By: Jill Phelan, DPT

So you've been dealing with that pesky shoulder on and off for years, that smarts when you get to that certain point when you reach overhead. That knee pain that you chalk up to your old running days. Or that hip that bugs you when you're putting on your shoes and socks. Some days are better than others. You often feel stiff after long bouts of inactivity, until you "get moving." You often her clicking or cracking, you may even have some intermittent swelling.

You're given the diagnosis of osteoarthritis (OA) or degenerative joint disease. OA is the most common joint disease, leading to wide ranges of disability and affects millions of people in the United States. How and why does this happen so frequently then? The etiology of osteoarthritis is not completely clear, but incidence increases with age or excess weight/obesity. Prevalence can also be associated with injury and overuse, such as those that do repetitive bending or overhead work. Some also suggest that an individual's genes may play a role as well, such as inherited bone abnormalities. In non-affected joints, the ends of bones are covered by rubbery cartilage that aids in the smooth fluidity of movement as well as supporting joints for shock absorption during weight bearing. As OA progresses it causes "wear and tear" on this natural cushion, causing joint space narrowing and bone begins to rub on another (you have probably heard someone at some refer to it as "bone on bone"). Subchondral sclerosis, or increased thickening of the bone occurs, as well as bone spurs and cysts. All of the aforementioned processes can result in an inflammatory and pain response within the body, leading to chronic discomfort and thus decreased activity and function.

You don't want or may not be deemed appropriate for surgery; possible pain medicine or injections have helped minimally. Now what? You may likely be a good candidate to trial physical therapy as a new and less invasive intervention. We as physical therapists routinely see patients daily that are suffering from arthritic changes. Often times the chronic pain and changes at your affected joint can lead to secondary changes in the surrounding structures whether it be alterations in muscle strength or control, joint mobility, extensibility or soft tissue restriction. Growing research has found therapeutic exercise, such as strengthening and joint mobility aid in reducing symptoms and in some cases may help decrease the need for surgery, such as joint replacement, or intra-atricular injections. Many patients may also profit from specialized manual therapy techniques, in which an educated and licensed physical therapist uses their hands to apply pressure to soft tissue structures and mobilize or manipulate joints.

As a new patient to one of our clinics, you would undergo an initial evaluation, in which your therapist would attain your personal history related to your arthritic diagnosis, main complaints and restrictions. He or she would complete an objective physical exam, investigating your anatomical and physiological strengths and deficiencies and how they contribute to your current deficits. Based on these factors, we would formulate an individualized plan of care with the main goal of decreasing the frequency, severity and duration of your symptoms to maximize your function. So whether your ambition is to be working in your yard or walking on the beach this upcoming summer, playing with your children or grandchildren or getting back to exercising regularly with decreased pain and limitation we at Professional Rehabilitation Services are here to help.

For further information on this or other related topics you can contact Jill Phelan, DPT, (Conway) (843) 733-3031, Richard Owens, PT, MS, OCS, Cert. SHT, CWcHP, Cert DN (Surfside) (843) 831-0163, Richard DeFalco, DPT, OCS, CSCS, CWcHP, Cert. DN (Myrtle Beach) (843) 839-1300, Kristin Lies, DPT (Murrells Inlet) (843) 314-3224 or Brian Kinmartin, PT, DPT, MTC, OCS, STC, CWcHP, Cert. DN, (Pawleys Island) (843) 235-0200. Please visit our website at www.prsrehabservices.com where you can learn more about the company and even download a referral form for your physician to fill out. You can also call and schedule a free 15-minute consultation at one our five facilities!