Fresh Insights in Osteoarthritis from OSN Conference

Osteopaths Laura Malady & Xavier Grech with friend & peer Bronwyn La Brooy (Burwood Osteo & Rehab)

Prom Health osteopaths, Laura & Belle eager for the conference to begin.

On Friday 10^th October, our team of osteopaths attended the Osteo Sports Network (OSN) conference in Footscray. We heard from leading hip & knee surgeon Dr. David Slattery, sports physicians Dr. Hussain Khan & Dr. Sam Harkin on injectables and evidence-based interventions for osteoarthritis and hip physiotherapist & researcher Dr. Micheal O’Brien. All the presenters offered our team fresh insights into the management of hip and knee injuries but for this article we will focus on what was discussed about osteoarthritis (OA).

Let’s dive into some of the take home lessons! 

First things first, OA is common. It may or may not cause us pain. OA is a complex pathology and isn’t a simple breakdown of tissue from use. We should move away from the negative, dismissive language that arthritis is simply ‘wear and tear’ and ‘bone on bone’. Our bodies are far more nuanced than such simplistic descriptions, and research shows that adopting such negative descriptions has a worse outcome on physical and mental wellbeing. The cause of OA is multifaceted. 

The following phenotypes (genetics & environment) are related to the development of OA: 

• Mechanical: malalignment, joint trauma, congenital or developmental. 

• Cellular Senescence: age-related changes in gene expression. 

• Inflammatory: systemically elevated cytokines. 

• Metabolic: obesity, metabolic syndrome (any 3 of the following; high blood pressure, high blood sugar levels, excess abdominal weight, high triglycerides, low ‘good’ HDL cholesterol). 

• Hormonal: postmenopausal or endocrine-related conditions. 

• Chronic Pain: central sensitisation, psychological factors (e

  .g., catastrophising).

  

  Presentation slide - Explaining the different phenotypes associated with OA.

We are yet to find a drug that alters the trajectory of OA rather than just giving symptomatic relief. 

We won’t sit around and wait for that day and in fact, we need to do the opposite. 

At the OSN conference, Dr. Hussain Khan, discussed a systematic review (a review of many studies) that analysed research from 2010 to 2020 that examined how exercise impacts physical and functional outcomes in adults with knee OA. (1) The findings of the paper supported the idea that exercise programs can improve pain and physical strength in those living with OA. 

Knee Osteoarthritis and Exercise

Hands on Osteopathic Examination & Treatment of OA

Exercise + OA = Pain Relief and Strength Gains 

The most consistent finding across the studies was the positive effect of exercise on pain reduction and muscle strength. Whether participants engaged in aerobic workouts, strength training or Pilates, improvements were noted when programs were followed for 8 to 12 weeks, with 3 to 5 sessions per week lasting around one hour each. The key, researchers emphasise, is consistency. So, by all means, choose something that you enjoy doing! 

Both land-based and aquatic exercise programs showed comparable benefits. Hydrotherapy offered a gentler alternative for those with severe joint pain. Pilates also emerged as a promising option, blending core stability with joint-friendly movement. 

If you have tried exercise and found that pain or stiffness is impacting your ability to move then we suggest that you try some osteopathic treatment to help restore mobility and lessen pain – this may be enough to get you going on the exercise front. 

To conclude, the main takeaways from the OSN conference were: 

• OA remains complex in its cause but is highly manageable.  

• Consider a fresh mindset around OA. Let go of defeatist language which leads to inaction. 

• Pick exercise that you enjoy! You need to participate in your chosen activity for 1 hour, 3-5 times per week consistently for 8-12 weeks. What a great investment of your time in bettering your health! 

• You have choices, e.g. Pilates, gym classes, aerobics classes, brisk walking, swimming & water aerobics. 

If you are in doubt, we’re always happy to answer your queries. Next time we will cover other strategies for managing your creaky joints! 

References:

1. Golightly YM, Allen KD, Caine DJ. A comprehensive review of the effectiveness of different exercise programs for patients with osteoarthritis. Phys Sportsmed. 2012 Nov;40(4):52-65. doi: 10.3810/psm.2012.11.1988. PMID: 23306415; PMCID: PMC4077018.