Osteoarthritis, which is the most common type of arthritis, is the biggest cause of disability and chronic pain in Australia (Ackerman et al 2016). Despite this burden on a large number of Australians, not to mention the huge cost to the healthcare system, this disease is not being treated as effectively as it should be.
How do we know this? Here’s two key insights
Where do you go for osteoarthritis information? The two most common sources are your GP (General Practitioner) and your other Doctor, Dr Google.
What are the GP’s doing in Australia?
Our doctors in Australia are certainly seeing a lot of people with osteoarthritis, and their peak body, the RACGP (Royal Australian College of General Practitioners) is saying the right things. Their 2018 guide for GP’s treating osteoarthritis strongly recommends weight management and land based exercise for all people with knee and hip OA regardless of their age, structural disease severity, function status or pain levels.
Unfortunately, research by Brand et al 2014 (admittedly this came out prior to the most up to date guides for GP’s) did not reflect the best practice advice. Brand found that GP referral rates for people with knee OA in Australia were as follows.
- 22% of people with osteoarthritis were sent for imaging.
- 23-28% were given pharmacological management, aids and passive treatments
- 12% were referred for surgery
- 3% were referred for exercise and weight control
With exercise and weight control having the highest evidence for being the most effective osteoarthritis treatment, there’s certainly and area for significant improvement.
And what is Dr Google recommending?
At the time of writing, a google search for osteoarthritis treatment displays the following results.
As you can see from above, the top of the page is all ads for medications that have little to no evidence for their usage in treating osteoarthritis. There’s a shopping snippet for herbal remedies and mechanical devices, again, not back by the evidence!
When we scroll down to the google search results there are a lot of mentions around drugs and seeing a doctor. But, unfortunately, we now know this has a 3% chance of getting you referred to an appropriate service.
Thank-fully as you get into the fine print you will find some of the strengthening and evidence of physiotherapy but still, most of us don’t get “below the fold” on a google search. This means if these results are under all the ads, shopping and snippets giving you non-evidence based advice, you’re highly unlikely to get the information you need to treat your osteoarthritis.
So what is the best osteoarthritis treatment? Active Management
Although there is currently quite a bit of overlap here in Australia for the recommended best management of OA, there is a large body of high quality evidence demonstrating that exercise has significant benefits for this population group. This research currently recommends active management involving weight loss, exercise, disease relevant education and self management support as first line treatment strategies. (Ackerman et al 2016).
Active management of osteoarthritis is so beneficial for people with severe knee OA to prevent or delay a knee replacement could save up to $233 million per year by 2030 (Ackerman et al 2016).
So the final word on osteoarthritis treatment is…
Well there isn’t a comprehensive one yet. To even attempt to slow down the rates of disease and healthcare costs we need to be more proactive and less reactive. This involves increasing active management involving weight loss, exercise, disease relevant education and self management support.
Engaging with your local Physiotherapists, Exercise Physiologists and Podiatrists at PridePlus Health is not a quick fix for OA, but is a big step toward decreasing the burden and improving quality of life.