inflamed, then it is ok to take things easy or rest until it has settled.
Can exercise damage my joints?
Osteoarthritis is not caused by too much exercise. Research suggests that exercise can actually prevent osteoarthritis. Strong muscles support joints and exercise can increase the level of anti-inflammatory chemicals inside the joints, which can protect against cartilage loss and joint damage.
Managing your pain
This is a really important part of managing your osteoarthritis. If you are able to take them, paracetamol can be really effective as can other over the counter medications, which you can discuss with your pharmacist or GP. The most important thing when taking pain relief is to make sure you take them regularly and to take them as recommended.
In addition to medication, ice or heat can be useful in helping with pain management and joint stiffness. When using ice or heat always make sure the hot water bottle, wheat pack or ice is wrapped in toweling with sufficient layers to avoid burning. Make sure you are awake when applying ice or heat and never leave on for more than 20 minutes. If using ice, you can apply every 2-3 hours (as long as your skin temperature has returned to normal); with heat you can use 2-3 times per day.
Weight management and diet
It is important for you to maintain a healthy weight and to consume a balanced. A healthy has an impact on your bone and joint health in addition to your general health and wellbeing.
Being overweight can place additional stress on your joints and so it is likely that by maintaining a healthy body weight will help you manage your osteoarthritis and will help you move much better.
A balanced and varied diet, which includes a range of vitamins and minerals, helps maintain good bone health in a variety of ways and can help you manage osteoarthritis.
For further information about osteoarthritis, we would recommend taking a look at the following:
- Versus Arthritis: www.versusarthritis.org/
- The Chartered Society of Physiotherapy (CSP) Rehabilitation Exercises: www.csp.org.uk/public-patient/rehabilitation-exercises
- NHS: www.nhs.uk/conditions/arthritis/
NICE Guidelines Osteoarthritis: Care & Management (2020)
Versus Arthritis: About Osteoarthritis (2018)