Physical Therapy Guide to Osteoarthritis -

Physical Therapy Guide to Osteoarthritis

Arthritis describes inflammation or swelling of joints. Osteoarthritis, or OA, is the most common type of arthritis damaging the joint surfaces. OA impacts the entire joint, including the bones and joints that bear weight, like the hips and knees, are the most often affected. Damage from OA can slowly worsen over time, leading to pain, stiffness, and swelling.

According to the Centers for Disease Control and Prevention, over 32 million Americans have some form of OA. The condition affects women more than men, and the risk of developing OA increases with age. Other risk factors include past joint injury and obesity.

Nearly half of Americans with arthritis report that it limits their activities. OA can affect many things, including:

Working.
Walking and climbing stairs.
Standing up and sitting down.
Grasping small items.
Balance.

People with arthritis are four times more likely to have at least two falls. They also are five times more likely to be hurt from falling.

Although a joint replacement is sometimes needed, this is not always the case. You may be able to decrease pain from OA by:

Safely increasing physical activity (such as walking, biking, swimming).
Getting stronger.
Maintaining a healthy weight.

Physical therapists can help people understand and manage their OA. Physical therapy treatments may lessen OA pain and increase strength, motion, and balance. These improvements can positively impact a person’s movement function and reduce the chances of falling. Physical therapists can also teach people about healthy lifestyle choices that may positively impact OA.

Physical therapists are movement experts. They improve quality of life through hands-on care, patient education, and prescribed movement. You can contact a physical therapist directly for an evaluation. To find a physical therapist in your area, visit Find a PT.

What Is Osteoarthritis?

Joints, like those in the hip and knee, are where two bones connect to allow motion. Synovial fluid is a “lubricating oil” in joints. Cartilage is a strong, smooth surface that covers and protects the bones at joints. It acts as a “cushion” when bearing weight while standing, walking, and climbing stairs. The cartilage and synovial fluid help reduce friction in the joints for motion. Over time, the protective cartilage can break down. If this happens, a person may have more pain and stiffness when moving.

The cause of OA is not known. Currently, growing older is the main risk factor for developing OA. Factors that may increase your risk for OA include things you can change, such as obesity, and other factors, like age, that we cannot change. Some factors that increase a person’s OA risk are:

Obesity. Extra weight adds more stress to joints that bear weight (such as the hips and knees).
Age. Cartilage and synovial fluid can break down and worsen over time.
Sex. Females are at higher risk than males.
Genetics. Some people have difficulty forming cartilage.
Past injury.
Jobs that require repeated and or prolonged squatting, bending, kneeling, and twisting.

How Does It Feel?

Typically, OA causes pain and stiffness in the affected joint. Common symptoms are:

Joint stiffness first thing in the morning or after sitting or lying down for a little while.
Joint stiffness that may get better after gently moving the joint.
Pain or aching during activity that may ease with rest.
Cracking, creaking, crunching, or clicking sounds while moving the joint.
Tenderness when pressing around the joint.
Joint swelling.
Increased bone growth (“bumps”) around the joint.

Caution: Warmth with swelling or redness around the joint is not typical with OA. It may indicate a different condition or signs of inflammation. Please consult your doctor if you have swelling, redness, and warmth in or around a joint.

How Is It Diagnosed?

Physicians and some physical therapists may diagnose osteoarthritis with an X-ray. Some signs that may lead your physical therapist to suspect OA include:

Joint stiffness.
Difficulty moving.
Joint cracking, creaking, or crunching.
Pain that is relieved with rest.

Physical therapists using the 2022 National Institute for Health and Critical Excellence criteria may consider an OA diagnosis if you are 45 years or older and have joint pain with activity but no stiffness in the morning, or have morning stiffness lasting 30 minutes or less.

How Can a Physical Therapist Help?

Physical therapy can be effective for OA. Physical therapy may help you avoid surgery and prescription pain medications. Although the symptoms of OA are different for each person, starting a targeted exercise program designed by a physical therapist may improve your symptoms and slow the impact OA has on your bones and joints.

Your physical therapist will:

Perform a thorough exam.
Observe what activities are difficult for you.
Design an exercise program to address your specific needs to improve your movement and function.
Use manual (hands-on) therapy to improve motion in the affected joint(s).
Suggest ways to adjust your work area to lessen the strain on your joints.
Teach you how to safely do aerobic and strengthening exercises to improve your movement and overall health.
Design and teach you an exercise program that you can do at home to maintain and improve your strength and movement after physical therapy.
Recommend a cane, walker, or knee brace if needed.
Discuss strategies and teach you exercises for safe weight loss to ease pressure on your joints if needed.
Recommend lifestyle changes that will help you maintain a healthier weight.

In cases of OA that are not helped by physical therapy alone, your physical therapist will refer you to an orthopedist or orthopedic surgeon to discuss other options. This may include medication, steroid shots, and even surgery in some cases.

Can This Injury or Condition Be Prevented?

Osteoarthritis is more common in older adults. It cannot be prevented entirely. Choosing an active, healthy lifestyle can help slow the onset or progression of OA.

This means maintaining a healthy weight and staying physically active. Taking part in a community exercise class can help you get the recommended amount of regular physical activity.

People who perform repeated movements that stress specific joints during work or sports can benefit from a physical therapist’s advice on proper movement techniques and muscle strengthening. This can lessen joint strain and promote joint health.

Everyone, especially older adults, should learn proper balance and movement techniques. This can lower their chances of falling and injuring a joint.

What Kind of Physical Therapist Do I Need?

All physical therapists are prepared through education and experience to treat OA. However, you may want to consider:

A physical therapist who is a board-certified clinical specialist or who has completed a residency or fellowship in orthopedic or geriatric physical therapy. This physical therapist has advanced expertise and experience that may help treat your OA.
A physical therapist who specializes in the treatment of OA.

You can find physical therapists with these and other credentials by using Find a PT, a tool built by the American Physical Therapy Association to help you search for physical therapists in your area.

General tips when you’re looking for a physical therapist (or any other health care provider):

Get recommendations from family, friends, or other health care providers.
Ask about the physical therapists’ experience in helping people with osteoarthritis when making an appointment.
Be prepared to describe your symptoms in as much detail as possible and say what makes your symptoms better or worse.

More Information on Osteoarthritis

Other Arthritis Resources

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