Manual therapy

Osteoarthritis Management Principles

Osteoarthritis Management Principles:

Pain, joint stiffness, decreased muscle performance. Decreased aerobic capacity affect the quality of life and increase the risk of disability for the individual with osteoarthritis. Therapeutic exercise and manual therapy interventions are important in the comprehensive management of osteoarthritis.

There are some principles for osteoarthritis management. Which are as follow.

Patient Instruction:

Education includes teaching the patient about the disease of osteoarthritis, how to protect the joints while remaining active and how to manage the symptoms instruct the patient in a home program of safe exercises to improve muscle performance ROM and endurance.

Pain Management:

Early stages pain and feelings of stiffness are common complaints during the early stages. Pain usually occurs because of excessive activity and stress on the involved joint and is relieved with rest. Brief periods of stiffness occur in the morning or after periods of inactivity. This is due to gelling of the involved joints after periods of inactivity Movement relieves the stasis and feelings of stiffness. Help the patient find a balance between activity and rest and correct biomechanical stresses in order to prevent retard or correct the mechanical limitations.

 Pain Management:

Late stages. During the late stages of the disease, pain is often present at rest. The pain is probably from secondary involvement of subchondral bone, synovium, and the joint capsule. In the spine, if bony growth encroaches on the nerve root, there may be radicular pain. Emphasize modification and use of assistive devices or splints to minimize joint stress. Pain that cannot be managed with activity modification and analgesics is usually an indication for surgical intervention.

Assistive and supportive devices and activity:

With the progression of the disease, the bony remodeling swelling and contractures alter the transmission of forces through the joint, which further perpetuates the deforming forces and creates a joint deformity. Functional activities become more difficult. Adaptive or assistive devices, such as a raised toilet seat, cane, or walker may be needed to decrease painful stresses and maintain function. Shock absorbing footwear may decrease the stresses in osteoarthritis of the knees. Aquatic therapy and group-based exercise in water decreases pain and improves physical function in patients with lower extremity osteoarthritis.

Stretching and Joint mobilization:

Use stretching and joint mobilization techniques to increase mobility. Teach the patient self-stretching flexibility exercises and the importance of movement to counteract the developing restrictions

Osteoarthritis Management Principles guidelines

Osteoarthritis Management Principle Guidelines:

Plan Of Care:

  1. Educate the patient
  2. Decrease effects of stiffness
  3. Decrease pain from Mechanical stress and prevent deforming forces
  4. Increase ROM
  5. Improve neuromuscular control, strength and muscle endurance
  6. Improves balance
  7. Improve physical conditioning

Intervention Osteoarthritis Management Principles :

  1. Teach about deforming forces and prevention, teach home exercise program to reinforce interventions and minimize symptoms
  2. Active ROM joint play mobilization techniques
  3. Splinting and assistive equipment to minimize stress or to correct faulty biomechanics strengthens supportive muscles alternate activity with periods of rest
  4. Stretch muscle, joint or soft tissue restriction with specific techniques
  5. Low-intensity resistance exercises and muscle repetitions
  6. Balance training activities
  7. Non-impact or low impact aerobic exercise.


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