Massage therapy · Kitchener–WaterlooOsteoarthritis

Almost any joint in the body can be affected by OA, but it most often causes problems in the knees, hips and small joints of the hands (NHS, 2023a). The spine and feet can also be affected. Sometimes just one joint is affected, but often several joints are affected at different speeds. So it is not uncommon to first notice some hip stiffness on one side, only to be followed months or years later by similar symptoms on the other side.

Several things are thought to increase the risk of OA, including a previous injury or operation on the joint, being overweight, getting older, a family history of OA, being a woman, and exercise or work that puts frequent strain on the joints (NHS, 2023a).

OA is different to rheumatoid arthritis. Rheumatoid arthritis is an autoimmune disease, which means the immune system attacks the cells that line the joints by mistake, making them swollen, stiff and painful (NHS, 2023c). Stiffness that lasts a long time in the morning can be a sign of rheumatoid arthritis rather than OA (NHS, 2023a). OA should also not be confused with osteoporosis. Osteoporosis is bone thinning, and has nothing to do with OA. Osteoporosis tends to be painless, and is known as a silent disease, until you fracture a bone from a fall or injury. With OA, fracture is far less likely, and it tends to be more painful generally.

Having OA does not mean you will suffer with pain for the rest of your life. OA is a long-term condition, but it does not necessarily get any worse over time and it can sometimes gradually improve (NHS, 2023a). Symptoms can be helped with exercise, losing weight if you need to, hot or cold packs and physical therapies (NHS, 2023b).

1. Diagnosis

OA is usually diagnosed by your family doctor or nurse practitioner from your symptoms and an examination of your joints. X-rays and other tests are not usually needed, but they may be used to rule out other causes (NHS, 2023a; NICE, 2022).

2. Exercise

Exercise is one of the most important treatments for OA, whatever your age or fitness. It should include exercises to strengthen your muscles as well as exercises to improve your general fitness (NHS, 2023b; NICE, 2022). Your family doctor or nurse practitioner, or a physiotherapist, can give you an exercise plan to follow at home.

3. Walking Stick

If OA in your hip or knee affects your walking, a stick can help by taking some of your weight. Hold it on the opposite side of your body to the affected leg (NHS, 2023b). I can help you choose a stick and set it to the right height.

4. Hot and Cold Packs

Applying hot or cold packs to the joint can relieve pain in some people, for example a hot-water bottle wrapped in a tea towel, or an ice pack wrapped in a towel if the joint is swollen (NHS, 2023b; Arthritis UK, n.d.).

5. Anti-Inflammatory Medications

The NHS (2023b) says a family doctor or nurse practitioner may recommend a non-steroidal anti-inflammatory drug (NSAID) for OA pain. Some NSAIDs come as creams or gels that you rub on the joint, some of which are available without a prescription, and these can work particularly well for knees and hands. NSAID tablets may be used if creams don't help, but they are not suitable for everyone, for example people with asthma, a stomach ulcer or angina. NICE (2022) advises using medicines at the lowest effective dose for the shortest possible time, so try to only use them when you really need them.

(This medicine information comes from the NHS and NICE, not from me. Always check with a pharmacist or your family doctor or nurse practitioner before taking any medicine.)

Options outside my scope

• Joint replacement: an operation to replace a damaged joint with an artificial one, most commonly done for hips and knees (NHS, 2023b).
• Joint fusion (arthrodesis): an operation to fix a joint in a permanent position, which may be suggested if joint replacement is not suitable; the joint becomes less painful but can no longer move (NHS, 2023b).

How I can help (see the My Approach tab)

Work on the buttock and hip muscles is only with your informed consent and a written consent form. If a joint becomes hot, red and very swollen, or morning stiffness lasts a long time, see your family doctor or nurse practitioner.