News from a Brighton Osteopath

Osteoarthritis – How an Osteopath can help

Osteoarthritis is a common condition that can affect any joint in your body, although it most likely affects weight bearing joints such as your hip, knee or feet as well as small joints that are used a lot e.g. hands.

In a healthy joint, there is a smooth layer of cartilage which covers the surfaces of the bone and helps the two surfaces glide across each other. When a joint develops osteoarthritis, the cartilage starts to thin and the surfaces becomes rougher. This process happens gradually and as the cartilage becomes worn / damaged the tissues within the joint try to repair themselves, which can start to alter the structure of the joint. The capsule (the synovium) around the joint can become thickened and stretched and bony spurs can be produced where your body is trying to repair the tissue as quick as it can. The tissue repair isn’t as organised as our body would like, which can be where bony spurs develop.

Most people will develop osteoarthritis in some joints in their body as we get older, but we might not have any symptoms or pain with it, so might not even be aware!

Symptoms of Osteoarthritis

Joints might be achy and painful and joints may appear swollen. There can be two causes of swelling: it can be soft swelling which could be being caused by the thickening & extra fluid within the joint capsule. Or it could be hard swelling which can be caused by the extra bone growth.

Also the muscles around the joint can appeared wasted (reduced muscle bulk). This can muscles are having to work harder and have therefore become weaker, or there is an altered structure to the joint so the muscles aren’t working as effectively.

How to Manage Your Symptoms

There is no cure for osteoarthritis – the symptoms have to be managed and in most cases they can be managed well. Here are some tips to help you manage your symptoms:

• Keeping active – Movement is very important- this is what your joints and muscles are designed to do. Being active enough to keep your muscles strong is important as the muscles help support and control your joints. A lot of patients we see are concerned that exercise will aggravate their symptoms, but doing the correct types of exercise and stretching can really make a difference. Although resting a painful joint initially makes it feel better, over time this can make joints stiffer and more painful.

Good types of exercise are:

• Strengthening exercises – using light weights, resistance bands or doing exercises in water to provide a resistance.
• Range of movement exercise – these involve taking your joints through the full range of movement that’s available and pain free. You shouldn’t push through the pain, listen to your body. Its important to keep the range of movement you have.
• Aerobic exercise – get your heart rate up! This type of exercise can help improve your sleep, reduce pain and burn calories which over time can help with weight loss. Walking, swimming and cycling are all great forms of aerobic exercise – doing 5 sessions of aerobic exercise for 15mins per week can really make a difference.
• T’ai Chi – this is a gentle form of exercise that is designed to calm the mind and promote self-healing. There is good evidence that T’ai chi can ease the symptoms of knee osteoarthritis currently.

Medications:

• Non-steroidal anti-inflammatory drugs (NSAIDS) are the most common form of pain relief for osteoarthritis such as ibuprofen. These are available as tablets, creams or gels. Paracetamol is also commonly recommended to help with pain levels – Speak to your GP or your pharmacist about which medication might suit you best and to make sure you are taking them correctly.
• Capsaicin cream – this is only available on prescription. Capsaicin cream is made from the pepper plant and can be an effective painkiller. It needs to be applied regularly (3 x p.d) for at least 2 weeks to see if it helps you. If this is something that interests you, speak to your GP.
• Steroid injections – this is where a long acting steroid in injected directly to the effected joint. These injections can start to improve patients symptoms within a few days and last for several weeks or months.
• Hyaluronic Acid Injections – Hyaluronic acid is a lubricant and shock absorber that’s found naturally in the fluid in your joints. Injections of hyaluronic acid have sometimes been used as a treatment for osteoarthritis of the knee. The treatment isn’t currently available on the NHS because research evidence on its long-term effectiveness is mixed. The treatment is, however, available privately.

Other treatment options:

• Osteopathy (or other manual therapy) – This type of treatment can help improve symptoms of osteoarthritis by helping stretch and massage the muscles around an arthritic joint and well as help improve the function in the surrounding joints e.g. if a patient has an arthritic knee, it’s important that the foot / ankle & hip on both sides can move and function as best they can.
• Acupuncture – There is good evidence to show that acupuncture can help with helping ease some of the symptoms of osteoarthritis.

Lifestyle Advice

• Weight Loss: If you’re over weight, losing weight can make a big difference to your symptoms. Even a small amount of weight can make a big difference esp. if weight bearing joints are affected such as hips or knees. If you make your main goal to be more active, then often some weight lose comes along with that! Win, win!
• Using heat or ice at home when at rest (a hot water bottle, wheat bag, frozen bag of peas wrapped in a tea towel etc) can help ease the symptoms of osteoarthritis. Contrast bathing where you alternate between hot & cold every 5 mins can also be helpful.
• Having good supportive footwear can also make a big difference to general life, esp. having shoes that strap over your feet (with laces / straps) as the straps are doing the work for you. Seeing a podiatrist could also help further. Having comfortable footwear & therefore comfortable feet can make a big difference to day-to-day living.

Remember to pace yourself – In the clinic we often hear patients stay that after they have had an active, busy day they find that their symptoms are more apparent the day after. So where possible, pace yourself. Have a busy, active day and then follow it with some rest and recovery time and stretch your muscles out nicely.

Gentle osteopathic treatment from a registered and professional osteopath could help you manage your osteoarthritis, give us a call on 01273 732740 today!

For more information on Osteoarthritis you can visit the Versus Arthritis website: https://www.versusarthritis.org/about-arthritis/conditions/osteoarthritis/