Exercise and Osteoarthritis

Osteoarthritis (OA) is the most common form of arthritis, and affects over 32.5 million adults in the US alone 1 . While OA can occur throughout your entire body, symptoms are most frequently reported in the spine, hands, knees, and hips. Osteoarthritis is commonly called a “wear and tear” disease. As cartilage breaks down with age, the underlying bone begins to form additional bone in its place to try and protect the joints. This process causes the once smooth articular surfaces of joints to instead become jagged, and reduces the space between these joint surfaces. Frequently reported symptoms include:

  • Joint stiffness
  • Aching or painful sensation in joint
  • Decreased range of motion
  • Grinding in joint (crepitus)
  • Loss of strength
  • Pain with prolonged standing if affecting low back, knees, or hips.

Despite your best efforts, OA will occur throughout your body regardless. It is a normal process that naturally occurs as we age. Over the past few years, multiple studies have shown it is possible to have OA without any pain associated. This study shows that it is possible to present with multiple physiological signs of OA on an MRI yet have no pain or symptoms 2 . The current theory for this suggests that pain from OA is not always caused by the arthritis itself, but inflammation throughout the joint or mechanical dysfunction which further decreases joint space.

While OA is frequently referred to as a “wear and tear” disease, movement and consistent exercise is one of the best ways to manage OA. To understand why, it’s important to understand the anatomy of a joint.

Joints throughout our body are composed of 3 major types: Fibrous, cartilaginous, and synovial. Synovial joints are the most common throughout our body, and the most mobile as well. Examples of synovial joints include hips and knees. These synovial joints are surrounded by a thick, fibrous capsule referred to as a synovial capsule, or joint capsule. The ends of the bones that make up these joints are also covered in hyaline cartilage which reduces friction between the bony surfaces, and works with synovial fluid to act as a shock absorber.

When this collective unit is stimulated through compression and decompression, whether that be through walking, exercise, or joint mobilizations, they produce a thick lubricating fluid known as synovial fluid.

Synovial fluid not only lubricates the joints, but brings fresh nutrients to the joint surfaces, and helps to flush inflammation, cellular waste, and debris from the joint space via the lymphatic system. All these processes combine to keep articulating surfaces of the joint healthy and smooth. Have you ever noticed how standing up and walking helps with the stiffness in your legs after sitting for too long? Part of that is the synovial capsules at work.

Exercise also stimulates all the various mechanoreceptors in the joint that give your nervous system feedback. With properly progressed exercises, it is possible to improve the tolerance of these mechanoreceptors, and to have less pain and discomfort with loading activities frequently encountered during day to day tasks, such as carrying in groceries.

While surgical interventions, such as joint replacement, are sometimes necessary there is growing evidence that nonsurgical treatments and lifestyle changes can be just as effective for mild to moderate OA. These changes include increasing activity, weight loss, and dietary changes to reduce systemic inflammation. At Cactus Medical Center, we also offer Regenerative Medicine which can help to restore both bone and articular cartilage that is damaged during the OA disease process. Read more about our Regenerative Medicine program here.

With all that said, it is highly recommended to try conservative treatment for OA before considering surgical intervention.

Osteoarthritis is unfortunately a normal part of aging, however, with proper management and healthy lifestyle changes it is possible to minimize the adverse effect it can have on your life.

Sources:
  1. “Osteoarthritis (OA).” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, 4 May 2020, www.cdc.gov/arthritis/basics/osteoarthritis.htm.
  2. Culvenor, Adam G, et al. “Prevalence of Knee Osteoarthritis Features on Magnetic Resonance Imaging in Asymptomatic Uninjured Adults: a Systematic Review and Meta-Analysis.” British Journal of Sports Medicine, BMJ Publishing Group Ltd and British Association of Sport and Exercise Medicine, 1 Oct. 2019, bjsm.bmj.com/content/53/20/1268.