Physical Therapy for Degenerative Joint Disease

Take Control of Degenerative Joint Disease 

Learning that you have degenerative joint disease can sound scary but there is a lot that can be done to manage it. While you may not have heard of degenerative joint disease (DJD) before, it is the most common type of arthritis, a condition most people are familiar with. Degenerative joint disease is characterized by a thinning or wearing down of the protective cartilage that lines the ends of the bones in a joint. This wearing of cartilage causes symptoms of DJD like joint pain and stiffness. Physical therapists are experts in the management of musculoskeletal conditions like DJD and participating in physical therapy can help relieve symptoms and improve your ability to participate in daily, work and recreational tasks. 

DIVING DEEP INTO DJD

DJD is the most common form of arthritis which affects the cartilage that lines the inside of a joint. The area where the ends of two bones meet is called a joint. The ends of each bone are lined with a protective cartilage that serves several important functions. First, the cartilage provides a smooth, low-friction surface on which the bones articulate and move. Second, the cartilage is responsible for transmitting forces into the underlying bones. When cartilage thins, tears or is damaged, the function of the cartilage becomes compromised and rubbing can occur between the bones.

DJD is typically considered a “wear and tear” condition. This means it often develops over time due to repetitive movements or load through a joint. Take a person who loads trucks for a living. Repetitively lifting and pushing heavy loads overhead into the truck could cause DJD in the shoulder joints. Women, older adults and those with a family history of DJD are also more likely to develop this condition. Because of the mechanism through which this condition often develops, it is most commonly diagnosed in weight-bearing joints like the hips, knees and spine though it can be present in any joint like the hands, feet or shoulders. 

When the protective cartilage tears, fissures or wears away, symptoms characteristic of DJD can develop. Symptoms are usually mild in the beginning and slowly worsen. Many individuals with DJD begin to notice pain in the affected joint during or after movement. Pain will typically worsen after a bout of inactivity like going on a long drive or sleeping, periods when joint fluid is not recirculated through joint motion. As the DJD progresses, swelling or tenderness around the affected joint may be noted and you may feel increased stiffness or decreased range of motion in that joint. Finally, grating, popping or cracking noises may be heard when moving a joint affected by DJD though perfectly healthy joints can also make these noises. 

HOW IS DJD DIAGNOSED?

Your doctor or physical therapist may suspect you have DJD if you present with the above-noted symptoms in one or more joints. Imaging is the definitive test for diagnosing DJD as it allows for visualization of the cartilage and the surrounding soft tissues. X-rays are used to evaluate the joint surfaces and the joint spaces. Joint space narrowing or signs of unevenness or loss of smoothness along the ends of the bones can indicate cartilage changes. An MRI may also be used to evaluate the bones and the soft tissues around the joints. Finally, your doctor may recommend other tests or bloodwork to rule out any other causes of joint pain or swelling such as rheumatoid arthritis. 

GET A MOVE ON

Those with DJD experiencing pain with movement often find themselves avoiding activity. It sounds logical that rest is best when movement causes pain but in fact, the opposite is true. Let’s explore some of the reasons why.

First, when a joint is flexed and moved it stimulates the release of synovial joint fluid. This fluid’s role is to cushion the joint and reduce friction between the bony ends. This fluid is especially important when the joint space is narrowed and cartilage is worn. One of the reasons you may notice increased pain in a joint affected by DJD after resting or sitting for a while is that a stationary joint is not circulating this fluid. Without adequate fluid, the worn and incongruous ends of the bones may be more likely to rub together and irritate nerve endings in the bones. So while resting may avoid the pain of activity, pain may worsen once it is time to get moving again. 

Another reason why reducing activity levels can exacerbate DJD symptoms lies in the role that strong muscles and optimal biomechanics play in minimizing joint irritation. Because joint surfaces are no longer smooth and pristine in the setting of DJD, pain and irritation can be minimized or exacerbated based on the strength and flexibility around the affected joint. Those who exercise more can strengthen the muscles around the joint and maximize flexibility which may reduce some of the rubbing between uneven joint surfaces and promote synovial fluid production. 

Now that you know that rest is often not the best choice in managing DJD, you may wonder how you can resume activity and exercise if either has worsened your symptoms in the past. The good news is that you do not need to figure out the answer on your own. Your physical therapist can show you the way. 

PHYSICAL THERAPY TO MANAGE DJD

After examining the affected joints, assessing your functional mobility and interviewing you about your symptoms, history and goals, my team of physical therapists and I will create an individualized plan of care to manage your symptoms of DJD and get you moving well again. We have many tools and techniques to address common symptoms of DJD.

Pain reduction is a primary goal of therapy and we can achieve this through a multimodal approach. We often utilize modalities and manual therapy techniques like soft tissue or joint mobilization to reduce swelling and stiffness. Muscle strengthening, stretching and motor control exercises are used to optimize the strength, flexibility and control of movement in a joint affected by DJD which can reduce symptoms like pain and stiffness. Physical therapy also emphasizes and trains biomechanics. Performing a movement in the best way possible can reduce the likelihood of joint irritation and a DJD symptom flare. 

Finally, we aim to help you resume as many activities as possible. Reintroducing activities with the guidance of your physical therapist can be helpful. We always strive to get you back to your prior level of activities but in cases where that is not possible without some modification, we are here to help advise you on adaptations you can make to help control your symptoms. 

CALL TO SCHEDULE A PHYSICAL THERAPY EVALUATION FOR DJD TODAY

Joint injections, surgeries and supplements are all possible treatments to manage the symptoms of DJD but if you have not tried physical therapy you are missing out on a huge piece of the treatment puzzle. Don’t wait until symptoms are unmanageable to begin working with a physical therapist, call Evolve Physical Therapy today to start managing your DJD.

Click here for more information about physical therapy for degenerative joint disease

About EvolveNY-

Brooklyn's Premier Holistic Physical Therapy Clinics- There’s physical therapy, there’s training, and then there’s EVOLVE. We use the science of biomechanics merged with fitness to help our patients get better and stay better!

First we evaluate, then we heal, then we strengthen our clients so they can reach their goals, feel better, and live happier lives. We do so by utilizing a range of core techniques and specialized treatments to reduce pain, improve mobility, enhance physical strength and deal with the underlying issues, not just the pain itself.

Multiple Brooklyn Physical Therapy Locations!

1-718-524-3261

https://EvolveNY.com