Dominic Stone
Osteoarthritis (OA) is a multifactorial condition associated with degeneration of the joint, with pathological changes to multiple musculoskeletal tissues such as cartilage, meniscus, ligament and synovium. It is the most common type of arthritis and typically affects the knees, hips, and small joints in the hands. OA can cause joint pain, stiffness, and loss of mobility, which can lead to muscle weakness and wasting (loss of muscle bulk). While the relationship between OA and muscle weakness is not yet fully understood, studies have shown that individuals with mild-to-moderate hip OA exhibit generalized muscle weakness of the affected limb. Furthermore, muscle impairments associated with knee OA can cause functional limitations, with patients demonstrating reduced functional capacity attributed to joint pain, stiffness, and loss of muscular strength.
| Characteristics | Values |
|---|---|
| Definition | Osteoarthritis (OA) is a subset of joint disorders resulting in degeneration of synovial joints. |
| Cause | Malalignment of bone or joint structures, musculoskeletal abnormalities, genetics, gender, environmental factors |
| Symptoms | Pain, stiffness, loss of mobility, muscle weakness, instability, swelling, tenderness, grating or scraping feeling when moving the joint |
| Affected areas | OA can affect any joint in the body, but the most common areas are knees, hips, and small joints in the hands |
| Treatment | Strength training, exercise, miRNA-based therapeutics |
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What You'll Learn
Muscle wasting and weakness
Osteoarthritis (OA) is a multifactorial condition associated with degeneration of the joint, with pathological changes to multiple musculoskeletal tissues such as cartilage, meniscus, ligament, and synovium. OA can affect any joint in the body, but the most common areas affected are the knees, hips, and small joints in the hands. OA is the most common type of arthritis and tends to occur in middle age or due to injury or obesity. It is not an inevitable aging disease, and some people never develop it.
OA can cause muscle wasting and weakness, but it is unclear whether muscle weakness precedes or is caused by OA. Women who develop knee OA have weaker quadriceps relative to body weight, but it is unknown whether stronger quadriceps are protective against knee OA onset and progression. Muscle impairments associated with OA are the primary underlying cause of functional limitations. Patients with knee OA demonstrate reduced functional capacity that can be attributed to joint pain, stiffness, and loss of muscular strength of the lower extremity muscles.
OA can cause muscle wasting and weakness, which can be treated with strength training and exercise therapy. Recent research has focused on investigating the use of miRNA therapies to regulate muscle mass and function and restore functional homeostasis.
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Joint instability
Osteoarthritis (OA) is a disease of the entire joint, including bone, cartilage, ligaments, fat, and the tissues lining the joint (the synovium). It is a progressive condition with no cure, and it can affect any joint, but it typically affects the hands, knees, hips, lower back, and neck. OA causes changes in the bone and weakens the tissues that hold the joint together and attach muscle to bone. As a result, OA can cause joint instability, particularly in the knee, ankle, and shoulder joints.
The knee is the joint most commonly affected by OA, and it is also one of the joints most susceptible to ligament injury and joint instability. As OA progresses in the knee, the patient may experience symptoms such as a wobbly or unstable feeling in the joint, as if it could buckle or "give out." This joint instability can further contribute to muscle weakness as the patient may become less active to avoid putting pressure on the affected joint.
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Knee osteoarthritis
Osteoarthritis (OA) is a multifactorial condition associated with degeneration of the joint, including bone, cartilage, ligaments, fat, and the tissues lining the joint (the synovium). It is the most common type of arthritis and tends to occur in middle age or due to injury or obesity. OA can affect any joint in the body, but the knees are one of the most common areas affected.
The relationship between knee OA and muscle weakness is bidirectional. While knee OA can cause muscle weakness, muscle weakness can also precede the disease onset and contribute to its initiation and progression. Women who develop knee OA, for instance, have weaker quadriceps relative to body weight.
Muscle impairments associated with knee OA are the primary underlying cause of functional limitations. Quadriceps, hamstrings, and hip muscles are significantly impaired in subjects with knee OA compared to age-matched controls. Muscle strength, especially quadriceps, is a major determinant of physical function. Patients with knee OA may experience reduced functional capacity due to joint pain, stiffness, and loss of muscular strength in the lower extremity muscles.
Exercise therapy targeting muscle impairments is crucial in the management of knee OA. While the molecular mechanisms underlying muscle wasting in OA are not yet fully understood, it is clear that skeletal muscle wasting plays an important role in OA development and progression. Strength training is recommended for managing OA, and novel approaches such as modulation of microRNAs to maintain muscle mass and function are being explored.
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Hip osteoarthritis
Osteoarthritis (OA) is the most common type of arthritis, typically affecting the hands, knees, hips, lower back, and neck. It can occur due to ageing, injury, or obesity. OA is characterised by the degradation of cartilage, changes in bone shape, and inflammation, resulting in pain, stiffness, and loss of mobility.
The extent and pattern of muscle weakness in the early stages of hip OA are not yet fully understood. However, as the disease progresses to advanced stages, muscle weakness and strength asymmetries become more pronounced. Atrophic, bilateral hip and knee muscle weakness are characteristic of advanced hip OA.
To manage hip OA, clinical practice guidelines recommend strength training interventions to target muscle weakness and prevent the development of strength asymmetries. These interventions aim to improve the performance of daily activities and enhance the quality of life for individuals with hip OA.
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Exercise and treatment
Exercise is a crucial part of osteoarthritis treatment, helping to ease pain and stiffness, improve overall health, and prevent weight gain. The U.S. Department of Health and Human Services recommends that individuals with osteoarthritis aim for 150 minutes of moderate-to-vigorous exercise per week.
A good exercise program to manage osteoarthritis has four components:
- Strengthening exercises: Building muscles around painful joints helps to ease the stress on them. Strength training involves contracting muscles against resistance, which can be from one's own body or from hand/ankle weights or resistance bands. It is important not to overexert oneself and to start with four to six repetitions, gradually increasing.
- Range-of-motion exercises or stretching: These help to reduce stiffness and maintain joint movement.
- Aerobic or cardio exercises: These improve stamina and energy levels and help with weight loss. Low-impact aerobic exercises such as walking, swimming, or cycling are recommended.
- Balance exercises: These strengthen small muscles around the knees and ankles, improving stability and preventing falls.
Exercising in water, such as in a pool, is often recommended for individuals with severe osteoarthritis pain as it provides a lower-impact form of exercise.
In addition to exercise, other treatments for osteoarthritis include physical therapy (often with heat therapy), occupational therapy, medications, and, in severe cases, joint replacement or other surgery.
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Frequently asked questions
Yes, muscle weakness around the joint is a common symptom of osteoarthritis.
Osteoarthritis causes changes in the bone and weakens the tissues that attach muscles to bones. It can also lead to swelling of the joint lining, which may cause muscle weakness.
Symptoms of osteoarthritis include pain, stiffness, tenderness, and reduced range of motion in the joints. It can also cause swelling and a “grating” or “scraping” feeling when moving the joint.
Staying active, maintaining a healthy weight, and receiving treatments such as physical therapy and heat therapy can help manage osteoarthritis symptoms and slow the progression of the disease.
Osteoarthritis commonly affects the hands, knees, hips, and spine. However, it can affect any joint in the body.
