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Arthritis

Arthritis literally means “inflammation of the joint.” Symptomatic degenerative joint disease (DJD) or osteoarthritis (OA) can become painful when cartilage and bone become inflamed due to excessive pressure on the joint surfaces. All weight bearing joints experience degenerative changes over the lifespan with a decrease in the amount of cartilage and in the joint space between the bones. These are considered normal age related changes. However, sometimes the level of degeneration is severe enough that an inflammatory reaction begins. Pain, swelling, and loss of function are typical symptoms which ensue. Lack of strength in the contractile tissues surrounding and crossing over the joint appears to be a factor in allowing excess pressure and force to be absorbed through the joint. Studies have shown that physical therapy is effective for reducing pain and restoring function for symptomatic osteoarthritis in weight bearing joints.

The soft tissues of the joints such as the synovium can become inflamed either acutely due to injury or by chronic disease processes such as rheumatoid arthritis (RA). Another form of arthritis is gout which results in the accumulation of uric acids in the joint fluid (synovial fluid) which then cause inflammation, swelling, pain, and loss of function.

For osteoarthritis low impact or non-weight bearing exercises, glucosamine suppliments, physical therapy, and bracing appear to be the conservative treatments of choice. Some patients may still need cortisone or Syn-Visc injections and/or possible surgical interventions. For rheumatoid arthritis and gout dietary modification appears to be a useful means of managing or eliminating the symptoms along with joint protection such as bracing and avoiding overuse. Physical therapy treatments can reduce inflammation and help to restore lost function as well and should be considered. There are surgical interventions such as a synovectomy (removal of the synovial tissue surrounding the joint) which can be employed if other more conservative measures fail.