I love when a patient comes in with osteoarthritis and thinks it’s just “something I’ll have to live with”, because it’s so nice to start an appointment with good news! Osteoarthritis is not something you just have to grit your teeth through until you can get the joint replaced.
What is Osteoarthritis?
Osteoarthritis (OA) is “wear and tear” arthritis. To be more accurate, it’s “wear, tear, and repair” arthritis. It is not an autoimmune condition like rheumatoid arthritis, and although there may be genetic predispositions to developing it, it’s essentially a mechanical condition.
OA affects the joint surface, which is smooth cartilage sitting on top of bone. Cartilage is living tissue, so like anything else it needs to receive nutrients and expel waste. This job is carried out by blood, but cartilage has a poor blood supply, so it relies on more passive movement of nutrients and waste. This is facilitated by compression and decompression of the cartilage itself. Imagine the cartilage as a sponge; compressing it squashes out the waste, and releasing it allows new fluid back in.
When a joint becomes arthritic, it loses movement. This might be subtle at first, with just the end of the range being lost. However, this restriction means that some parts of the joint are constantly being compressed, and others are always decompressed. As a result, these areas have less fluid exchange than they should have.
Wider Reaching Effects
If your joint has a smaller range for a long period, the muscles around it react. They want to be as efficient as possible, so they shorten where they are never stretched. This makes it harder to pick up that lost movement again.
We see some recurrent patterns in clinic. Hip OA is a good example of this. Extension is the movement most commonly lost first: this is when your leg extends behind you. The body compensates for this by tilting the pelvis forward. Now your leg can still extend behind you, but your hip is not the joint doing that work.
If nothing else adapted to this pelvic tilt, you’d be leaning forward. This isn’t viable, so the body straightens you up somewhere in the spine. If the neck takes the brunt of this, it might develop OA itself as it’s asked to work in a completely different position to normal.
Osteopathy for Osteoarthritis
Since we know how OA develops, we know what the joint needs in order to be as healthy as possible. If you come to clinic with an arthritic joint, we might gently work through the limits of its current movement. It’s not unusual to find that when we move the joint for you, there’s more movement than you could get yourself – but still not as much as there should be. Through treatment and your home exercises, we aim to improve the range as much as possible.
We also want to address the local and more general effects. Muscles that hold the joint in a limited range can be relaxed with massage and stretching techniques. Osteopaths treat the body as a whole, so we will look for areas throughout the body that may have adapted to the joint in question. Whether we nip the arthritis in the bud, or the compensatory changes – the sooner we intervene, the better your outlook.
In my experience of treating people with osteoarthritis, patients can be happily surprised by the changes we can make. Even the first few sessions can show massive improvement, especially if you can keep up your exercises! I have treated a lady with a walking frame for hip OA who saw me as a last resort, but after a few months discharged herself after finding that she no longer needed the frame at all. Most prefer the “little and often” approach, where we get as much pain relief and movement as possible, then keep on top of it with appointments every few weeks. You can book an appointment online if you have any joint pain from OA. Hand and wrist OA can be debilitating but it seems to be one of the least common areas I see in clinic. No joint is too small – if you’re suffering, let us help.
This article is written by Freya Gilmore, Registered Osteopath at Shefford Osteopathic Clinic.