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November 16, 2021


Understand Your Osteoarthritis to Improve Your Pain and Function


Osteoarthritis is a common condition that we see every day in the clinic at Health in Balance. It’s characterised as a systemic increase in inflammation that can involve different pain experiences, local joint inflammation and stiffness, and reductions in joint cartilage. Some of the more prevalent symptoms associated with osteoarthritis include pain, joint stiffness, reduced range of motion, and swelling. Some of the more common areas where osteoarthritis are found are hands, spine, hips, knees, and ankle joints. Even though osteoarthritis is considered a systemic increase in inflammation and affects the entire body, it's important to appreciate the effects that it can have on joint cartilage. With osteoarthritis, we have a breakdown of the cartilage that's situated between two bones of a given joint, or perhaps a more simple way of thinking about this is a cushion between those two bones has been worn down over time.


The prevalence

Osteoarthritis is the most prevalent form of arthritis and it's expected that up to 10% of all Australians will suffer from some form of arthritis, with 63% of these cases being osteoarthritis-related. Regarding who is susceptible to suffering from osteoarthritis, there still has been no direct cause found. However, we do know there is a sharp increase from the ages 45 and above. Some other risk factors that have been linked to osteoarthritis include gender (with females being more susceptible), previous joint trauma, fat mass, and repetitive bloating.

The new approach

You might have picked up that we’ve been referring to osteoarthritis as a holistic or body-wide condition. This is part of a new approach to osteoarthritis that's arisen through a better understanding of osteoarthritis through modern research studies and testing. This newer approach is having a drastic implication on how we both look at osteoarthritis and how we treat it as well. Osteoarthritis can really no longer be considered a single joint condition, and it does need to be considered as a whole-body issue. This is because of the increase in systemic inflammation. That increase in inflammation can have a drastic effect on our neuroimmune response, which not only affects the way we perceive our pain associated with osteoarthritis, but also the way we move, exercise, and even live our lives. Additionally, another important component of this newer approach to osteoarthritis is that experts are suggesting that it is bioplastic in nature, meaning that it's malleable and we can change the way we both perceive our osteoarthritis and the way we function with it too. Experts have suggested that there are three main components that we can work on to improve the bioplasticity and malleability of dealing with osteoarthritis. These three areas include improving your knowledge around osteoarthritis, increasing your physical activity and exercise levels, and reducing inflammation.

Today we are going to improve your knowledge about osteoarthritis.  

The more you know, the less pain you have

There have been some key developments in recent years around the understanding and treatment of osteoarthritis, and what we now know is that your understanding of osteoarthritis and the human pain system matters. The old, outdated understanding of osteoarthritis involved phrases such as osteoarthritis being a cartilage problem, it involves wear and tear or bone on bone, caused by age, injury, and overuse, and that the outcome of osteoarthritis is inevitable; there's not much you can do about it and you will eventually need joint replacement surgery. Do these phrases sound familiar? They don't really provide much hope that things will get better, do they? And it doesn't really make sense that movement or exercise could help. However, with the new modern understanding of osteoarthritis, we now know that osteoarthritis is a whole-body process that involves systemic inflammation and can affect many joints. And osteoarthritis is not so much wear and tear. It presents more like wear and repair.

The outcome of osteoarthritis is in your control

There are many things you can do to help and you may not need surgery. (This sounds a bit more hopeful, doesn't it?) Exercise can be such a great tool for the repair component of osteoarthritis. Some of you might be thinking: “But when I exercise my joints are a bit sore. Is it still okay to exercise when I’m a bit sore?”. That's a really good question. To answer that, we need to understand that pain is not an accurate measure of tissue damage. Pain is a dynamic protector to stop us doing damage to ourselves. To explain, let's use the twin peaks model.

If you look at this model of a healthy pain system versus the pain system of someone with osteoarthritis, you will see that with osteoarthritis, our pain system becomes overprotective and causes us to feel pain well before we need to. This is the orange “protect by pain” line. We can exercise a little bit with pain and it can be safe and it can be effective. This is the green safe line. Exercising in the blue “safety buffer zone” can help improve the function of the pain system resulting in less pain. So we can and should exercise with osteoarthritis.

If you want to find out more about treating osteoarthritis, get in touch with an exercise physiologist at Health in Balance. Stay tuned for more blogs regarding osteoarthritis education and how to exercise safely.


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