Osteoarthritis 101

Behind low back pain, OA ranks at $460 billion in all-cause medical expenses (2). OA occurs in 1/3 of those over 65 years, greater in women than men, and is present in those with other common chronic conditions (3). As with other chronic conditions, OA has a multitude of factors to include: structure of bones and variability, the ability for the joint to take loads, history of injuries or surgeries in the respective areas, limb length differences, occupation and physical activity, or other joint specific factors (fat pad, cartilage differences, bone spacing)(1). Whew. One topic that is never covered or analyzed is diet. We are what we eat and our genetics express based on the signals they receive from food and intake into the body. There has to be a link, but this is a current gap in the research knowledge.

The two most studied conditions for OA is the knee and the hip; however, OA can occur in the neck, shoulder, elbow, wrists, hands, lower back, ankles, and toes. The old saying “motion is lotion” helps with OA because the movement, in pain free ranges and in the least amount of gravity, helps to stimulate the joint fluid; thus, making the joints feel better. Most OA is painful in the morning than eases as time progresses throughout the day. However, moments of inactivity will cause the joints to stiffen and swell. The body is giving an inflammatory sign, are you sure this is just arthritis because that is what arthritis does? What is in the joint that is being attacked and causing an immune response? We wonder why there are no answers to things probably because the right question is not being asked. Because of the pain and loss of motion, most seek a total knee arthroplasty or a total hip arthroplasty. These two surgical methods replace the joint with titanium and plastic to restore the joint motion. Just because a surgery has been performed does not mean that everything is good to go because of the amount of trauma that has be caused by the surgery. This is where traditional physical therapy comes into play.

References

1. Allen KD, Thoma LM, Golightly YM. Epidemiology of osteoarthritis. Osteoarthritis Cartilage. 2022 Feb;30(2):184-195. doi: 10.1016/j.joca.2021.04.020. Epub 2021 Sep 14. PMID: 34534661; PMCID: PMC10735233.

2. Lo J, Chan L, Flynn S. A Systematic Review of the Incidence, Prevalence, Costs, and Activity and Work Limitations of Amputation, Osteoarthritis, Rheumatoid Arthritis, Back Pain, Multiple Sclerosis, Spinal Cord Injury, Stroke, and Traumatic Brain Injury in the United States: A 2019 Update. Arch Phys Med Rehabil. 2021;102(1):115-131.

3. Hawker GA, King LK. The Burden of Osteoarthritis in Older Adults. Clin Geriatr Med. 2022;38(2):181-192. doi:10.1016/j.cger.2021.11.005