Managing Osteoarthritis: When to Consider Rehabilitation Therapy

Osteoarthritis

1.
About a year ago, I had difficulty squatting with my left foot, and I experienced pain, especially at night when I was trying to sleep.
I initially sought treatment through acupuncture at a traditional Chinese medicine clinic for a period of time, which provided some improvement, but it did not completely resolve the issue.
I then visited an orthopedic doctor who ordered an X-ray and diagnosed me with bone spurs.
The doctor prescribed pain relievers and muscle relaxants, and after taking the medication for a week, I felt better.
2.
However, a year later, on April 6 of this year, I experienced pain again.
I returned to the same orthopedic doctor, who ordered another X-ray.
The results were similar to the previous year's X-ray findings.
The doctor prescribed the same medication for another week.
Although I have completed the course of medication, I am still experiencing pain, and my condition seems to have worsened compared to last year.
Would it be more appropriate for me to see a rehabilitation specialist for physical therapy? Thank you!

Tianren, 60~69 year old female. Ask Date: 2018/04/26

Dr. Wang Zhaomin reply Rehabilitation

X-ray examination revealed the presence of osteophytes, indicating degenerative changes that are difficult to completely eradicate.
Although there was improvement after the last medication, the degenerative bone spurs remain and are prone to recurrence.
This time, the symptoms do not necessarily indicate a worsening condition.
To prevent repeated recurrences, in addition to oral medication, rehabilitation therapy can also be incorporated to alleviate pain, strengthen muscles, and improve quality of life.

Reply Date: 2018/04/26

More Info

Managing osteoarthritis (OA) can be a complex process, especially when symptoms like pain and limited mobility persist despite initial treatments. Your experience with left foot pain, particularly when squatting and at night, is not uncommon among individuals with osteoarthritis, especially when bone spurs (osteophytes) are present. The fact that you have sought both traditional Chinese medicine (acupuncture) and Western medical treatments indicates a proactive approach to managing your condition.

1. Understanding Osteoarthritis: OA is a degenerative joint disease characterized by the breakdown of cartilage, leading to pain, stiffness, and reduced function. Bone spurs can develop as the body attempts to stabilize the joint, but they can also contribute to pain and discomfort. The fact that your X-rays show similar findings over the years suggests a chronic condition that may require ongoing management rather than a one-time fix.

2. Initial Treatments: The use of pain relievers and muscle relaxants is common in the management of OA. While these medications can provide temporary relief, they do not address the underlying issues of joint degeneration. Your improvement after taking these medications indicates that they can be effective for symptom management, but the recurrence of pain suggests that a more comprehensive treatment plan may be necessary.

3. Rehabilitation Therapy: Given your ongoing symptoms, considering rehabilitation therapy could be beneficial. Rehabilitation can include physical therapy, which focuses on strengthening the muscles around the affected joint, improving flexibility, and enhancing overall function. A physical therapist can design a personalized exercise program that takes into account your pain levels and mobility limitations. This approach can help reduce pain, improve joint function, and potentially slow the progression of OA.

4. When to Consider Rehabilitation: It is generally advisable to consider rehabilitation therapy when:
- Pain persists despite medication.

- There is a noticeable decrease in mobility or function.

- You experience difficulty with daily activities, such as squatting or climbing stairs.

- You want to avoid surgery or further invasive treatments.

5. Benefits of Rehabilitation: Engaging in rehabilitation can lead to several benefits, including:
- Improved strength and flexibility in the affected joint.

- Better pain management through targeted exercises and modalities (e.g., ultrasound, electrical stimulation).

- Education on joint protection techniques and activity modifications to minimize strain on the joint.

- Enhanced quality of life through increased activity levels and reduced pain.

6. Long-term Management: OA is a chronic condition that often requires long-term management strategies. In addition to rehabilitation, consider lifestyle modifications such as weight management, low-impact exercises (like swimming or cycling), and dietary changes that may help reduce inflammation. Regular follow-ups with your healthcare provider can help monitor your condition and adjust your treatment plan as needed.

In conclusion, given your ongoing symptoms and the limitations you are experiencing, it would be prudent to explore rehabilitation therapy. This approach can provide you with the tools and strategies needed to manage your osteoarthritis more effectively and improve your quality of life. Always consult with your healthcare provider to discuss the best options tailored to your specific situation.

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