OSTEOARTHRITIS

A progressive degradation of joint cartilage which results in pain, limited range of motion, and swelling;
and impacts occupational performance

Epidemiology:
Etiology:
- 44-70% of people over 55 years have
some radiological evidence of - Origin: most commonly affects hand, knee,
osteoarthritis hip, and spine joints
- 85% of people over age 75 - Cause: wearing down of the protective
- 12% of people over 65 years have cartilage covering the bone ends of joints so
symptomatic osteoarthritis that bone is rubbing against bone
Risk factors: - Effect: irreversible damage which impacts the
entire joint – cartilage, bone, connective
- Age tissues, joint lining
- Women
- Obesity
- Joint injuries Signs:
- Repetitive stress
- Genetics https://medlineplus.gov/ency/article/000423.htm - Joint stiffness (especially preceding activity, like in the
- Bone deformities (congenital) morning)
- Metabolic diseases (diabetes, - Limited joint range of motion
hemochromatosis – too much iron) - Bone spurs
- Swelling
- Hearing a popping or crackling with joint movement
(associated with grating sensation)
- CMC subluxation
Precautions and
contraindications: Symptoms:

- infections and blood - Pain (initially acute, sharp pain especially during or after
clots after surgery movement which progresses to a chronic, constant, aching
- gentle exercise to pain)
limit pain and further - Joint tenderness with light pressure
wear and tear - Grating sensation when moving the joint
- minimize repetitive
actions
Associated conditions/comorbidities:

- Obesity
- Diabetes
- Depression
- Fibromyalgia
Prognosis: progressive disease but
can be managed well especially if
caught early
 COMMON MEDICAL INTERVENTIONS

Diagnosis: Treatment:
o X-rays o Medication: acetaminophen, NSAIDs (Advil,
o MRI (for additional information in Motrin IB, Aleve), Duloxetine (normally used
complex cases) as an antidepressant but can be used to treat
o Blood tests (to rule out rheumatoid chronic pain)
arthritis) o Cortisone injections to relieve pain (limited to 3-
https://www.news-medical.net/health/Psoriatic-Arthritis-
o Joint fluid vs-Osteoarthritis.aspx 4 injections/yr because can worsen joint damage
analysis over time)
(to rule o Lubrication injections (similar properties to
out gout synovial fluid; conflicting research on efficacy)
or o Realigning bones (to shift body weight away
infection) from the worn-out part of the knee)
o Arthroplasty (hip and knee replacements)

Role of OT:
{generally referrals from general practitioners}
- Assessments: ROM, grasp strength, pinch strength, occupational function (COPM and Modified Health
Assessment Questionnaire), pain, fall risk assessments
- Lifestyle redesign:
o Maintain healthy weight and promote physical activity (swimming, walking, gentle yoga)
o Teach strategies to adhere to diet and exercise
- Compensation/adaptation: facilitate task performance despite limited joint ROM
o Using a larger toothbrush grip for someone with osteoarthritis in hands)
o Shower bench to relieve standing pain with knee osteoarthritis
o Additional assistive devices (braces, shoe inserts, cane, gripping/grabbing tools)
- Remediation:
o Improve ROM and strength such as grip force, pinch force, joint stability
o Posture
- Prevention/Mental Health:
o Address mental health
- Address sleep, ADLs, IADLs, work, leisure, play, education, social participation
- Pain management
o Splints
https://www.adaptivetechsolutions.com/built-
o Modalities include heat (including hot foot bath), cold, and TENS up-foam-grip-handle/

Resources:
Doherty, M, Abhishek, A (2019). Clinical manifestations and diagnosis of osteoarthritis. UpToDate. from, https://www-uptodate-
com.proxy.lib.ohio-state.edu/contents/clinical-manifestations-and-diagnosis-of-
osteoarthritis?search=osteoarthritis&source=search_result&selectedTitle=2~150&usage_type=default&display_rank=2
Ezheltha, S., Sharmila, J (2015). Effectiveness of hot foot bath versus exercises on reducing pain among patients with osteoarthritis.
International Journal of Nursing Education, 7(3), 70–75. https://doi-org.proxy.lib.ohio-state.edu/10.5958/0974-
9357.2015.00137.3
Grant M. (2005). Occupational therapy for people with osteoarthritis: scope of practice and evidence base. International Journal of
Therapy & Rehabilitation, 12(1), 7–13. https://doi-org.proxy.lib.ohio-state.edu/10.12968/ijtr.2005.12.1.17356
Kjeken, I. (2011). Occupational therapy-based and evidence-supported recommendations for assessment and exercises in hand
osteoarthritis. Scandinavian Journal of Occupational Therapy, 18(4), 265–281. https://doi-org.proxy.lib.ohio-
state.edu/10.3109/11038128.2010.514942
Osteoarthritis. (n.d.) Mayo Clinic. Retrieved Marth 15, 2021, from https://www.mayoclinic.org/diseases-
conditions/osteoarthritis/diagnosis-treatment/drc-20351930