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The Truth About Osteoarthritis


For those who experience knee pain, one of the most dreaded diagnoses for its cause is osteoarthritis (OA). This is typically because OA is often seen as a one-way degenerative journey for joints. A quite common belief is that if you develop OA, your pain will never improve and will continually worsen until a joint replacement can be performed. This concept is partially reinforced by the prevalence of both hip and knee replacements, two of the most common operations performed by orthopaedic surgeons. While the idea that OA is continuously progressive and irreversible has become incredibly prevalent in society, it simply isn’t the case.

A commonly heard expression is that a joint is ‘worn out’, as if someone were describing a car part that needs replacing. This is often a harsh and unrealistic view of the human body, and the normal changes which occur as we age. While there are physical changes which manifest in our joints with age, these changes have little association with doing too much activity. In fact, we now know that loading plays a key role in maintaining healthy joints. So, as opposed to causing further ‘wear’, one of the best things you can do for a ‘worn out’ joint is to continue or increase the amount of activity it’s involved in.

It’s also important to be aware that the amount of change to the joints which can be seen on x-rays has little relationship to how your joints feel. Someone with lots of visible changes can have next to no pain or symptoms, while others with much less change at their joints can be in severe pain. OA has many more layers than simply age-related changes to our skeletons.

The pain and disability that tend to come with the progression of OA can be incredibly disruptive to living a normal life. We do know however that with a targeted exercise program, this pain can be significantly reduced, and the health of the joints maintained or even improved. By increasing the strength and endurance of the surrounding muscles and tissues, not only does it make moving easier by providing extra support, it also has positive effects on the healing of irritated structures within the joint. The introduction of an exercise program can be extremely beneficial in significantly slowing down the progression of OA, to the point where surgery can be delayed for several years, or even avoided entirely.

While painful movements and activities can be frustrating, physiotherapists are experts at creating programs which can be helpful for people of all physical abilities. This can help improve the quality of your life regardless of what stage of the OA journey you’re at, whether it’s a new diagnosis or you’ve lived with it for a few years. While surgery may eventually be necessary at some point during your life, the best first step you can make is to see a physio. They will help to determine the best management strategy to continue, or return to, the things you want to be doing.

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Thomas Bloem
Thomas Bloem

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