Osteoarthritis

What is Osteoarthritis?

an inflammation (ITIS) of a joint (ARTH)
osteoarthritis refers to the bones versus rheumatoid arthritis which refers to the arthritic component of a system wide medical condition
in medical terms -- osteoarthritis is the wear and tear degeneration of the articular cartilage and subchondral bone
pain, deformity, and limitation of movement in joints is the result of cartilage destruction
articular cartilage
the white, smooth surface which covers the ends of the bones at the joints
lubricating and shock-absorbing functions
made of glucosaminoglycans, proteoglycans, hyaluronic acid
subchondral bone
the layer of bone underneath the articular cartilage

Where does it hurt?

commonly in the joints most often affected are the weight bearing joints
neck and low back
hips, knees, ankles
hands, feet
pain can be referred from these areas to others e.g. neck to shoulder and upper arm

Why does it hurt?

the underlying layer of bone contains many nerve fibres that convey pain

What hurts and why?

MOVEMENT

joint surfaces rubbing bone on bone

BEARING WEIGHT

compressing bone on bone

OVERUSE

excessive irritation of inflamed bone

REST

blood pooling causes aching

MORNING STIFFNESS

lack of joint lubrication due to prolonged rest

What shows up on x-ray?

narrow joint spaces
extra bone formation (osteophytes)
degrees of severity ranging from mild to severe
biomechanical alterations e.g. knock knees (valgus)

What causes it?

Cumulative effects of years of use of the joints
Limited ability of the body to restore articular cartilage
previous injury
poor mechanical alignment
excessive body weight
small hereditary component

How do I slow the progression?

you cannot reverse the degenerative process once it is seen on x-ray, but you can slow the rate of progression (early stages are reversible)
exercises to stretch and strengthen surrounding muscles that support and protect the injured joint are vital
gentle mobilizations of the joint, performed by your physiotherapist, decrease the pain associated with arthritis and stretch structures you may not be able to
good posture is of utmost importance – poor posture leads to increased pain levels
everybody is different – exercises and mobilizations for your area of arthritis are very specific for you
maintaining flexibility, strength and good posture can help to slow the rate of the arthritic progression
your physiotherapist can help you to get the most out of your exercises

Nutritional Supplements

Glucosamine

sold as sulfate or hydrochloride (HCl)
both equally effective
HCl less expensive and more pure
stimulates the manufacturing of substances necessary for joint repair
glycosaminoglycans & proteoglycans
used by the body in the manufacture of collagen, which is the protein portion of a fibrous substance that holds joints together
collagen is also the main component of articular cartilage
more glucosamine means your body has a better chance of decreasing or eliminating pain caused by insufficient lubricants and poor shock absorption
glucosamine is sometimes combined with Chondroitin sulfate
glucosamine and chondroitin are available in pharmacies and health food stores
typical dose of 1500 mg / day
effects should be noticed in three to six weeks depending upon age and severity of the condition
most published trials of the compound lasted only 4-8 weeks and are therefore unconvincing in the medical community although…

“The Use Of Glucosamine Appears To Be Safe And Might Be Effective
For The Treatment Of Osteoarthritis”

Glucosamine for Arthritis, The Medical Letter on Drugs and Therapeutics,
Volume 39, Pages 91-92, September 26, 1997.

Chondroitin

acts like” liquid magnets”
helps attract fluid (H20)
sweeps nutrients into the cartilage
acts as a spongy shock absorber
maintains viscosity in joints
stimulates cartilage repair mechanisms
inhibits enzymes that break down cartilage

Caution …

there are no reported drug interactions
SIDE EFFECTS
Occasional digestive discomfort and nausea have been reported
it is derived from Chitin ~ a component of shellfish shells

** CAUTION SHELLFISH ALLERGIES **

some glucosamine is processed with sodium chloride (table salt), which may be restricted in some diets particularly for people with HIGH BLOOD PRESSURE
if you are DIABETIC or PREGNANT, it is advised that you discuss the use of glucosamine with your physician

What do you do?

if you feel that you can benefit from the services of a physiotherapist, consult your physician or contact us directly
we would be pleased to help you...

YOUR PHYSIOTHERAPIST CAN HELP YOU WITH THE REST…