Osteoarthritis – Best Non-Surgical Management

What is Arthritis?

Arthritis is often referred to as a single disease. In fact, it is an umbrella term for more than 100 medical conditions that affect the musculoskeletal system, specifically joints where two or more bones meet.

These conditions cause damage to the joints, usually resulting in pain and stiffness. Arthritis can affect many different parts of the joint and nearly every joint in the body.
Arthritis affects people in different ways, but the most common symptoms are:

• Pain
• Stiffness or reduced movement of a joint
• Swelling in a joint
• Redness and warmth in a joint
• General symptoms, such as tiredness, weight loss or feeling unwell. (1)

Types of Arthritis

There are over 100 forms of arthritis. Each type of arthritis affects you and your joints in different ways. Some forms of arthritis can also involve other parts of the body such as the eyes. The most common forms of arthritis are:

  • Osteoarthritis
  • Rheumatoid arthritis
  • Gout
  • Ankylosing spondylitis (1)

Osteoarthritis

Osteoarthritis (OA) is the most common form of arthritis. It is a condition that affects the whole joint including bone, cartilage, ligaments and muscles. Although often described as ‘wear and tear’, OA is now thought to be the result of a joint working extra hard to repair itself. (2)

OA may include:

  • Inflammation of the tissue around a joint
  • Damage to joint cartilage – this is the protective cushion on the ends of your bones which allows a joint to move smoothly
  • Bony spurs growing around the edge of a joint
  • Deterioration of ligaments (the tough bands that hold your joint together) and tendons (cords that attach muscles to bones). (2)

Osteoarthritis affecting the hip

If you are affected by Osteoarthritis this article (3) is easy to read, concise and very informative.

Osteoarthritis Guidelines for Non-Surgical Management

The OA research international (OARSI) is an evidence team made up of thirteen experts from relevant medical disciplines who come from three continents and ten countries (USA, UK, France, Netherlands, Belgium, Sweden, Denmark, Australia, Japan, and Canada). They are experts in

  • Primary care
  • Rheumatology
  • Orthopaedics
  • Physical therapy
  • Physical medicine and rehabilitation, and
  • Evidence-based medicine

Together with a patient representative – these people made up the Osteoarthritis Guidelines Development Group (OAGDG) and researched appropriate treatment modalities for all individuals with knee OA. (4)

Appropriate treatments for Osteoarthritis included

  • Biomechanical interventions (eg appropriate footwear, orthotics if appropriate)
  • Intra-articular corticosteroids (by injection)
  • Exercise (land-based and water-based)
  • Self-management and education
  • Strength training
  • Weight management.

Physiotherapists are ideally qualified to help with all of these things (except the cortisone injections into the joint!).

Other  treatments found to be appropriate for specific clinical types of OA included

  • Paracetamol
  • Balneotherapy(bathing in warm mineral baths)
  • Capsaicin
  • Cane (walking stick)
  • Duloxetine
  • Oral non-steroidal anti-inflammatory drugs (NSAIDs; COX-2 selective and non-selective)
  • Topical (via the skin) NSAIDs

Treatments of uncertain appropriateness for specific clinical types of OA included

  • Acupuncture
  • Avocado and soybean unsaponfiables
  • Chondroitin
  • Crutches
  • Diacerein
  • Glucosamine
  • Intra-articular hyaluronic acid
  • Opioids (oral and transdermal)
  • Rosehip
  • Transcutaneous electrical nerve stimulation
  • Ultrasound

Treatments voted not appropriate included risedronate and electrotherapy (neuromuscular electrical stimulation).

If you need help with Arthritis – please get in touch with us at Burleigh Heads and Broadbeach  Physio Clinics 07 5535 5218

References

(1) Understanding Arthritis
(2) Osteoarthritis – Arthritis Australia
(3) Osteoarthritis – Fast Facts
(4) OARSI guidelines for the non-surgical management of knee osteoarthritis

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Our Response to Covid-19

This page is up to date to our best knowledge, however, this is a rapidly evolving situation so we apologise for any potential delay in updating this information.

We want to reassure all our patients that we are following stringent infection control procedures in our clinic, and screen all people coming into the clinic, to exclude any patients that have any signs or symptoms consistent with Covid-19, as well as screening any patients that should be in isolation ie recently returned from overseas, or have been advised to isolate due to recent exposure with a known Covid-19 patient.

All our staff have now completed the Department of Health Covid-19 Infection Control Training.

What are we doing to minimise risk?

  • Screening patients for risk factors over the phone or through text messages before they attend appointments. Those with risk factors or symptoms are advised not to attend & to seek medical advice.
  • Hand sanitiser station at the front of the building must be used before you enter.
  • Following stringent infection control measures within the clinic. This includes
    • Disinfecting all beds, door handles, EFTPOS machine before and after each patient use.
    • Linen changed between each patient and commonly touched surfaces through the practice are cleaned regularly throughout the day.
    • Minimising the distances between clients in the waiting room- some chairs are outside undercover.
  • We have advised our team members not to come to work if they have cold or flu-like symptoms.
  • We are following all Department of Health recommendations for our type of business.

On the 30th March 2020 – the Australian government issued a statement that “People aged over 70, aged over 60 with pre-existing conditions, or Indigenous people aged over 50 should stay home wherever possible for their own protection.”

The decision to come in for physiotherapy treatment really is an individual one – if you feel that your treatment is medically necessary, and are comfortable with the risks of leaving your home and coming to physiotherapy, then rest assured that when you attend our physiotherapy clinic, we are following our strict infection control processes and doing everything we can to minimise your risk whilst in our care. However, we completely understand if you are not comfortable with coming in for treatment.

TELEHealth Consultations

We are offering telehealth consults and home visits (where suitable) for patients who cannot attend our clinic.

Read more about TELEhealth Consultations here.

Staying Healthy

  • Wash your hands often (and for 20 seconds) with soap and water
  • Cough into your elbow or use a tissue to cover your mouth when you cough or sneeze
  • Social distancing practices – Avoiding close contact with others, such as touching, including shaking hands
  • Limit contact with people who are sick, and stay home if you are sick and encourage employees to stay home when sick
  • Get 7-8 hours’ sleep a night to help your immune system stay strong
Please stay safe and take care of each other!

We are monitoring the situation very closely and will make adjustments to our business as we are further informed. Our priority is the health & well being of our patients and our staff. Thanks for your understanding.

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