Disabling effects – lower limb joints
The Feet
Osteo-arthritis of the foot generally affects the joint at the base of the big toe. Eventually the toe may become stiff (hallux rigidus), which makes walking difficult, or bent (hallux valgus), which can lead to painful bunions. Surgery may be necessary in feet that are painful and deformed due to progressive bunion formation.
The Knees
The knee joints are frequently affected by OA. They may become stiff, swollen and painful with consequent functional limitations. In severe cases, activities such as dressing and walking may become restricted. Other activities including stairs, getting in and out of chairs, the bath and motor vehicles may become difficult. Kneeling may become almost impossible. Difficulty in picking up items from the floor may occur. Care and mobility needs may be present.
Medication, weight loss if required, exercise and walking aids may reduce functional restrictions. In severe cases, knee replacement may be considered.
The Hips
OA of the hip can lead to pain, stiffness and considerable functional limitations. Pain from OA of the hip may be felt in the hips or groin, inner thighs, buttocks or knees. OA of the hip may restrict walking and bending. This may make daily activities such as dressing, getting into and out of the bath, climbing stairs and getting out of a normal height chair difficult. If hip movements are severely restricted, it may not be possible for the person to attend to their own personal hygiene, cut their toenails, put on socks or tights, do up their shoelaces or rise from the toilet unaided. Walking may also be restricted leading to mobility needs.
The use of assistive equipment such as a stick or walking frame may reduce the stress on the hip, however if pain is severe and not helped by medication, hip replacement surgery may be recommended.
The Low Back (See also back pain)
Back pain is the commonest orthopaedic complaint. Most people (60-80% of the world’s population) will experience back pain at some point in their lifetime. 85-90% of all episodes of back pain are non-specific or mechanical in nature.
The prognosis for complete recovery in mechanical back pain is excellent. By the end of 6 weeks, 90% of both new and recurrent episodes of mechanical back pain are symptom free, with the majority of these resolving fully in 1-2 weeks. A further 5% recover within 12 weeks. Typically, most people with Mechanical Back Pain are able to walk normally and attend to activities of daily living for the majority of the time.
The remaining 5% develop persistent pain leading to chronic low back pain. The development of chronic low back pain however does not equate with disability. As a general rule, individuals with chronic (longstanding and persistent) back pain have minimal care needs or mobility restrictions.
