Osteoarthritis:
An overview and introduction to
pain management and activity
Presented by: Melanie Fuller-Clinical Exercise Specialist
Sherwood Park Primary Care Network
Objectives
• What is arthritis?
• What are the symptoms of arthritis?
• Ways to decrease pain and manage
symptoms
• Things you can do at home to help with daily
living tasks
• Specific exercise guidelines and resources
Osteoarthritis: What Is It?
• Also called "wear and tear"
arthritis or degenerative joint
disease, osteoarthritis (OA)
• Progressive breakdown of the
joints' natural shock
absorbers. This can cause
discomfort when you use the
affected joints
• Most people over 60 have
some degree of OA, but it also
affects people in their 20s and
30s
Osteoarthritis: Where Does It Hurt?
• In most cases,
osteoarthritis develops
in the weight-bearing
joints of the knees, hips,
or spine. It's also
common in the fingers,
thumb, neck, and big
toe.
• Other joints are usually
not affected, unless an
injury is involved.
What does it look like?
Osteoarthritis: Symptoms
•
•
•
•
•
•
•
Pain
Tenderness
Stiffness
Loss of flexibility
Grating sensation
Bone spurs: hard lumps
Swelling
Osteoarthritis: What
Causes It?
•Every joint comes with a natural
shock absorber in the form of
cartilage.
•This cushions the ends of the
bones and reduces friction in
healthy joints.
•As we age, joints become stiffer
and cartilage is more vulnerable
to wear and tear.
•Repetitive use of the joints over
the years irritates the cartilage. If
it deteriorates enough, bone rubs
against bone, causing pain and
reducing range of motion.
Risk Factors You Can't Control
• Older Age
• Gender
– Female (2.6 times more likely
to develop OA)
• Bone deformity: bow legged
Risk Factors You Can Control
• Body Weight (11 lb weight
loss results in 50% decrease
chance of OA in the knee
• Activities
– Repetitive motions
– Previous Injury from certain
sports (ACL)
Research shows that “for
each 1 pound increase
in weight, the overall
force across the knee
increases 2 to 3
pounds. (Felson et al. 2000).
Impact on Daily Life
• Everyone is different
• Mild pain v.s. severe pain
Diagnosing Osteoarthritis
• Describe symptoms
• X-ray or other imaging
• Blood tests (rheumatism)
Long-Term Complications
• It can lead to deformities
that take a toll on mobility.
• Severe loss of cartilage in
the knee joints can cause
the knees to curve out,
creating a bow-legged
appearance (shown on the
left).
• Bony spurs along the spine
(shown on the right) can
irritate nerves, leading to
pain, numbness, or tingling
in some parts of the body.
What causes pain?
Arthritis pain can be caused by:
• inflammation, the process
that causes heat and
• swelling in your joints
• damage to the joints
• muscle tension, from trying
to protect joints from
• painful movements.
Medication for OA
• Consult your family
physician or pharmacist
• Over the counter pain
relievers
• Sprays, gels, creams
• Prescription pills
• Natural remedies: hot/cold
therapy, massage therapy.
• Pain Management is key!
Treatment: Exercise Therapy
• There is no treatment to
stop the erosion of cartilage
in the joints, but there are
ways to improve joint
function.
• Increase flexibility
• Strengthen the muscles
around the affected joints
• Hot or cold therapies to
relieve pain.
Supportive Devices
• Supportive devices, such as
finger splints or knee
braces, can reduce stress on
the joints and ease pain.
• If walking is difficult, canes,
crutches, or walkers may be
helpful.
• People with osteoarthritis
of the spine may benefit
from switching to a firmer
mattress and wearing a
back brace or neck collar.
Osteoarthritis and Weight
• Losing weight is one of the
most effective ways to
relieve pain.
• Can reduce long term
damage
Preventing Osteoarthritis
WORK SMARTER….NOT HARDER
• The most important thing you
can do is keep your weight in
check. Extra weight puts stress
on the joints and may even
alter the normal joint
structure.
• Preventing injuries is also
important.
• Take precautions to avoid
repetitive motion injuries on
the job. If you play a sport, use
proper equipment and
observe safety guidelines.
Osteoarthritis and Exercise
• Many patients do not
exercise because of fear of
pain.
• Exercise helps:
–
–
–
–
Strengthen muscles
Support joints
Increase joint lubrication
Improve flexibility
How do I Achieve these
Health Benefits?
What do I need to know?
There are 3 major components to physical activity
Flexibility or Range of Motion Exercises
Muscle Strength and Endurance
Overload principle
Aerobic/Cardiovascular Fitness
Lets get moving!
Warm up to work out
• Apply heat to the joints you'll be working before you exercise.
