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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 (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)

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


(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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