Arthritis and other rheumatic diseases are common conditions that cause pain, swelling, and limited movement. They affect joints and connective tissues around the body. Post-traumatic arthritis is a kind of arthritis that specifically occurs after any kind of physical injury. The physical injury could be inflicted by a vehicle accident, sports accident, military exercise, etc.
An injury of any sort can lead to damage in the tissue which eventually keeps weakening and breaking down at a slow rate. Eventually, the pain of the injury sets in the area causing joints to go stiff and swell up, leading to arthritis. Any kind of physical trauma can damage either the cartilage or the joint of the injured area, leading to quicker degradation of the joint as compared to normal. The susceptibility to post-traumatic arthritis increases especially if the injured continues to put stress on that specific body part, for example, a soccer player continuously playing the game even after a knee injury is at a greater risk.
Throughout the types of post-traumatic arthritis, osteoarthritis is the most common form of arthritis, which results in the gradual deterioration and loss of cartilage joint without expert post-traumatic arthritis treatment. While it tends to be most common in the knee, one of the most overused joints in the body, it can also develop in any joint, including:
- Elbow
- Wrist
- Ankle
- Shoulders
Osteoarthritis has traditionally been associated with “wear and tear” and aging, but it can also result from prior injuries to the joint, such as in post-traumatic arthritis. It can also be caused by certain underlying illnesses.
Causes & Symptoms
Injury and trauma-related arthritis are some of the most common causes of post-traumatic arthritis. According to studies, millions of people are diagnosed with trauma-related arthritis every year. The lifetime risk of developing post-traumatic arthritis in the knee is estimated to be 57% for anyone with a previous injury like an ACL tear or a bone fracture.
Physical trauma in any form can lead to the loss of protective cartilage in the joint. The most common arthritis-related traumatic injuries include:
- Sports injuries (with contact sports such as football, basketball, and soccer being associated with stress fractures, muscle and ligament tears, sprains, and joint injuries).
- Vehicle accidents.
- Impact from a fall (for example, falling from the stairs).
- Side effects and complications from a previous surgical procedure.
Post-traumatic arthritis can develop many years after the initial injury or as a result of repeat injuries in the same joint. A little time off in the short term will go a long way towards preventing potentially permanent joint damage in the long run…
Symptoms from post-traumatic arthritis can vary from mild to severe depending on the Individual. Advanced cases of osteoarthritis can cause chronic pain and mobility problems in the affected joint. The most common symptoms linked to post-traumatic arthritis include the following below:
- Swelling and inflammation.
- Pain and tenderness.
- Limited range of motion.
- Bone spurs.
- Loose particles of cartilage floating in the joint space.
- Stiffness in the joint, especially first thing in the morning or after long periods of inactivity.
Decreased tolerance for walking, sports, stairs, and other activities that stress the joint.
Who gets Post Traumatic Arthritis?
In addition to the impact of a traumatic incident, there are secondary lifestyle factors that can also put children and adolescents at a greater risk for joint problems in the future. Increasing obesity rates and weight problems among young children put greater pressure on the joints, making them more susceptible to injuries. Once an injury occurs, the risk for re-injury increases significantly, making patients who have suffered a sports-rated lower extremity incident three to five times more likely to suffer a recurrence. This may be due in part to the initial injury never healing properly, and insufficient physiotherapy and rehabilitation time.
Other certain risk factors linked to post-traumatic arthritis include the following:
- Age – The risk of post-traumatic arthritis increases within age; degeneration is a large factor that makes patients much more prone to experience a recurrence of their recent injury.
- Past joint injuries – Injuries, such as those that occur when playing sports or from an accident in the past, can increase the risk of post-traumatic arthritis. Even injuries that occurred many years ago and seemingly healed can increase the risk of this arthritic condition.
- Repeated stress on a joint – If your job or a sport that you play places repetitive stress on a joint, that joint might eventually develop post-traumatic arthritis.
- Bone deformities – Some people are born with malformed joints or defective cartilage. This may cause post-traumatic arthritis to occur at an increased rate.
- Genetics – Some patients inherit a tendency to develop post-traumatic arthritis.
How Does it Affect You? How Serious is it?
Generally, any medical or surgical treatment can have side effects or risks. NSAIDs can cause stomach irritation, kidney, liver, or other problems. Cortisone can cause elevation of heart rate and blood sugar and should not be given too often. Surgical treatments have risks of infection, damage to the surrounding structures, and wearing out or loosening of implants.
Also, there is a risk of medical complications such as blood clots, heart attack, stroke, infection, and other problems. Fortunately, all these problems are infrequent. In addition, depression and sleep disturbances can result from the pain and disability of post-traumatic arthritis.
Post-traumatic arthritis isn’t a condition that can be eliminated but rather managed by medication to decrease symptoms. When that is no longer effective, the joint is replaced with a prosthesis also referred to as joint replacement is performed. After surgery, you can expect some discomfort.
