Osteoarthritis: Degenerative Joint Disease Treatment and Exercise

By Tracy Hartley, PT, DPT

Degenerative Joint Disease at a Glance

hip pain djd Osteoarthritis: Degenerative Joint Disease Treatment and Exercise

Degenerative joint disease can affect any joint in the body.

Osteoarthritis is the number one cause of degenerative joint disease leading to disability in America, especially in the elderly. Osteoarthritis is the most common form of arthritis leading to degenerative joint disease. Degenerative joint disease (DJD) is a condition in which joint surfaces deteriorate causing pain and functional limitations. The joint surfaces exposed to weight bearing have a higher incidence of joint disease. DJD treatment options to date have mostly targeted the relief of pain rather than slowing or reversing the progression of the disease process.

Osteoarthritis Osteoarthritis: Degenerative Joint Disease Treatment and Exercise

Masking the Arthritic Pain

Medication options for DJD pain control are available but have no effect on the disease process.  Acetaminophen (Tylenol) is the most widely used drug for pain reliefIbuprofen (Advil, Motrin) and naproxen (Naprosyn) are non-steroidal anti-inflammatory (NSAIDS) medications also commonly used for DJD pain control and are available over the counter and in prescription strengths.  NSAIDS are generally more effective for pain control in mild to moderate DJD, but adverse side effects with long-term use can be a deterrent.  Many other NSAIDS are available by prescription only.  Opioids are another class of drugs used for more severe joint disease pain control but should only be used short term for a couple of months due to side effects and potential for addiction and abuse.

Optimism in Clinical Trials of New Drugs

Another type of medication is in the infant stage of development. These new drugs, known as diseasemodulating agents, have the potential to change the clinical management of osteoarthritis and DJD. Their goal is to slow or halt the progression of DJD. These drugs are only in the clinical trial stage at this point.

Treatment for Severe Degenerative Joint Disease

Severe DJD results in significant degrees of functional limitations usually because of debilitating pain. In these most severe cases, eventually the treatment of choice isjoint replacement. Since weight-bearing joints wear faster with osteoarthritis and DJD, the majority of joint replacement surgeries involve total knee and total hip replacements. Obesity remains the number one modifiable risk factor for developing osteoarthritis and DJD that leads to joint replacement surgery.

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Hip replacement surgery restores function.

Diet and Exercise for Degenerative Joint Disease

Studies show weight loss and exercise are both beneficial for decreasing DJD pain. Further, studies also show that weight loss with exercise are more effective than either one alone for relieving pain and preventing the need for joint replacement surgery.

Physical Therapy Interventions for Degenerative Joint Disease

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Physical therapy studies involving subjects with osteoarthritis and DJD have associated manual therapy and patient specific exercises with improvements in walking distance, pain, stiffness, and function. Furthermore, subjects that received physical therapy were 4 times less likely to undergo joint replacement surgery at one-year after discharge. The patient specific exercises provided during physical therapy included low impact and stabilization exercises for hip and knee strength that were continued as a home exercise program.

Eliptical trainer for low impact exercise. Osteoarthritis: Degenerative Joint Disease Treatment and Exercise

The low impact exercises included exercise bike, elliptical trainer, water walking, and water aerobics with a frequency ranging from 3-5 days per week. Stabilization exercises consisted of strengthening the quads and hip muscles called adductors and abductors using isometrics. The isometric exercises consisted of contracting the quads, adductors, and abductors without movement of the diseased joint. Researchers hypothesized that stabilization exercises resulted in improved control of joint motion in the involved degenerative joint. Patients that adhered to their prescribed home exercise program demonstrated greater benefits at the one-year follow up after discharge.

Isometric exercise to treat djd Osteoarthritis: Degenerative Joint Disease Treatment and Exercise

Fine-Tuning Degenerative Joint Disease Treatment for the Individual

Treating degenerative joint disease consists of pain control and exercise that is fine-tuned to meet the specific needs of the individual. Mild to moderate pain control consists of a combination of medication and lifestyle changes including managing obesity.  Your doctor will best determine the medication that is right for you and help you develop a safe and effective weight loss program. A physical therapist can fine-tune an exercise plan that limits impact on the degenerative joint usually consisting of low impact and stabilization exercises eventually incorporated into a home exercise program.  The goal is to customize an exercise program that provides all of the benefits of exercise but also prevents further degeneration of the compromised joint surfaces and further decline in function.

Managing degenerative joint disease (DJD) does require some effort and diligence to maintain function and control pain.  However, with your efforts come great rewards with improvements in walking distance, pain, stiffness, and function.

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4 Responses to Osteoarthritis: Degenerative Joint Disease Treatment and Exercise

  1. divasupermum antoinette November 25, 2011 at 11:54 pm #

    very interesting post,exersise seems to be the way forward, thanks for the information

  2. Sophie Hardy November 28, 2011 at 11:48 am #

    This is a great article and explains why exercises are so important if you have degenerative joint disease and why you must do an exercise programme specifically designed for the level of DJD you have. You can also do simple things like use hot and cold packs. Use hot when you feel stiff (like in the morning) and cold when you have been overactive and are in pain. You can also use cold as preventation against a bad reaction from doing too much. Using a cold pack straight after an activity you know aggrevates your DJD will reduce the suffering later. Frozen peas wrapped in a tea towel work fine or a hot water bottle wrapped in a hand towel for heat. How long you leave them on for will depend on which joint you have the DJD in. For more information on this plus self help physical therapy programmes that include massage therapy and exercise programmes you can go to http://exercisesforosteoarthritis.com/osteoarthritis-therapy/

  3. Marje Newman December 3, 2011 at 8:43 am #

    I LOVE this post!! Thank you so much. I am new to your blog & I love it. You are full of very helpful & needed information.
    Just Another Day “2retirednewmans”

  4. Tasha @ Dine n' Dash December 7, 2011 at 7:41 am #

    very thorough. loved the post!

    Tasha Collins PT, DPT

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