Hip and Knee Osteoarthritis


Osteoarthritis (OA) is a chronic, degenerative condition that can affect any joint in the body but is more common in the hips, knees and fingers. There is joint damage, loss of cartilage (which cushions the joint during weight bearing and allows joints to glide on each other during movement), formation of bone spurs (small bony growths on normal bone surface) and mild inflammation.

OA usually develops gradually with age but can also occur in younger individuals who have had previous joint injuries. Risk factors of developing this condition include being overweight, having a family history of OA and repetitive loading or overuse of the joint.

Common symptoms of OA are pain, stiffness, crepitus, loss of range in the joint and if severe, functional activities like walking, climbing stairs or gripping objects may become difficult. Diagnosis of OA can be made by physical examination of the joint and can be confirmed with Xrays. However, it is important to note that degenerative changes on Xrays does not always mean that there will be pain in the joint as there are people who have degeneration on imaging but are asymptomatic.

Management of OA can be classified into pharmacological, conservative and surgical management. Patients with OA may be given simple analgesics (such as paracetamol) or Non-Steroidal Anti-inflammatories (NSAIDs) for pain management. Stronger medication may be prescribed by your doctor if necessary. Conservative management includes Physiotherapy, as recommended by the Royal Australian College of General Practitioners (2009).

Physiotherapists are well-trained to assess and manage OA with a variety of treatment options, such as electrical modalities or dry needling for pain, exercise therapy for weight management and muscle strengthening and manual therapy to improve joint mobility. As OA is a chronic condition, your physiotherapist will teach you how to modify certain activities so that you protect your joints and slow down the progression of your condition. If conservative management does not provide sufficient relief of your symptoms, your doctor may refer you to an Orthopaedic Specialist to discuss possible surgical options like an arthroscopic debridement or a joint replacement.