Hydrotherapy & Aquatic Equipment for Osteoarthritis

Overview of Osteoarthritis

Osteoarthritis is the most commonly suffered out of all the arthritic diseases, with some 2.2 million (9.3%) Australians suffering from this condition, according to the Australian Bureau of Statistics 2017–18 National Health Survey. Osteoarthritis represents over half (62%) of all arthritic conditions in 2017–18. 

Osteoarthritis and arthritis are two separate conditions; however, they are usually confused and often interchanged. However, they are different, and many of their symptoms are very distinct.

Osteoarthritis is a mechanical condition that is characterized by the gradual wearing down of cartilage in the joints. The most common risk factor for Osteoarthritis is aging.

While Arthritis is a generic term covering several diseases affecting the connective tissues in joints, skin, and various internal organs. Arthritis is not said to be caused by the normal wear and tear of bones, but instead, it is the inflammation that leads to the secretion of substances that gradually destroy the joint structure. It can be infectious, genetic, or metabolic of origin.

What is Osteoarthritis?

The degeneration of cartilage in joints characterizes Osteoarthritis. It is a progressive and chronic condition that primarily affects the hands, spine, and joints such as hips, knees, and ankles. Its primary cause of pain is the gradual decay of cartilage and subchondral bone—not the inflammation associated with rheumatic diseases. 

Osteoarthritis is not life-threatening, but it can be pretty disabling if left untreated. In severe cases, joint replacement surgery may become necessary. However, many people with Osteoarthritis may be able to avoid surgery and chronic pain with the help of physical therapies like Water Therapy.

Osteoarthritis is a very prevalent degenerative disease of the joint. It comes from the wearing down of the cartilage found on the ends of the joints over the years. Once deteriorated, those bones rub against one another, causing damage and affecting how well you move.

Who's most likely to suffer from Osteoarthritis?

Osteoarthritis is common with age, with manifestations often occurring in middle age. 1 in 5 Australians or at least 22% over the age of 45 have Osteoarthritis. Osteoarthritis is far more common among women than it is in men, affecting 10% of women compared with 6.1% of men.

Although Osteoarthritis may damage any joint, the disorder most commonly affects joints in the hands, knees, hips, and spine. 

Hands:Osteoarthritis seems to be hereditary. If someone in your family has Osteoarthritis in their hands, you're at risk of having it, too. Females are significantly more likely to develop Osteoarthritis in their hands than males are. 

Knees:The knees are among the joints most commonly affected by Osteoarthritis. Each knee consists of two individual joints: the tibiofemoral and the patellofemoral. These weight-bearing joints are the most vulnerable to Osteoarthritis. The pain caused by Osteoarthritis in the knees may lead to short-term or long-term disabilities affecting one's mobility. And since this disease is degenerative, it's crucial to help patients with knee osteoarthritis slow the decline as much as possible. If you suffer from Knee Osteoarthritis please refer to our blog article on best-exercises for osteoarthritis of the knee and knee pain.

Hips:The hips are also common sites of pain, and the pain is felt not just in the hips themselves but also in the groin, inner thigh, buttocks, or even the knees. Hip osteoarthritis is also one of the most common types of Osteoarthritis that can affect everyday living. 

Spine:Osteoarthritis of the spine may have symptoms such as stiffness and pain in the neck or lower back. In most cases, arthritis-related changes in the spine cause pressure on the nerves where they exit the spinal column, which results in weakness, tingling, or numbness of the arms and legs. In severe cases, this can affect the bladder and even the bowel function.

Symptoms of Osteoarthritis

Osteoarthritis is ordinarily diagnosed through clinical and radiographic evidence. The initial diagnostic goal is to differentiate Osteoarthritis from other arthritides, such as rheumatoid arthritis and its severity. The history and physical examination findings of a patient are sufficient to diagnose Osteoarthritis. Many people suffering from Osteoarthritis say that they have at least many, if not all, of these symptoms:

• Deep, achy joint pain

• Reduced range of motion

• Stiffness during rest - May develop, with morning joint stiffness usually lasting for less than 30 minutes 

• Tenderness- Your joints and surrounding areas might feel tender when you apply light pressure to or near it.

• Loss of flexibility

• Grating sensation

• Bone spurs

• Swelling

Causes

Risk factors for Osteoarthritis include:

• Age  

• Obesity  

• Trauma  

• Genetics (significant family history)  

• Reduced levels of sex hormones  

• Muscle weakness  

• Repetitive use (i.e., jobs requiring heavy labor and bending)  

• Infection  

• Crystal deposition  

• Previous inflammatory arthritis (e.g., burnt-out rheumatoid arthritis)  

• Heritable metabolic causes (e.g., alkaptonuria, hemochromatosis, and Wilson disease)  

• Underlying morphologic risk factors (e.g., congenital hip dislocation and  

slipped femoral capital epiphysis)  

• Disorders of bone (e.g., Paget disease and avascular necrosis)  

• Previous surgical procedures (e.g., meniscectomy) 

Water Therapy & Osteoarthritis

For those with Osteoarthritis, regular exercise may be too painful and cause further joint deterioration. Gravity puts pressure on the joints. Water buoyancy relieves that pressure. 

