Written by Michael Thompson
Arthritis is defined as acute or chronic joint inflammation. The symptoms of arthritis include pain, stiffness, decreased range of motion,weakness, insatiability and joint deformities. They may also be accompanied by fatigue and sleep disturbance.(1) Arthritis can be monoarticular (single joint), oligoarticular (2-4 joints) or polyarticular (several joints)(2).
More than 100 different types of arthritis have been described, the most common being osteoarthritis or degenerative arthritis which is non-inflammatory arthritis.
Inflammatory arthritis can occur in several settings, and inflammation can be caused by autoimmune processes, crystal deposition induced inflammation or infections. Inflammatory arthritis can also accompany other autoimmune connective tissue diseases.(1)
Osteoarthritis (OA) is the most common type of arthritis and the major cause of chronic musculoskeletal pain and mobility disability in elderly populations worldwide (3). As many as 40% of people over the age of 65 in the community in the United Kingdom suffer symptoms associated with knee or hip OA and it is estimated that 40% of men and 47% of women will develop osteoarthritis in their lifetime (2). With the incidence increasing to 60% if they have a body mass index greater than 30 (2). Knee OA bears more responsibility than any other disease for disability in walking, stair climbing and housekeeping (4)
There is a strong correlation between muscle atrophy and osteoarthritis that has been found on many occasions. It is currently believed that muscle atrophy regardless of causative pathomechanism is a major contributing factor for the development of OA (5). Therefore, current research focuses on the possibility to employ exercise and sports in the prevention and treatment of OA (5). Furthermore, several studies show a beneficial effect of land-based aerobic and strengthening exercises on pain relief and joint function (5)
International guidelines advocate non-pharmacological treatments as the first line of management for people with OA (Pendleton 2000). Non-pharmacological treatments currently considered to have sufficient levels of scientific evidence are exercise, patient education, diet, appliances (sticks, insoles) and weight reduction(6)
Although OA is a very common disease there are also many ways to prevent/ reduce symptoms to enhance quality of life . For example, enhanced strength of the lower limb may lessen internal knee forces, reduce pain and improve physical function. Increased muscle strength may modify biomechanics, resulting in a decreased joint loading rate or localized stress in the articular cartilage. Improved fitness may enhance quality of life by allowing a greater range of available daily tasks, thereby improving physical function (5)
1) Home - books - NCBI (no date) National Center for Biotechnology Information. U.S. National Library of Medicine. Available at: https://www.ncbi.nlm.nih.gov/books (Accessed: November 8, 2022).
2) Senthelal, S., Ardeshirzadeh, S. and Li, J. (2022) Arthritis, National Center for Biotechnology Information. U.S. National Library of Medicine. Available at: https://pubmed.ncbi.nlm.nih.gov/30085534
3) Rhon, D. (2008) “Re: Zhang W, Moskowitz RW, Nuki G, et al.. OARSI recommendations for the management of hip and knee osteoarthritis, part II: OARSI evidence-based, expert consensus guidelines. osteoarthritis cartilage 2008;16:137–62.,” Osteoarthritis and Cartilage, 16(12), p. 1585. Available at: https://doi.org/10.1016/j.joca.2008.04.019.
4) Fransen, M. and McConnell, S. (2008) “Exercise for osteoarthritis of the knee,” Cochrane Database of Systematic Reviews [Preprint]. Available at: https://doi.org/10.1002/14651858.cd004376.pub2.
5) Valderrabano, V. and Steiger, C. (2011) “Treatment and prevention of osteoarthritis through exercise and sports,” Journal of Aging Research, 2011, pp. 1–6. Available at: https://doi.org/10.4061/2011/374653.
6) “Re: Zhang W, Moskowitz RW, Nuki G, et al.. OARSI recommendations for the management of hip and knee osteoarthritis, part II: OARSI evidence-based, expert consensus guidelines. osteoarthritis cartilage 2008;16:137–62.,” Osteoarthritis and Cartilage, 16(12), p. 1585. Available at: https://doi.org/10.1016/j.joca.2008.04.019.