Recommended Treatment & Rehabilitation
If you think you may have post-traumatic arthritis, it is recommended to see a healthcare provider. The provider will begin by asking about your symptoms and explaining how joint pain can affect your life. He / she will then perform a physical exam, which may include:
- Evaluating your health overall to determine if a different condition could be causing your symptoms.
- Checking for areas of tenderness or swelling around your joints.
- Assessing mobility and range of motion in your joints.
Imaging tests may help your healthcare provider get a better image of your bones, joints, and soft tissues. An X-ray, MRI, or ultrasound can reveal bone fractures or dislocations that can be causing joint pain, muscle, ligament, or tendon injuries near your joints, and soft tissue inflammation.
If you have been diagnosed with osteoarthritis in your knee, hip, shoulder, or other joint, you may want to know how to relieve your joint pain and slow down the disease’s process. Physiotherapy can help you resolve both problems. To reach a solution, a physiotherapist may design a combination of treatments to reduce most symptoms associated with arthritis. Here are a few strategies a physiotherapist may work with you, such as:
Maintain your range of motion
Post-traumatic arthritis can make a joint stiff; physiotherapy can improve your ability to bend and straighten a joint. Even incremental improvements in a joint’s range of motion can make a significant difference in joint function. For example, getting an arthritic knee to bend just 10 degrees more may allow you to comfortably get in and out of low chairs.
Strengthen muscles that support an arthritic joint
When post-traumatic arthritis causes protective cartilage to wear away in a joint, there can be painful friction between the joint’s bones – you can decrease this friction by strengthening the surrounding muscles that support the joint. Your physiotherapist can identify areas of impairments and teach you how to address these impairments with functional strengthening to help you improve strength and stability in your joints.
Improve your balance
Individuals with this arthritic condition often have impaired balance resulting from muscle weakness, decreased joint function, decreased mobility, and other factors. Additional to functional strengthening, your physiotherapist may also incorporate balance components into your treatment plan that include changes in terrain / surface, walking distances, and elevation to help stimulate daily functional tasks in an effort to improve balance and reduce your risk of falling.
Supporting equipment
Walkers, canes, crutches, splints, and shoe inserts may be recommended to help take pressure off certain arthritic joints depending on the severity of the condition. Understanding when and how to use these assistive devices can help decrease the risk of injury and / or further impairment. Your physiotherapist can teach you how to properly fit and use certain assistive devices while also fostering an environment for you to work toward your functional independence.
Postural adjustments
A good posture can take the stress off arthritic joints. Your physiotherapist can educate you about ways to adjust your posture and put less stress on joints as you sit, stand, and walk. This may include suggestions to modify your environment at home and work and even in your car. Some simple changes, such as adjusting the position of your car seat, can put less stress on your arthritic joints to make your daily activities easier.
A healthcare provider typically only recommends surgery for certain severe cases of arthritis. These surgical treatments include:
Joint replacement
A damaged, arthritic joint gets replaced with an artificial joint. Joint replacement preserves joint function and movement. Examples include ankle replacement, hip replacement, knee replacement, and shoulder replacement.
Fusion
Two or more bones are permanently fused together. Fusion immobilizes a joint and reduces pain caused by movement.
Unfortunately, there is no cure for post-traumatic arthritis, however, there are treatments that can help you manage the condition. Your treatment plan will depend on the severity of post-traumatic arthritis, its symptoms, and your overall health. Conservative treatments include the following:
Medication
Anti-inflammatory and pain medications can help relieve your arthritis symptoms. Another medication called biologics can target your immune systems and inflammatory response. A healthcare provider may recommend biologics for your rheumatoid or psoriatic arthritis.
Therapeutic injections
Cortisone shots may help temporarily relieve pain and inflammation in your joints. Arthritis in certain joints, such as your knee, may improve with a treatment called viscosupplementation. This injects lubricant to help joints move smoothly.
Alternative & Homeopathic Treatment
The following types of exercise and homeopathic treatment may help relieve the pain, joint stiffness, and other symptoms that can cause post-traumatic arthritis:
Stretching
Stretching can help improve flexibility, reduce stiffness, and increase range of motion. Stretching daily is important for relieving arthritis symptoms. The ideal stretching routine will be different for each person and depend on which joints are affected and what symptoms occur.
Walking
Walking is a low-impact form of exercise that can help with aerobic conditioning, heart and joint health, and mood. It is essential to wear proper shoes and stay hydrated, even if the walking is not as strenuous.
Strength training
Strengthening the muscles around the affected joints can help increase strength while reducing pain and other arthritic symptoms. Using a resistance band is a way to challenge the body and build muscle over time.
Hot and cold application
Heat therapy boosts circulation and can soothe stiff joints and aching muscles, while cold therapy restricts blood vessels, which shows circulation, reduces swelling, and numbs the pain.
Massage
Some studies show that regularly massaging the muscles and joints can help soothe pain resulting from arthritis. Experts believe that massage lowers the body’s production of the stress hormone cortisol and helps improve mood by boosting serotonin levels.