By Dr. Stacey Coulthard (Osteopath)
Did you know OA is the most common form of arthritis in the world? In 2019 It was estimated to affect around 3.2 million Australians (Australian Institute of Health and Welfare, 2020)!
What is it?
Osteoarthritis is a commonly misunderstood condition thought to be produced by general ‘wear and tear’ of the articular cartilage and bone found within your joints (Yunus et al., 2020). We now know that OA is actually a condition of joints that can exist in highly metabolic and inflammatory states. This environment can unfortunately create irreversible change to the bone and cartilage in the area; leaving our joints with a decrease in joint space and function (Sen & Hurley, 2022).
When we take a closer look at a joint, we have two bones with a cartilage covering connected via ligaments and a synovial fluid filling. The cartilages’ role within this space is to provide a smooth protective barrier that acts as a shock absorber taking stress off everyday tasks or exercise (Yunus et al., 2020). Without this shock absorption other tissues in the joint can be placed under extra stress and start to rely on other parts of the body to compensate.
Despite the change that occurs being irreversible, the progression and condition itself can be prevented. OA is not always painful, and most individuals can live a long and happy life by implementing health lifestyle choices.
How does it present?
⁃ Muscle weakness/instability (“giving away” or “buckling”)
⁃ Loss of motion
⁃ Joint pain/discomfort
⁃ Poor balance and control
⁃ Swelling &/or Joint deformity
Most commonly seen in:
⁃ Joints in your hands and feet
⁃ Hips
⁃ Knees
⁃ Neck (Cervical spine)
⁃ Lower back (Lumbar spine)
(Sen & Hurley, 2022)
Factors that increase your risk:
Age
Though OA is most common in individuals aged 75 and over it can occur at any point of life, typically from the age of 45 (Australian Institute of Health and Welfare, 2020). Despite the correlation with ageing OA isn’t an inevitable consequence of growing old and it is a multifactorial condition that takes into account other risk factors and stresses throughout life that can affect your joints (Anderson & Loeser, 2010).
Gender F>M
Though Osteoarthritis can occur in any gender, females aged 65 years or more have a 68% risk of developing OA compared to males of the same age only having a 58% (Yunus et al., 2020). This can be due to females experiencing the post-menopausal phase at that time of their life (Mahajan & Patni, 2018). Despite this by increasing bone mineral density and strength through a healthy lifestyle the onset and progression of OA can be prevented (Mahajan & Patni, 2018).
Family history of OA
If you and your family members are living with OA there is a chance it was inherited. OA can be caused through mutations of the type 2 collagen gene or COL2A1 for short (Kannu et al., 2010). Having this knowledge is always accessible as it isn’t the only reason for cause of OA, but by knowing your family history, at risk individuals can implement preventative strategies early on to reduce the risk and progression of OA development (Kannu et al., 2010).
Previous joint injury or trauma
As mentioned previously cartilage is a durable tissue that allows our joints to function optimally providing necessary shock absorption for daily tasks. However, any injury that results in damage of the cartilage or sub-chondral bone can increase the risk of OA progression (Yunus et al., 2020). Typically these pathological changes can appear 10 years post injury though are highly linked to the individuals age at time of first injury (Yunus et al., 2020).
Obesity
Obesity not only results in significantly more weight distributed between your joints but it can additionally produce metabolic abnormalities and excessive amounts of adipose tissue that leave your joints in higher inflammatory states (Yunus et al., 2020). Negatively impacting the environment your joints need to function optimally, obesity can increase the risk and development of OA. Luckily this is the most preventable risk factor and OA can easily be prevented or delayed with a balanced diet and regular exercise!
Gut dysbiosis
Diets consisting of high amounts of processed foods with high volumes of saturated fat, simple carbohydrates and low amounts of fibre can result in poor gut health and altered gut microbiota (GMB) (Biver et al., 2019). This change in GMB can create a microbial which can further promote low-grade inflammation and obesity; two important risk factors to the onset and development of OA (Yunus et al., 2020)
Anatomy and bone development
The shape and development of bones and joints throughout life can influence the onset of OA. Individuals for example have a high incidence of developing OA in their knees when they experience abnormalities to their lower limb alignment such as leg length discrepancies of ³1cm and bowed legs (Yunus et al., 2020).
How Osteopathic treatment help?
Osteopaths take a holistic approach to all conditions and OA Is no exception. Through a thorough assessment we can begin to understand how your body moves and choose techniques accordingly to help increase joint space, decrease inflammation, pain and improve overall movement throughout your body.
In addition to hands on manual therapy, Osteopaths are able to educate individuals about their condition and further discuss healthy lifestyle choices such as dietary changes and increasing physical activity.
Exercise rehabilitation for example is an important intervention that all individuals with OA should partake in. Osteopaths are able to prescribe exercises that can decrease an individual’s overall symptoms; improving their joint function and quality of life (Dantas et al., 2020).
Note: This blog post is an educational tool only. Everyone’s journey with OA will be different and therefore it’s important to speak to your healthcare practitioner about your condition and the choices present.
Any other questions not answered here? Get in touch!
References:
Anderson, A. S., & Loeser, R. F. (2010). Why is osteoarthritis an age-related disease?. Best
practice & research. Clinical rheumatology, 24(1), 15–26. https://doi.org/10.1016/j.berh.2009.08.006
Australian Institute of Health and Welfare. (2020). Osteoarthritis, what is osteoarthritis?
Biver, E., Berenbaum, F., Valdes, A. M., Araujo de Carvalho, I., Bindels, L. B., Brandi, M. L.,
Calder, P. C., Castronovo, V., Cavalier, E., Cherubini, A., Cooper, C., Dennison, E., Franceschi, C., Fuggle, N., Laslop, A., Miossec, P., Thomas, T., Tuzun, S., Veronese, N., … Rizzoli, R. (2019). Gut microbiota and osteoarthritis management: An expert consensus of the European society for clinical and economic aspects of osteoporosis, osteoarthritis and musculoskeletal diseases (ESCEO). Ageing research reviews, 55, 100946. https://doi.org/10.1016/j.arr.2019.100946
Kannu, P., Bateman, J. F., Randle, S., Cowie, S., du Sart, D., McGrath, S., Edwards, M., &
Savarirayan, R. (2010). Premature arthritis is a distinct type II collagen phenotype. Arthritis and rheumatism, 62(5), 1421–1430. https://doi.org/10.1002/art.27354
Mahajan, A., & Patni, R. (2018). Menopause and Osteoarthritis: Any Association ?. Journal of
mid-life health, 9(4), 171–172. https://doi.org/10.4103/jmh.JMH_157_18
Sen, R., & Hurley, J. A. (2022). Osteoarthritis. StatPearls.
Yunus, M. H. M., Nordin, A., & Kamal, H. (2020). Pathophysiological Perspective of
Osteoarthritis. Medicina (Kaunas, Lithuania), 56(11), 614. https://doi.org/10.3390/medicina56110614