Osteoarthritis is the most common joint disorder in the world and one of the most common sources of pain and impairment in the elderly

Osteoarthritis is the most common joint disorder in the world and one of the most common sources of pain and impairment in the elderly.1 At the same time there remains considerable divergence in defining osteoarthritis among epidemiological studies, the evidence is compelling that age remains the single greatest risk factor for the advance of osteoarthritis in susceptible joints.1
This paper have as an objective to overview osteoarthritis (also known as OA) a common joint disease that most often affects middle-age to elderly people,1 follow by a description of the etiology, signs, symptoms, pathology, prognosis, the commonly provided physical therapy intervention and its potential implications.
Despite to osteoarthritis be commonly referred to as “wear and tear” of the joints, we know that osteoarthritis is a disease of the entire joint, involving the breakdown of cartilage, deterioration of tendons and ligaments, various degrees of inflammation of the joint lining, and bony joints changes of the joints.1,2
Radiographic changes, in particular osteophytosis, are very common in the aging population and when used alone may provide a misrepresentation of the true prevalence of symptomatic osteoarthritis.1
Rather than directly originating osteoarthritis, aging changes in the musculoskeletal system contribute to the advancement of osteoarthritis by making the joint more vulnerable to the effects of other osteoarthritis risk factors that include unusual biomechanics, joint injury, genetics, and obesity.2
Describing osteoarthritis merely as joint pain occurring in an older adult without evidence for another form of arthritis is also imprecise as there are many explanation of no particular pain, such as bursitis, that are common in older adults.1
Osteoarthritis is classified as either primary (idiopathic) or secondary.3 The etiology of primary osteoarthritis is unknown.4 Other disease that sets off the joint degeneration, such as an infection, severe injury, or a congenital deformity are the causes of etiology of secondary osteoarthritis.4
Osteoarthritis characterized by joint stiffness and pain caused by articular cartilage damage, particularly first thing in the morning or after resting, the alteration of subchondral bones the shock absorber in weight-bearing joints, formation of osteophytes that represent an enlargement of the normal bony structure, and thickening of synovial linings.5
Others signs and symptoms for patient suffering from knee osteoarthritis, complain of limited movement and pain when they initiate movement of the knee or start to walk. In advanced disease, they may complain of nocturnal or permanent knee pain.3
Osteoarthritis can damage any joint in your body, the disorder most commonly affects joints in your hands, shoulder, knees, hips and spine.4 Staying active, maintaining a healthy weight and treatment with Vitamin E may slow progression of the disease and help improve pain and joint function.1,4,6
The pathology of osteoarthritis is complex and engage cooperation of multiple factors and processes. 7 These spectrums from genetic predisposition, altered mechanical loading and temporary or low?level inflammation to changes in the gene expression repertoire of the articular chondrocytes, including “unsilencing” by epigenetic components.7
Among adults over 60 years of age, the predominance of osteoarthritis is approximately 10% in males and 13% in females.8 Given the ongoing worldwide demographic direction in which the older population is growing expeditiously, osteoarthritis patients are expected to increase in the future. Despite this large number of osteoarthritis patients, no disease-modifying drugs have been developed to efficiently treat osteoarthritis, and the accessible drugs only relieve osteoarthritis symptoms. Therefore, joint replacement is the only remedy available to osteoarthritis patients who reach the final stage of osteoarthritis, calling attention to the urgent need to develop effective anti- osteoarthritis drugs.8
Physical therapy interventions for patients with osteoarthritis can help to reduce the pain, swelling, stiffness, and it can help improve joint function.9 Is focused on improving the functional status of patients through exercise program, patients who received physical therapy increased joint function also results in the reduction of pain.4
It can also make it easier for you to walk, bend, kneel, squat, and sit by strengthening weak muscles groups, endurance activities and home exercises programs.4,9 In fact, a study found that a combination of manual physical therapy and supervised exercise has functional benefits for patients with knee osteoarthritis and may delay or prevent the need for surgery.9
The two main types of physical therapy are passive and active treatments can help make osteoarthritis more manageable.9 With passive treatments, the physical therapist and physical therapist assistant does the majority of the work. However, with active treatments, the patient do more of the work, such as at-home exercises. Modalities used to alleviate pain consist of heat, ice, ultrasound, electrical stimulation, and massage. For feet and hands paraffin wax bath may be more effective as it is able to surround the toes and fingers opposed to other modalities.4
As physical therapist assistant, I would develop a treatment for a patient with osteoarthritis that would engage to try to walk as much as possible to maintain aerobic capacity, mobilize stiff joints, and strengthen muscles. Pace activity to little and often, rather than too much, and promoting low-impact exercise that will encourage the benefits of exercise at the same time preventing the potentially damaging consequences of high-impact activities.4,10
Although a positive disposition towards exercise could increase motivation, more important is the enthusiasm and ability to accommodate exercises into everyday life, include patient as partners in reasonable decisions about therapy, an approach that is call concordance. Majority of patients are probably partially compliant at best, conflict with regular routines, combination of a busy life and a reduced commitment to the physical therapy can explain why continuing with exercise is not possible.10,11
Patient non-compliance to physical therapies is not only very common, but is usually a reasoned response, continued compliance relies on the patient’s understanding of their symptoms, the effectiveness of the intervention, their ability to include it into everyday life and the reinforcement from physical therapists and physical therapist assistant. The recognized severity of osteoarthritis symptoms is an important component in motivation, with those experiencing severe pain and/or loss of mobility being most likely to continue to exercise.10
Therapists should ensure patients’ beliefs and social circumstances are consider using the model of concordance, been certain they are explored and understood.


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