– by Lorna Rose

What is osteoarthritis?

Osteoarthritis is the most common type of arthritis, it is a clinical syndrome characterised by joint pain accompanied by varying degrees of functional limitation and reduced quality of life. The most common peripheral joints to be affected are the knees, hips and small joints of the hand. Structural changes to joints can happen without any symptoms at all. It is usually when people are unable to compensate for these changes that they start to become symptomatic. Joints are particularly vulnerable to developing osteoarthritis if they’ve been injured in the past or if the normal healthy movement has been disrupted.

There are various ways of managing osteoarthritis, both pharmacological and non-pharmacological, to understand the role that manual therapy can play it is useful to know what changes happen within an osteoarthritic joint:

Osteoarthritis is characterised pathologically by localised loss of cartilage, remodelling of adjacent bone and associated inflammation. Loss of cartilage leads to reduced space between the boney surfaces of the joint, initially this can lead to increased mobility but as the joint capsule contracts and the surrounding muscles shorten, mobility is reduced.

What can osteopaths do?

One of the main objectives for us when treating an osteoarthritic joint is to maximise the mobility of the joint. We do this by gently moving the joint within a pain-free range and by stretching surrounding muscles. The benefits of this are reinforced by doing exercises at home.

Joint cartilage relies on compression and decompression to access nutrients from the synovial fluid contained within the joint capsule. This is one of the reasons exercise is so important for osteoarthritic joints. By passively moving the joint during treatment, we’re helping to coat the cartilage with fluid and changing the pressure by gently stretching the joint.

My experience of treating patients with osteoarthritis

Lots of my patients suffering with osteoarthritis have found treatment really benefitted them and helped to minimise the impact of the condition on their day to day activities. Of course there are limits to what can be achieved through conservative management of osteoarthritis. On those occasions I would encourage patients to communicate with their GP to discuss other options, including steroid injections and joint replacements if indicated. However, having witnessed the benefits of osteopathic treatment for patients with osteoarthritis I think it is definitely worth seeing what can be achieved through osteopathic treatment first.