Hydrotherapy exercises are usually advocated in the treatment process of Osteoarthritis because of the water properties, particularly those associated with buoyancy, which potentially reduces joint loading. Water pressure and temperature could also lead to increased sensory input and further help in joint pain relief. The improvements in physical function and the easing of pain have been observed by implementing hydrotherapy exercises. They are similar and consistent with the findings of previous clinical trials of hydrotherapy for patients with Osteoarthritis.

A study on a Water Rehabilitation Program in patients with Hip Osteoarthritis before and after total Hip Replacement as showed a positive effect. The study found a significant reduction of pain, increased ranges of motion, increased muscle strength, and reduced need for pain medicines.

Deep and achy joint pain:This is the disease's primary symptom. Water helps provide an ideal environment for patients to exercise due to the buoyant force that acts as a counteraction to the downward pull of gravity, therefore reducing the overall weight that is placed on the joints. Previous studies have shown that anything up to 50% of body weight is supported in waist-deep water, while 90% of a person's weight is supported if the submersion is water in neck-deep. Patients who suffer from Osteoarthritis are often unable to perform traditional land-based exercises due to increased pain created by the impact. In a supportive medium such as water, patients can perform similar strengthening or endurance exercises with the benefit of gentle resistance and a reduction in pain.  

Reduced range of motion and crepitus:These are symptoms frequently present in Osteoarthritis. The water physically supporting you will help prevent stress on the muscles and the joints, therefore, freeing you mentally from the fear of falling. Hydrotherapy helps to increase both the range of motion that you can achieve and overall mobility. 

Stiffness:Stiffness during rest or gelling may develop, with morning joint stiffness usually lasting for less than 30 minutes. Many people who suffer from osteoarthritis report stiffness, which is generally widespread in the body.  Like other pain-bearing diseases, the stiffness is usually worse in the morning and would otherwise improve as the day progresses.  Exercising in water is an excellent form of physical therapy as it allows the muscles and stiff joints to relax and release stiffness.

Joint pain:The body pain of a person suffering from Osteoarthritis may range from a dull ache to a burning or shooting pain. The buoyancy of the water helps support weak muscles, making it easier to balance and hold good posture.

Tenderness:Your joints might feel tender when you apply light pressure to or near it, especially when on land. Due to the water physically surrounding and supporting you, preventing stress on these tender parts will help you move easier, and you will be more confident in moving in the water.

Loss of flexibility:By working out in the water, you will improve your flexibility because of the pressure and support caused by the water surrounding you.

Grating sensation:When using the affected joint, you might feel a painful grating sensation, and you might hear audible popping or crackling. Aside from possible biochemical changes that occur in the brain when one experiences a different sensation, moving in the water helps relax all the skeletal muscles and alternates stretch. Practicing breathing deeply in a rhythmic pattern similar to the breathing taught in Yoga is also helpful in avoiding these sensations.

Bone spurs:These are extra pieces of bone that can feel like hard lumps and form around the affected joint. Water therapy is excellent in releasing these additional pieces of bone as the pressure from the water is safe for the joints.

Swelling:This symptom might be caused by soft tissue inflammation around the joint. In order to address this, water physical therapy utilizes the healing properties of water and the body's reaction to it at different temperatures.  For instance, therapists may use cold water to reduce inflammation, while therapists may use warm water to increase circulation.

Tender points:These points are areas of tenderness in the body. Preventing stress on these tender points as you move in the water will help you be more confident in moving around. 

Water Therapy Equipment & Osteoarthritis

An Aqua Bike is also a great piece of aquatic equipment that can help alleviate the symptoms of Osteoarthritis and enables exercise with minimal pain as it can:  

• Reduces stiffness in the body

• Reduces joint pain when moving

• Relieves tenderness in joints and muscles

• Enhances blood flow

• Improves mobility

• Builds even strength in both legs

• Builds strength in the support structures quads, glutes ankles and hips.

• Helps in avoiding after workout pain

• Provides physical and mental relief 

• Improves flexibility

An Aqua Treadmill is also an excellent piece of equipment that helps symptoms of Osteoarthritis and enables exercise with minimal pain as it: 

• Improves mobility without impact or pain

• Reduces overall body fatigue

• Enhances blood flow

• Relaxes the body and mind 

• Improves body control

The soothing effect of the water may reduce the perception of pain, helping lower anxiety and improves the quality of life. However, we recommend seeking the advice of an Orthopaedic expert to scan the suspected area and advise the most appropriate form of treatment for your specific situation.

Note: Please seek medical advice before exercising & always train under the advice your medical specialist.