Arthritis: What is it, and how can Osteopathy help?
There are more than 10 million people who suffer from arthritis in the UK. Those who are over 45 are more likely to develop the condition. It might surprise you to know arthritis can affect people of all ages, even children!
Arthritis can lead to your joints feeling sore and stiff, currently there are limited treatment options on the NHS. So what can you do about your arthritis? Is it really just part of the aging process?
Types of arthritis
There are multiple different types of arthritis, a few being:
- Rheumatoid arthritis
- Psoriatic arthritis
- Reactive arthritis
- Infective arthritis
- Ankylosing spondylitis
The two most common types are Osteoarthritis and Rheumatoid arthritis, these are the two we will discuss further in this blog.
Osteoarthritis is the most common, affecting nearly 9 million people in the UK alone. Women over the age of 45 are most at risk of developing the condition, especially if there is a family history of the condition. This doesn’t mean that it can’t happen to anyone else! An injury or other joint-related condition such as, gout or rheumatoid arthritis, can lead to the condition.
Osteoarthritis itself initially affects the smooth cartilage lining of the joint. Cartilage allows the joint to slide and glide freely preventing damage as the joints move. Osteoarthritis damages the cartilage. As the condition progresses movements become more difficult than usual, leading to pain and joint stiffness. This also has a knock on effect to the tendons and ligaments. They have to work harder as the cartilage lining starts to roughen and thin out. This process usually causes swelling and the formation of bony spurs called osteophytes. Both of these processes result in the arthritic symptoms.
There are four stages to the severity of osteoarthritis.
- Doubtful osteoarthritis – Minimum disruption to the joint itself. There is around 10% cartilage lost.
- Mild osteoarthritis – The joint space is narrowing. The cartilage is beginning to break down and osteophytes are being formed.
- Moderate osteoarthritis – Moderate joint space narrowing, leading to less and less joint space. Gaps are starting to appear in the cartilage, these gaps can expand until they reach the bone.
- Severe osteoarthritis – Joint space is severely reduced. There is around 60% of cartilage lost. The osteophytes have grown and are now large osteophytes.
In severe cases a loss of cartilage can lead to bone rubbing on bone, altering the shape of the joint and forcing the bones out of their normal position.
Osteoarthritis most commonly affects the hands, spine, knees and hips.
Rheumatoid arthritis is less common than osteoarthritis however, it still affects more than 400,000 people. Women between 40 and 50 are the most commonly affected people.
Unlike Osteoarthritis, in rheumatoid arthritis (RA), the body’s immune system targets affected joints, which leads to pain and swelling. The outer layer of the joint, the synovium, is targeted. This can lead to pain and swelling. The condition then spreads across the joint leading to further swelling and a change in the joint’s shape. This may cause the bone and cartilage to break down. The joint then tries to repair itself however, this can lead to deformation of the joint.
The stages of rheumatoid arthritis include:
- Early stage RA – You may start to feel pain, swelling or stiffness of the affected joint. This is because the joint is inflamed, in particular the synovium which is a sheath around the joint. The bones themselves are not damaged in this stage.
- Moderate stage RA – The inflammation now starts to damage the joint cartilage which covers the ends of the bones. This leads to a reduction in joint mobility.
- Severe stage RA – Damage now affects the bones as well as the joint. Because the cartilage has been worn away, the bones will start to rub together. This can lead to more pain and swelling, muscle weakness and even mobility loss in the joint.
- End stage RA – The inflammation is no longer present. The joint itself has reformed but is no longer functioning as it should, in some cases the bones have now fused together. In this stage you may still experience pain, swelling and stiffness.
People with rheumatoid arthritis can also develop problems with other tissues and organs in their body. This is because rheumatic conditions affect the whole body.
Rheumatoid arthritis commonly effects both sides symmetrically. It usually affects wrists, hands, elbows, shoulders, knees and ankles.
Common symptoms of arthritis include:
- Joint pain, tenderness and stiffness
- Inflammation in and around the joints
- Restricted movement of the joints
- Warm red skin over the affected joint
- Weakness and muscle wasting
The current NHS guidelines for the treatment of osteoarthritis include lifestyle changes, medications and surgery.
Rheumatoid arthritis treatment has slightly different guidelines. Treatments include medication, physical therapy and surgery.
There are other support networks available to everyone. Versus Arthritis provides help and support for people in the UK with arthritis, plus their families and friends. They have a free helpline you can call for further information and support on 0800 5200 520, Monday to Friday, 9am to 8pm. (1)
There is also a NHS choices page with some information about living with arthritis. Link below.
How can Osteopaths help with Arthritis?
Osteopaths can treat both arthritic pain and rheumatic pain.
Osteopaths treat arthritis by first relieving muscle tension around the affected joint. Then we work to improve the range of motion in the joint, some of which may have been lost due to the condition. Osteopaths encourage better joint health by encouraging and increasing blood and lymph flow to and from the area. The end goal of this treatment is to reduce pain and inflammation whilst also increasing flexibility.
In addition, osteopaths work to optimise the function of related areas of the body, to ensure that movement and loading is distributed as evenly as possible. For example this could mean working on your feet or hips, if you had knee arthritis.
Osteopaths have a multitude of techniques which we can use for joint arthritis these include gentle articulation, massage, stretch and joint mobilisation. As well as lifestyle advice, home stretches and exercises you can do yourself. (2)
Age doesn’t always equal arthritis, and those with arthritis don’t have to live in pain. Don’t suffer in silence with your arthritis, there is help out there for you.
Qu XD, Zhou JJ, Zhai HW, Chen W, Cai XH. Therapeutic effect of exercise acupuncture and osteopathy on traumatic knee arthritis. Zhongguo gu shang= China journal of orthopaedics and traumatology. 2019 Jun;32(6):493-7.
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