While joint pain can be caused by a number of factors, the most common is Osteoarthritis (OA). OA affects approximately 10% of the population and is the most common joint disorder in several countries. Joint pain from OA is primarily caused by mechanical stress, which deteriorates the article cartilage of joints. As the bones continue to be stressed and the articular cartilage deteriorates, pathological changes occur in the bones. There are a number of risk factors that can be modified prior to the onset of symptoms.
Osteoarthritis Risk Factors
The risk factors for OA include: age, gender (female > male), family history, occupation, previous injury, obesity, and joint laxity. If this sounds like you, it is important to be able to recognize the symptoms of OA.
The “STWLR” system is commonly used in the diagnosis of arthritis.
In order to detect arthritis, 2 points from the below list are required in addition to tenderness. Joint tenderness is always present in arthritis, except when it is an adult with neuropathy or a child of pre-school age.
Swelling – 2 points
Tenderness – T
Warmth – 1 point
Limitation of motion – 1 point
Redness – 1 point
After you start experiencing the symptoms of OA there effective ways to combat them and the progression of the condition.
Osteoarthritis Symptom Management
A number of different national and international guidelines have been developed for the management of OA. They all share an emphasis on self-management strategies, including weight loss and low impact exercise.
Significant results with exercise, regardless of the type, have been found to reduce pain in people with OA. Furthermore, weight loss can improve pain by greater than 50%. A minimum weight loss of 7.7% body weight yields clinically meaningful results, while greater than 10% weight loss is associated the greatest improvements in symptoms. Those who diet in combination with exercise report significantly less pain longterm than those who only diet or exercise to lose weight.
The research shows modest effects of pharmacological interventions on pain in people with OA. Furthermore, the benefits of taking opioids versus non-steroidal anti-inflammatory drugs (NSAIDs) is not significant.
The long term effects of OA can be mitigated by symptom management. If these measures are unsuccessful, secondary deficits can result from the condition.
Osteoarthritis Long Term Effects
OA can occur in inflammatory episodes that provoke pain. In it’s later stages OA pain can be chronic and is caused by capsular fibrosis (hardening of the joint capsules) and muscle contracture around the joint. OA pain is usually localized to the affected joint, but it can also be referred to the adjacent joint (hip OA can cause knee pain).
Those suffering from joint inflammation will experience pain during movement and with pressure applied to the area. Because of this, the person experiencing joint inflammation will decrease the degree to which they move the joint, so as to avoid pain. As joint movement becomes less frequent and less intense, the joint capsule becomes fibrotic and muscle contractures set in. In the longterm it is no longer joint inflammation that is causing pain, but secondary deficits that were the result of immobility.
Pain is a powerful symptom and can prevent the strongest of people from doing what they love. The answer isn’t to give up what you love because you have pain, but to maintain your level of function so the pain doesn’t get worse.
Joint pain can have specific effects on sports performance. Knee pain alters running mechanics by significantly decreasing hip adduction and plantar flexion during stance phase. This means that as the runner’s foot contacts the ground it lands in a position lateral to where it should and the runner does not push off through the foot as forcefully. This is just one example, but it isn’t hard to see how joint pain can cause a person to perform poorly in sports, or defer them from playing altogether. By modifying the appropriate risk factors and following a program of low impact exercise it’s realistic to return to sports and all daily activities.
All TherRex™ content is written by Doctors of Physical Therapy and sourced from medical journals.
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