Osteoarthritis

Pathophysiology

Osteoarthritis is the most common form of arthritis and is one of the leading causes of pain and disability. It referrers to a clinical syndrome of joint pain accompanied by varying degrees of functional limitation and subsequent reduced quality of life.

There is often a poor link between changes visible on an x-ray and symptoms of osteoarthritis; minimal changes can be associated with a lot of pain, or modest structural changes to joints can occur with minimal accompanying symptoms.

Osteoarthritis is a condition that results from a loss of cartilage with subsequent remodelling of adjacent bone and subsequent inflammation. It is some of these changes in the joint structure that can then be seen on x-ray. It is a dynamic process that involves all joint tissues: the bones, cartilage, joint capsule, lubricating fluid and surrounding muscles.

Sometimes the altered joint structure compensates for the changes and does not cause pain. It’s when the natural repair process cannot compensate enough that the joint starts to become painful.

Symptoms

  • Stiffness, generally worse in the morning for less than 30 minutes which improves with movement
  • Reduced range of movement
  • Functional restrictions e.g. putting on shoes/socks, getting in/out of a car or bath
  • Activity related joint pain- may be felt on the outside of the thigh, in the buttock but most commonly in the groin

Management

  • Activity modification
  • Ice or heat
  • Pain relief
  • Walking aids
  • Appropriate footwear which provides support
  • Weight loss if overweight or obese (most people will notice an improvement in joint pain and function after losing 5% of their body weight)
  • Physiotherapy including range of movement exercises and a graded strengthening programme
  • Orthopaedic options- If pain and function is limiting or conservative measures for 6 months has failed then hip replacement surgery may be appropriate

Investigations

  • X-ray can assess the level of osteoarthritis

Exercises to try:

Hip exercises

Bridging

Lie on your back with your knees bent and your feet flat on the bed

Keeping hands by your side, squeeze your bottom cheeks together before lifting your bottom up as high as you can

Hold for 10 seconds before gently lowering your bottom and relaxing and repeat as able

4

Standing Abduction

Stand holding on to a support

Lift your leg out to the side whilst keeping your body upright (do not lean your body over)

abd

Standing Extension

Stand holding onto a support

Lift your leg behind you while keeping your body upright (do not lean your body forwards)


close
Select font size
Site colour