Understanding arthritis

Arthritis is not a single condition. It is an umbrella term covering more than 100 different types of joint disease, each with distinct causes, patterns and management requirements. The two most common types we see at Nudge are osteoarthritis and rheumatoid arthritis.

Osteoarthritis

Osteoarthritis is the gradual breakdown of the cartilage that cushions your joints. As the joint space narrows, movement becomes painful, stiffness sets in and the surrounding muscles tighten to compensate. It most commonly affects the knees, hips, hands and spine. Morning stiffness that eases within 30 minutes, pain that worsens with activity and a creaking or grating sensation in the joint are typical features.

Rheumatoid arthritis

Rheumatoid arthritis is an autoimmune condition where the immune system attacks the joint lining, causing inflammation, pain and progressive joint damage. It tends to affect multiple joints symmetrically, often the hands, wrists and feet, and produces morning stiffness lasting longer than 30 minutes. Fatigue and systemic symptoms are common alongside the joint presentation. Management is primarily medical under the care of a rheumatologist, but osteopathy plays a valuable role in supporting function and reducing musculoskeletal pain alongside that care.

Other types we see

We also work with patients managing psoriatic arthritis, ankylosing spondylitis, gout and post-traumatic arthritis following joint injury.

How osteopathy helps

Osteopathic care for arthritis is not about forcing change in a compromised joint. It is about working carefully within what the joint can tolerate to reduce pain, maintain movement and keep the surrounding structures functioning as well as possible.

Pain relief

Hands-on treatment reduces the protective muscle spasm that develops around arthritic joints. That spasm is the body's response to pain, but it creates a secondary layer of tension that restricts movement further and amplifies the pain signal. Releasing it provides real, often significant relief.

Maintaining joint mobility

Arthritic joints stiffen. Regular gentle mobilisation, working within available range and never forcing, helps maintain the movement that remains and slows the rate at which stiffness accumulates.

Improving joint loading

Many patients with arthritis develop compensatory movement patterns that concentrate load on already compromised areas. By improving how the whole body moves and strengthening the muscles that support affected joints, we reduce the mechanical stress on those joints and help distribute load more evenly.

Strength and stability

Weak muscles around an arthritic joint increase instability, reduce shock absorption and accelerate functional decline. Targeted strengthening, particularly of the quadriceps for knee arthritis and the gluteals for hip arthritis, is one of the most well-evidenced interventions for managing osteoarthritis long term.

Balance and fall prevention

Arthritis affects proprioception, the body's sense of joint position and movement. For older patients particularly, this increases fall risk. Balance training and gait assessment are a standard part of how we approach arthritis care.

Flare management

When symptoms increase, we adapt treatment accordingly. During a flare, we focus on calming the surrounding tissue, reducing load and supporting you through the acute phase rather than pushing through it.

Techniques we use

We never apply forceful or high-velocity techniques to arthritic joints. Treatment is always adapted to your specific condition, the joints involved and how you are presenting on the day.

Techniques we draw on include joint mobilisation using slow, rhythmic passive movement within comfortable range to promote synovial fluid circulation and maintain mobility, soft tissue release to the muscles and connective tissue surrounding arthritic joints, muscle energy technique where you gently contract specific muscles against light resistance to assist joint movement, articulation to rhythmically move joints and reduce accumulated stiffness, myofascial release for broader restrictions in the connective tissue surrounding affected areas, and counterstrain which finds and holds comfortable positions to calm hypersensitive joints during acute phases.

What to expect across your care

Your initial appointment runs 45 to 60 minutes. We take a thorough history covering your diagnosis, affected joints, pain patterns, current medications, previous treatments and what you want to be able to do. Physical assessment covers joint range of motion, muscle strength, gait and posture. You leave with a clear understanding of how osteopathy can help your specific situation and a treatment plan built around it.

From there, treatment is tailored to your type of arthritis and your goals. Osteoarthritis management focuses on maintaining mobility and strengthening the muscles that support affected joints. Rheumatoid arthritis management works around your disease activity, with treatment adapted depending on whether you are in a flare or a quieter period. For patients preparing for joint replacement surgery, we focus on building the strength and function that improves surgical outcomes and speeds recovery. For those who have already had joint replacement, we address the compensatory patterns that developed in the years leading up to surgery and support the return to full function.

The long-term goal is self-management. We equip you with a home exercise program, pacing strategies, joint protection principles and a flare management plan so that you are not dependent on regular appointments to stay on top of things.

When to book an appointment

Osteopathic care is worth pursuing if morning stiffness is affecting the start of your day, pain is limiting activities you want to do, you are finding daily tasks increasingly difficult, or you want to maintain function and slow the progression of the condition. It is also appropriate if you are preparing for joint replacement surgery and want to go in as strong as possible, or if you have recently had surgery and want support beyond the standard physiotherapy component.

If you develop a hot, red, swollen joint that comes on suddenly, seek medical attention first. This may indicate an acute flare or joint infection that requires medical review before hands-on treatment.