OSTEOARTHRITIS
Osteoarthritis is a noninflammatory degenerative disorder of the joints characterized by progressive deterioration of the articular cartilage.
TYPES :-
(a) primary when the aetiology is natural wear and tear with aging, overuse or obesity
(b) secondary when it follows some known primary cause, e.g., trauma, infection and rheumatoid arthritis (RA)
COMMON SITES :-
◼ Weight-bearing joints: Hip, knee, ankle and spine
◼ Overused joints: wrist joints, carpometacarpal joint of thumb, distal metacarpophalangeal joints, etc.
◼ Most common site: knee joints
CLINICAL FEATURES :-
↪Pain is the main presenting symptom.
↪The joint becomes swollen due to synovitis.
↪Stiffness gradually sets in, severe pain and capsular contractures.
On examination
There is swelling due to synovial thickening and/or effusion,
muscle wasting
prominence of the articular margins Movements are painful and restricted. Crepitus is felt on passive joint movement.
Radiographic examination reveals the following main features
◼ Narrowing of the joint space
◼ Osteophytes at the margins of articular cartilages
◼ Sclerosis and cysts in the subchondral bone
2. Control of pain
3. Prevention of further damage
4. Improvement in range of motion (ROM)
5. Improvement in strength, endurance and muscle functions .
6. Improvement in the functional status
pain can be reliably assessed by the visual analogue scale (VAS)
2. Assessment of function: The impact of the disease on the functional performance of the patient is examined and recorded on a functional evaluation chart.
3. Assessment of joint stiffness: Accurate evaluation of the passive ROM with its end feel.
5. Assessment of tenderness: The degree and the area of tenderness, effusion and crepitus.
Prevention: Physiotherapy can play a vital role in the prevention of the painful symptoms of osteoarthritis. Understanding the following factors
1. History of trauma:
2. Characteristics of joint cartilage:
3. Effects of immobilization:
4. Weight bearing:
5. Full ROM exercises:
(a) To control pain, suitable electrotherapeutic modality ,Ultrasound therapy, transcutaneous electrical nerve stimulation (TENS), Short-wave diathermy (SWD) may be used in the later phase .
(b) Hydrotherapy is particularly useful when the weight-bearing joints are affected.
(c) proper position, splints or joint distraction by manual or mechanical traction, CPM or functional bracing.
2. Improvement of muscle power, endurance and tone: Graduated exercise programme is initiated, which consists of progressive resistive exercises (PRE), strong and sustained repeated sessions of isometrics .
3. Improvement in ROM
(a) Active free relaxed rhythmic movements .
(b) Relaxed passive movements should be started first to mobilize stiff joints.
4. Improvement of functional independence:Providing assistive aids, modified supports, corrective orthoses.
Osteoarthritis is a noninflammatory degenerative disorder of the joints characterized by progressive deterioration of the articular cartilage.
TYPES :-
(a) primary when the aetiology is natural wear and tear with aging, overuse or obesity
(b) secondary when it follows some known primary cause, e.g., trauma, infection and rheumatoid arthritis (RA)
COMMON SITES :-
◼ Weight-bearing joints: Hip, knee, ankle and spine
◼ Overused joints: wrist joints, carpometacarpal joint of thumb, distal metacarpophalangeal joints, etc.
◼ Most common site: knee joints
CLINICAL FEATURES :-
↪Pain is the main presenting symptom.
↪The joint becomes swollen due to synovitis.
↪Stiffness gradually sets in, severe pain and capsular contractures.
On examination
There is swelling due to synovial thickening and/or effusion,
muscle wasting
prominence of the articular margins Movements are painful and restricted. Crepitus is felt on passive joint movement.
Radiographic examination reveals the following main features
◼ Narrowing of the joint space
◼ Osteophytes at the margins of articular cartilages
◼ Sclerosis and cysts in the subchondral bone
Principles of physiotherapeutic management (general) in osteoarthritis.
General principles of treatment
1. Prevention2. Control of pain
3. Prevention of further damage
4. Improvement in range of motion (ROM)
5. Improvement in strength, endurance and muscle functions .
6. Improvement in the functional status
Assessment
1. Assessment of pain: Pain is an index of the degree of joint irritability. The site of pain, its nature and duration are noted.pain can be reliably assessed by the visual analogue scale (VAS)
2. Assessment of function: The impact of the disease on the functional performance of the patient is examined and recorded on a functional evaluation chart.
3. Assessment of joint stiffness: Accurate evaluation of the passive ROM with its end feel.
5. Assessment of tenderness: The degree and the area of tenderness, effusion and crepitus.
Prevention: Physiotherapy can play a vital role in the prevention of the painful symptoms of osteoarthritis. Understanding the following factors
1. History of trauma:
2. Characteristics of joint cartilage:
3. Effects of immobilization:
4. Weight bearing:
5. Full ROM exercises:
**Treatment*
1. Pain control(a) To control pain, suitable electrotherapeutic modality ,Ultrasound therapy, transcutaneous electrical nerve stimulation (TENS), Short-wave diathermy (SWD) may be used in the later phase .
(b) Hydrotherapy is particularly useful when the weight-bearing joints are affected.
(c) proper position, splints or joint distraction by manual or mechanical traction, CPM or functional bracing.
2. Improvement of muscle power, endurance and tone: Graduated exercise programme is initiated, which consists of progressive resistive exercises (PRE), strong and sustained repeated sessions of isometrics .
3. Improvement in ROM
(a) Active free relaxed rhythmic movements .
(b) Relaxed passive movements should be started first to mobilize stiff joints.
4. Improvement of functional independence:Providing assistive aids, modified supports, corrective orthoses.
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ReplyDeleteEverything you have written here about joint pain is on point.Dr. Desai Hand Doctor is ready to serve you with best of their service. Main thing we can do is to avoid getting fat and add exercise in your daily routine. Thank you for this informative post.
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