Therapies... - Massage - Various Arthritis Forms and DJD

Osteoarthritis (OA), Degenerative Joint Disease (DJD),
Osteoarthrosis, or Hypertrophic Arthritis

OA is the most common joint condition an is often associated with the "wear and tear" of joints with age. It affects synovial joints, particularly weight-bearing ones like hips and knees. It is caused by trauma, overuse, advancing age, and poor posture.

Very smooth, hard articular cartilage covers the bone surfaces within a joint to reduce friction among the opposing surfaces. The joint is lubricated with synovial fluid to further reduce friction. Abnormal biomechanics lead to damage of the articular cartilage. The body cannot repair the damage done to the collagen fibres that make up the cartilage, and there is loss of chondroitin sulfate from the cartilage as well. This softens the articular cartilage and it is unable to withstand the stresses placed upon it. This can lead to changes in the joints margins and in the subchondral bone (bone just beneath the cartilage). This is followed by inflammation and restricted joint motion. In later stages, osteophye formation may occur, further restricting joint movement and increasing pain.

Osteoarthritis can also result secondary to another condition such as a previous injury or congenital deformity, gout, rheumatoid arthritis, osteoporosis, and some endocrine disorders (like osteomalacia). Excessive steroid injection into a joint and some metabolic disorders can also lead to the development of OA. Some neurological disorders, which result in hypermobility or reduced proprioception of the joint , as well as some infections can also result in OA.

Signs and symptoms reported in early stages include pain with use, which is relieved by rest. You may experience stiffness of the joints in the morning that is relieved after a short period of activity. The muscles crossing the joint may be hypertonic or in spasm. You may experience a slight decrease in the joint's ROM. In the later stages you may feel pain that is not relieved by rest. The joints can be affected by changes in barometric pressure. There may also be a noticeable enlargement of the joint along with a decrease in it's ROM.

The aims of treatment in the early stages will revolve around restoring optimal joint usage, whereas in the later stages the aims will be to maintain tissue health and slow the degenerative process. Your therapist can decrease SNS firing to help decrease the pain. Pain relief can also be addressed by working on any trigger points and reducing muscle spasm. Your RMT can use techniques to maintain or increase circulation to aid in the removal or metabolic waste products. Range of motion of joints and health of joint tissues (especially cartilage) and be maintained through use of rhythmic techniques or joint play. Some techniques may be contraindicated if osteophytes have formed in the area.

Many people respond very well to hydrotherapy applications for OA. The use of deep, moist heat in the form of a whirlpool, epsom salt bath, hydroculator, etc., can help to remove waste products and decrease pain. Parafin wax treatments can also be beneficial. Be aware that hot hydrotherapy applications are contraindicated for replaced joints because the metal implants may painfully retain heat.

Remedial exercises are important in the maintenance of joint mobility and health for sufferers of OA. Regular aerobic exercise is important. Short periods of movement, stretch and rest, several times a day can also help. Resistance exercises can help keep muscles surrounding the joint/s strong.