Arthritis and Manual Therapy

It is reported that one in six Canadians over the age of 15 is affected by arthritis. Osteoarthritis is one form of arthritis. This degenerative condition is characterized by wear and tear on the cartilage between joints.

Coinciding with the wear and tear is swelling and stiffness. The joints most commonly affected are the hip and the knee. Another common finding is the muscles and soft tissue around the affected joint will tighten and spasm.

Signs of hip osteoarthritis include hip pain (the pain can be deep inside the hip, on the outside of the thigh or in the groin and leg) a decrease in mobility (in rotation, moving the knee towards the chest and extending the hip), morning stiffness that lasts longer than 60 minutes and a limp.

Signs of knee osteoarthritis include knee pain, clicking or grinding with motion, more than 60 minutes of morning pain, joint swelling and bony enlargement around the knee. As well a limp develops while stairs, squatting and rising from chairs become increasingly difficult.

Physiotherapy will work best if the signs and symptoms of arthritis are recognized early and receive treatment in a timely fashion.

A recent study in Arthritis and Rheumatism showed a substantial improvement of symptoms in patients with hip osteoarthritis after 9 visits of manual physical therapy intervention. There was improvement of pain, stiffness, hip function and range of motion. Another recent study published in Physical Therapy demonstrated a decreased reliance on medications and improved function in patients who had knee OA after 8 treatment sessions of manual physical therapy combined with supervised exercise and a home exercise program.

Mulligan mobilization with movement (MWM) for hip stiffness

Manual Therapy is beneficial as it works to improve the mobility of sore and stiff joints as well as the tight muscles around the joint. The manual therapy can take the form of joint mobilization and manipulation, soft tissue work on the muscles and stretching.

Exercise is very beneficial in the treatment of arthritis and can be in the form of home exercise and/or aquatic exercise. In Kelowna there are a number of pool programs geared towards individuals with osteoarthritis. Typically exercise programs include both mobility and strengthening exercises.

The best current best research supports manual physical therapy combined with exercise for hip and knee arthritis.