The most common form of arthritis we see in clinic is osteoarthritis (OA). Unlike rheumatoid arthritis, OA is not autoimmune. It is a more mechanical process, sometimes referred to as “wear and tear”. More recently, it has become “wear, tear, and repair” to recognise the potential for healing.
Osteoarthritis is the process in which the cartilage of a joint degrades. This can be secondary to injury, or more insidious. In either case, the cartilage becomes unhealthy, which is associated with a change in movement. Cartilage does not have its own direct blood supply, so relies on being squeezed and released (like a sponge) to clear out waste and take in nutrients. If some of the joint movement is lost, the waste and nutrients will not be exchanged across all of the cartilage.
Over time, the joint surface becomes more rough as the cartilage degrades. In later stages, there may be flakes of cartilage that detach and float freely in the joint. Beyond this, the bone beneath the cartilage can develop painful cysts, by which time there is not much we can do to help.
The knee is actually made of three joints:
- The main hinge joint
- The joint between the knee cap and the rest of the knee
- The small joint between the shin bones
Any of the three can develop OA, and all present slightly differently. If the main hinge joint is affected, you might experience locking while walking or driving. This happens more in the later stages, especially if some of the cartilage breaks off.
When the knee cap is involved, walking downhill or down stairs can be particularly uncomfortable. It may be possible to get some quick relief by relaxing off the quadriceps muscles. The knee cap sits within the ligament of the quadriceps, so when they get tight, they add pressure to the joint in question.
When the hip develops osteoarthritis, the first movement lost is typically extension. This is the movement of moving your leg backwards. The body is quick to adjust to discomfort, and often the arthritis can go unnoticed for quite a while.
When extension becomes difficult, typically the pelvis and back tilt forwards to accommodate. This allows the leg to move back, but does not require so much movement from the hip itself. The spine corrects itself further up, often requiring extension of the neck to keep the head up. This can be a factor in headaches and neck pain, and may also come with a hunched posture.
Just like the lower back adapts to hip arthritis as mentioned above, the same can be true for other areas. It is worth noting that sometimes lower back pain can be explained by early hip or knee arthritis. Shoulder or wrist arthritis can lead to overworking of the elbow, and arthritis in the spine can cause compensation in the joints above or below it.
Osteopathy for Arthritis
Your osteopath is qualified to help with your hip or knee arthritis. You can expect them to also look for compensation elsewhere, and manage both the symptoms and the causes together. It is possible that your osteopath will find asymptomatic areas that would benefit from treatment. This will be discussed with you in your appointment.
The earlier the condition is picked up, the better the possibility for repair. In later stage arthritis, the cartilage is significantly lost, and the underlying bone can be injured. Treating the joint while the cartilage is still relatively thick is ideal.