• Move your joints gently at first to warm up. You might begin with
range-of-motion exercises for five to 10 minutes before you move
on to strengthening or aerobic exercises.
• Exercise with slow and easy movements. If you start noticing pain,
take a break. Sharp pain and pain that is stronger than your usual
joint pain might indicate something is wrong. Slow down if you
notice inflammation or redness in your joints.
• Ice your joints after exercising. This can reduce swelling and pain.
Use a cold pack on your joints for 10 to 15 minutes.
Range of Motion or Flexibility
Stretching Continued
Seated Hip
March
• This move can strengthen hips and thigh muscles to help with daily
activities, such as walking or rising from a chair.
Sit up straight in chair. Slightly kick back your left foot but keep toes
on the floor. Lift your right foot off the floor, keeping knee bent.
Hold right leg in the air five seconds. Slowly lower your foot to the
ground. Repeat 10 times. Rest and do another 10, then switch legs.
Too hard? Use your hands to help raise your leg.
Quad Set
• Is the straight leg raise too
tough? Do quad sets
instead. With these you
don't raise your leg.
Simply tighten the thigh
muscles, also called the
quadriceps, of one leg at a
time.
Start by lying on the floor.
Keep both legs on ground,
relaxed. Flex and hold left
leg tense for five seconds,
as seen in right-hand
photo. Relax. Do two sets
of 10. Then, switch to
other leg.
Hamstring
Stretch
• Lie down. Loop a bed sheet around your right
foot. Use sheet to help pull and stretch leg up.
Hold for 20 seconds. Repeat twice, then switch
legs.
Straight Leg
Raise
• To try this leg strengthening move, lie on the floor. Prop your
back up on your elbows. Bend your left knee, keeping foot
on floor. Keep the right leg straight, toes pointed up. Tighten
thigh muscles of your right leg. Slowly and smoothly use
your thigh muscles -- not your back -- to raise your leg.
Pause, as seen above, for five seconds. With thigh still tight,
slowly lower leg to ground. Relax. Repeat 10 times. Rest. Do
another 10; then switch legs.
Pillow Squeeze
• This move helps strengthen the inside of your legs to help support your
knee. Lie on your back, both knees bent. Place a pillow between knees.
Squeeze knees together, squishing pillow between them. Hold for five
seconds. Relax. Repeat 10 times. Rest, then do another set of 10.
Too hard? You can also do this exercise while seated. See photo to right.
Heel Raise
Hold back of chair for
support. Stand straight
and tall. Lift heels off
ground and rise up on
toes of both feet. Hold
for five seconds. Slowly
lower both heels to
ground. Repeat 10
times. Rest. Do another
10.
Too hard? Do the same
exercise, only sitting in a
chair.
Side Leg Raise
Hold back of chair for
balance. Place your weight
on left leg. Lift right leg out
to the side. Keep right leg
straight and outer leg
muscles tensed. Don't
slouch. Lower right leg and
relax. Repeat 10 times.
Rest. Do another 10, then
repeat with left leg.
Too hard? Increase leg
height over time. After a
few workouts, you'll be
able to raise your leg
higher.
One Leg Balance
Your goal is to do this handsfree. Steady yourself on a chair,
if needed. First, shift your body
weight to one leg but do not
lock your knee straight. Slowly
raise the other foot off the
ground, balancing on your
standing leg. Hold for 20
seconds. Lower raised foot to
the ground. Do twice, then
switch legs. This move helps
when getting out of cars or
bending.
Too easy? Balance for a longer
time. Or try with your eyes
closed.
Walking
With stiff or sore knees,
walking may not seem like a
great idea. But it's one of the
best exercises for knee
arthritis. It can reduce joint
pain, strengthen leg muscles,
and improve flexibility -- and
it's good for your heart. The
best part -- no gym
membership needed.
Good form is key: Look
forward, walk tall. Keep arms
and legs moving, relaxed.
Always ask your doctor before
starting exercise when you
have osteoarthritis.
Low-Impact
Activities
Being active may also help
you lose weight, which takes
pressure off joints. Other
exercises that are easy on the
knees: biking, swimming, and
water aerobics. Water
exercise takes weight off
painful joints. Many
community and hospital
wellness centers, YMCAs, and
pools offer classes for people
with arthritis.
Don't give up favorite
activities, like golf. Talk to a
professional about modifying
painful moves.
How Much
Exercise?
Start with a little. If you can
do it without pain, do more
next time. Aim for 30 minutes
a day.
Over time you'll build your leg
muscles to support your knee
and increase flexibility.
Some muscle soreness is
normal, but hurting or
swollen joints need rest. Take
a break and ask your doctor
or health professional for
advice.
How to Get
Started?
•Assess your
baseline
•Work towards
small
achievable
goals
Thank-you
References
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Additional Sources
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