Osteoarthritis: the challenge of managing disability

Edito of 09/02/2013

The quality of life of the osteoarthritic patient depends largely on their autonomy, challenged by functional impairment related to the stiffness of the joint.

Pain is the warning sign of the disease. It is mechanical, exacerbated by exercise and relieved by rest. Its intensity is evaluated by visual scales without there being any relationship between this intensity and the degree of joint damage.

Joint stiffness appears after a certain time of evolution. It is analysed during the physical examination of the patient and confirmed by the limitation of the affected joint in passive movement. It may be associated with joint swelling, cracking, deformation or abnormal movement.

Functional impairment results from the association of joint pain and stiffness. It is evaluated by Lequesne algo-functional indices (knee and hip).
This assessment has several objectives. First of all, to asses the intensity of the pain and the degree of functional impairment. Next, to monitor the effects of the therapeutic measures and see if they need to be changed when they are insufficient. Lastly, to help make a decision regarding joint replacement (when this possibility is being considered).

Improving functional disability (and quality of life) can only come from managing the 2 components (pain and stiffness).
The analgesics and non-pharmacological measures (aerobic exercises, mobilisation and muscle strengthening) aim to reduce pain and maintain articular range of motion, which is essential in enabling the OA patient to retain their autonomy.

References
- LaRhumato The tools of the rheumatologist (Lequesne tool)

Arthrolink Editorial Committee