Lecturer in Physiotherapy in the Charles Sturt University School of Allied Health, Exercise and Sport Sciences Dr Tim Retchford explores this year’s theme - arthritis, and the impact it has on someone’s life.
What do tennis player Caroline Wozniacki, golfer Tiger Woods and comedian Magda Szubanski have in common? Well, apart from being highly successful in their respective fields, they all have arthritis.
Arthritis is very common, affecting an estimated 3.6 million Australians. The name is derived from Latin words meaning joint (arthro) inflammation (itis).
People with arthritis can have joint pain, swelling, and stiffness. It is associated with reduced function, dexterity, and quality of life. Arthritis is an umbrella term for more than 100 different conditions that affect the body’s joints, such as knees, hips and the spine. Arthritis can affect people of all ages, including children, and all activity levels, including extremely fit athletes.
The three most common types of arthritis include juvenile idiopathic arthritis (JIA), rheumatoid arthritis (RA) and osteoarthritis (OA).
Juvenile idiopathic arthritis (JIA) – causes, symptoms and treatment
No-one knows the exact cause of JIA. What is known is that JIA is an autoimmune disorder – the immune system becomes overactive and produces inflammation.
Just as uncertain as its cause is its diagnosis, as there are no specific tests. A combination of patient history (including family history), physical examination (particularly of the joints, skin and eyes), lab tests (including blood tests) and X-rays are often used to rule in JIA.
The common signs and symptoms of JIA include joint pain, swelling, warmth and stiffness, fatigue, skin changes, fever and eye inflammation, and can develop in babies as young as six months old through to teenagers at 16 years of age.
The prognosis for JIA is hugely variable. For some kids, symptoms may only remain for a few months, while for others, it can be much longer (i.e. years). For a smaller number of children with JIA, the disease persists into adulthood and requires lifelong management.
Management is tailored to the child but may include medical (a range of medicines, this is the primary management) and physical treatment. Physiotherapists are experts at providing appropriate advice, education, and exercise for children with JIA, to help manage pain and improve overall wellbeing.
Rheumatoid arthritis (RA) - causes, symptoms and treatment
Rheumatoid arthritis (RA) is an autoimmune disease that causes pain and swelling of the body’s joints. RA usually affects smaller joints, such as the joints in the hands. However, larger joints such as the hips and knees can also be affected.
In addition to joint symptoms, people with RA may experience fatigue, fevers, loss of appetite and other medical problems.
Despite these symptoms, it’s possible – and encouraged – to be active. Physiotherapists are knowledgeable about guiding people with RA to appropriate levels of activity and can prescribe specific and safe exercises.
Former world number one ranked tennis player Caroline Wozniacki, who was diagnosed with RA in 2018, shared her experience playing at an elite level with arthritis after winning her last title that same year.
“...winning that tournament was so special because I think I proved to myself that I can do this and I can still play at a very, very high level and I can beat the best players in the world,” she said in an interview with Eurosport.
Osteoarthritis (OA) - causes, symptoms and treatment
OA was traditionally considered a primary degenerative condition – a wearing of the joint cartilage. However, the cause of OA would seem to be much more complex than simply wear and tear. Some researchers suggest it is primarily inflammatory and may be influenced not only by mechanical loading but also genetics and hormones.
The signs and symptoms of OA usually come on slowly and can vary from person to person. Most commonly people will feel joint pain and stiffness but feelings of clicking and grating are also common. The joint pain and reduced mobility may affect capacity for normal daily activities, sports, and hobbies.
A physiotherapist can help with this diagnosis, including through physiotherapy-led management programs. One program, reported a 36 per cent reduction in participant pain levels, reduced requirement for pain medication and reduced perceived need for joint replacement surgery.
A physiotherapist can also provide a comprehensive approach to patient care, providing contemporary advice and education and safe and effective exercises.
Physiotherapists are actively involved with the design and implementation of injury prevention programs. Acute knee injuries, such as anterior cruciate ligament (ACL) tears are common in sports like soccer, football and netball. In fact, 25 players missed the recent Women’s soccer World Cup due to ACL injury.
Concerningly, ACL tears have been associated with a six-fold increase in risk of knee OA. However, studies on programs such as the FIFA 11+ (a warm-up protocol involving running, strength and coordination exercises) have shown promising results in reducing injuries, including ACL tears.
Arthritis is just one of many health conditions that physiotherapists are skilled at assessing and managing. A physiotherapist can help you get the most out of life.