Arthrosis – What you should know about the joint disease

You can read about how physical therapy for osteoarthritis works in the article. Physiotherapy for arthritis: Why exercise is the best medicine.

Specific forms of osteoarthritis: coxarthrosis and gonarthrosis

Coxarthrosis

Coxarthrosis affects the hip joint and can manifest as pain in the groin, thigh, or buttocks. This pain often occurs during movement and, in advanced stages, can also be present at rest. The restricted mobility of the hip joint can severely impair walking and other daily activities, resulting in a significant reduction in quality of life.

Gonarthrosis

Gonarthrosis, on the other hand, affects the knee joint. Those affected often experience pain in the knee that can worsen with walking, climbing stairs, or prolonged sitting. Swelling and crepitus (knocking sounds) in the joint are also characteristic symptoms. Here too, mobility can be severely restricted and inadequate treatment can lead to significant mobility limitations.

Symptoms of osteoarthritis

The symptoms of osteoarthritis can vary, but typically include:

• PainThese often only occur at first during exercise and can also be felt at rest in advanced stages.

• StiffnessEspecially after periods of rest, the joints feel stiff and immobile.

• SwellingThese can occur in the affected joints.

• Movement restrictionsThe affected joints are more difficult to move.

• Crunching noises: Noise may occur in the joint during movement.

Differentiation of pain

Osteoarthritis pain is typically associated with movement and exertion and can increase in intensity throughout the day. It is important to distinguish this pain from that of chronic joint inflammation such as arthritis, as the latter often also occurs at rest and at night.

When should you see a doctor?

A visit to the doctor is necessary if:

• The pain and stiffness severely restrict daily activities.

• swelling and inflammation that do not subside.

• The joint hurts and swells after injuries.

• The mobility of the joints is significantly restricted and does not improve.

Early diagnosis helps to start the appropriate treatment quickly and maintain quality of life. The diagnosis is usually made clinically – an X-ray or MRI is often not necessary at all.

Arthrosis: What the studies show

• Core treatment: Education, self-management, training, and – in the case of obesity – weight loss form the basis. Surgery is intended for individuals for whom these measures are not sufficient (Hunter 2019).
• Training on the knee: Targeted exercises relieve pain and improve function (Fransen 2015).
• Training on the hip: Here too, exercise programs reduce pain and improve daily functioning (Fransen 2014).
• Weight and training combined: In overweight and knee-pain patients, diet plus exercise resulted in more weight loss and fewer inflammatory markers after 18 months compared to exercise alone (Messier 2013).
• Paracetamol: Only brings minimal improvements in the wear of the knee and hip (Leopoldino 2019).
• Operation or training? The knee prosthesis was more effective, but had more serious side effects. 74% of the people in the training program were able to go a year without surgery (Skou 2015).

Self-help: What you can do yourself

Stay active regularly, even if you have any discomfort – joint-friendly activities like swimming or cycling maintain mobility. Maintain a healthy body weight to relieve pressure on the joints, and change positions regularly when sitting down.

What helps with osteoarthritis?

There are various approaches to working with Osteoarthritis and to alleviate the symptoms:

• Movement therapyExercises that promote mobility and muscle strength are essential. Our physiotherapy team at Waidfuss helps with this by providing customized therapy plans.

• MedicationAnti-inflammatory ointments (especially on the knees and hands) or tablets can relieve pain. According to a Cochrane review, paracetamol only brings minimal improvements in the knees and hips. Discuss the medications with your doctor.

• WeightIn the case of overweight, weight loss – preferably combined with exercise – can relieve the knee joint and alleviate the symptoms.

• Physiotherapy: Techniques such as Trigger point therapy IMTT® and Manual therapy They can additionally relieve pain. However, the core of the treatment remains active training.

• OperationsIn severe cases, an artificial joint may be useful – especially when good conservative treatment is not enough. In a study on the knee, the prosthesis provided more relief, but often led to serious complications; around three-quarters of the people in the training program did not need an operation within a year (Skou 2015).

Difference to arthritis

While in the case of osteoarthritis, pain and changes in the entire joint are the primary concerns, arthritis is an inflammatory joint disease. The most common form, rheumatoid arthritis, affects the immune system and leads to chronic inflammation in the joints. It is important to make an accurate diagnosis, as treatment methods are different.

Conclusion

Osteoarthritis is a degenerative joint disease that can lead to significant mobility and functional disorders. Early diagnosis and targeted treatment approaches, such as those offered in our practice, can help to maintain quality of life and alleviate pain. Do not hesitate, an appointment with our experienced Waidfuss physiotherapy team so that together we can create the best possible treatment plan for you.

Sources

• Hunter DJ, Bierma-Zeinstra S. Osteoarthritis. Lancet 2019
• Fransen M et al. Exercise for osteoarthritis of the knee. Cochrane 2015
• Fransen M et al. Exercise for osteoarthritis of the hip. Cochrane 2014
• Messier SP et al. Effects of intensive diet and exercise on knee joint loads, inflammation, and clinical outcomes (IDEA). JAMA 2013
• Leopoldino AO et al. Paracetamol versus placebo for knee and hip osteoarthritis. Cochrane 2019
• Skou ST et al. A randomized, controlled trial of total knee replacement. N Engl J Med 2015
• Bannuru RR et al. OARSI guidelines for the non-surgical management of knee, hip, and polyarticular osteoarthritis. Osteoarthritis Cartilage 2019