OA is most common in the small joints of the hands, the spine, the knees, the hips, and certain toe joints. OA primarily affects the articular cartilage: the slippery, cushioned surface that covers the ends of the bones in most joints and lets the bones slide without rubbing. Articular cartilage also functions as a shock absorber.

In OA, the articular cartilage becomes damaged or worn away. As this happens, the joint no longer fits together well or moves smoothly. In the early stages of OA, the cartilage actually becomes thicker as your body tries to repair the damage. The repaired areas are more brittle than the original cartilage, and these brittle areas begin to wear away and become thin. They may even wear away entirely. This eventually leads to a condition called eburnation, in which the bones become thick and polished as they rub together. X-rays can show these changes in the cartilage and bones.

But OA is not just a disease of the cartilage. The damage to the cartilage seems to start a sort of chain reaction that involves all the parts of the joint. Bone spurs, or outgrowths, often begin to form around the edges of the joint. The joint capsule (the watertight sack around the joint) can become thickened and lose its stretch. The synovial membrane that lines the inside of the joint capsule may become inflamed (swollen, red, hot, and painful), and crystals may form in the synovial fluid. The tendons and ligaments around the joint can also become inflamed.

Even the muscles around the joint can lose their strength. This usually occurs as a result of under-use of the muscles due to pain in the joint. When something hurts we subconsciously change the way we use the joint to avoid the pain. This causes the muscles to become weakened.  Cartilage itself does not have nerves to feel pain, therefore the pain of OA probably comes from these other changes in and around the joint.

The exact cause of OA is not known. Major injuries and repetitive stress both seem to be a contributing factor to the development of OA. A person who breaks an ankle is likely to develop OA in that same ankle. Just like any machine, a joint that is damaged and unbalanced wears out faster. People who consistently put heavy stress on the same joint, such as jackhammer operators or baseball pitchers, are more likely to develop OA in that joint.

OA of the knee and hip occurs much more often in people who are seriously overweight. A study that followed overweight young adults for thirty-six years found that being overweight at a young age was closely related to developing OA later in life. The same study also showed that losing even small amounts of weight decreased the odds of developing OA.

Heredity–your genes–may also play a role for some people, especially women. OA in the fingers, which affects ten times more women than men, shows up much more often among women in the same family. Researchers do know that some genes cause problems with cartilage formation.

There is no cure for OA. Medication usually only provides short-term relief. Though it is chronic, it is also a very treatable disease. Our goals of treatment at Physioflow Physical Therapy are to relieve your pain and to improve or maintain the movement of your joints. Treatment for arthritis should start early for the best outcome.

Following evaluation, Dr. Trinh will provide hands-on manual therapy and teach you:

• specific exercises to improve your joint mobility and strength
• proper body mechanics
• joint protection techniques
• how to modify basic activities to minimize joint wear and tear
• how to properly use adaptations, such as walking aids or tools for opening jars

Many individuals with arthritis believe that Physical Therapy cannot help them, though research begs to differ. One particular study found that patients with knee osteoarthritis who were treated in therapy with both manual techniques and exercises had twice the pain relief and improvement in function when compared to those who performed the exercises on their own at home. Better yet, this relief lasted even when they were checked again a year later!