Osteoarthritis: What Is The Latest Evidence?

Osteoarthritis: What Is The Latest Evidence?

I recently attended the GLA:DTM (Good Living with Osteoarthritis from Denmark) course for physiotherapists in Australia. The course provided the latest evidence for treatment of patients with hip and knee osteoarthritis.

Osteoarthritis is a disease that mainly affects the articular cartilage in the joints (commonly in the hips and knees). It’s a very common problem that can cause pain and disability particularly in older people (as your bones tend to weaken with age).

The following is a brief list of common signs and symptoms that people present with when they are suffering from osteoarthritis…


  • Pain with weight-bearing
  • Stiff and unstable leg
  • Knee giving way
  • Crunching or clicking noises
  • Finding it hard to walk up and down stairs, or get from sitting to standing
  • Occurs with deformities like knock-knees or bowleg.


  • Pain can be located outside the hip, deep in the groin or down the thigh
  • Sometimes pain is not in the hip, but instead on the inside of the knee
  • Reduced range of motion in the hip joint
  • Trouble getting in and out of a car, putting on socks, picking things up from the floor.
  • Step length will often get shorter when walking
  • It may be hard for you to straighten your hips, so you may tend to bend forward when walking.

Source: GLA:D Australia: https://gladaustralia.com.au/

Risk Factors:

There are two types of factors that can influence your risk of developing osteoarthritis:

Non ModifiableModifiable
Age: More common after the age of 50
Sex: Women more likely than men
Heredity: Runs in families
Obesity: Due to increased load and other
inflammatory factors associated with being
Physical inactivity: Cartilage needs load to be
Muscle weakness: Joints need support from
muscles to move effectively


The clinical guidelines for osteoarthritis are based on a three-tiered system:

Tier 1: Treatment options that should be offered to ALL patients suffering from osteoarthritis…

  • Education regarding the physiology of osteoarthritis, pain and ways to cope
  • Exercise: We will give you the option to undertake an appropriate exercise program for your specific problem
  • Weight Control: We will discuss weight control, if this is a problem for you, advising on a weight loss program, dietitian or similar.

Tier 2: Treatment options that should be offered to SOME patients suffering from osteoarthritis…

  • Pharmacological pain relief (medications, injections)
  • Aids (including walking stick, frame, orthotics etc.)
  • Passive treatment (such as massage) provided by a therapist

Tier 3: Surgery: Treatment options for those with VERY SEVERE symptoms (usually only 10-15% of patients)

  • Joint replacement
  • Osteotomy: a wedge of bone is surgically removed

Source: GLA:D Australia: https://gladaustralia.com.au/

As you can see, it’s important that tier one options for treatment should be offered before the second and third tiers. If the first line of treatment doesn’t lead to a satisfactory outcome then you can progress through the tiers until symptoms are managed. It’s important to note that exercise, education and weight loss are always included in treatment for osteoarthritis no matter when you come and see us.

In my next blog I will start to address further the exercise component of the osteoarthritis treatment plan. As a physiotherapist this is the area that I am passionate about and I enjoy helping patients to increase function, reduce pain and improve quality of life.

If you would like further information about the GLA:DTM program please visit their website, click here

Please note that information provided in this article is general advice only. For individual advice, we recommend a consultation. For more information or if you are experiencing symptoms of osteoarthritis and would like to book an appointment, you can…

  • Contact our friendly reception team on 9822 4999 (Armadale) or 9486 0512 (East Melbourne)
  • Book online. Select ‘make a booking’ in the top right-hand corner of the screen and follow the prompts
  • Email us on [email protected]


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Our values are the basis of everything we do at Fitwise.

Excellence, Respect, Innovation and Fun – For our clients, for our team and for ourselves.

This is evident with the service we provide, the environment in which we provide it, the way in which we operate as a team and how we care for and value our clients, referral partners and ourselves; we live the Fitwise values every day.

Our culture is one where everyone feels supported, respected and safe. Our clients and our team, experience a leading-edge health environment where we remember to have fun along the way.

Our Story

In 2004, Gen McGlashan and Libby Oldfield founded Fitwise Physiotherapy. They first met in 1994.  Libby was Gen’s physio when she had her first child. Gen then worked for Libby for 10 years in Libby’s previous business, located at the Epworth Freemasons Maternity Unit in East Melbourne. They have been a team working together for a very long time!!

Libby and Gen have always had a passion for empowering women, by helping provide accurate evidence based information and treatment to help women live their best lives. Excellence in all that they do, practising and operating in an innovative way has always been their core. Fitwise was the first multi-practitioner practice providing Women’s Health physiotherapy consultations, exercise classes and clinical pilates in Melbourne.

Gen and Libby

In February 2005 Gen and Libby moved their one room practice to Albert St East Melbourne. They had expanded to 2 treatment rooms, an exercise studio and a pilates studio with a small team of physiotherapists and one receptionist. This was exciting as they wanted to be able to help more people and to grow their team – enabling their other passion: teaching and mentoring clinicians who also wanted to work within the Women’s, Men’s and Pelvic Health arena.

5 years later, they expanded their East Melbourne clinic and in 2015 opened their second clinic in Armadale.

Remedial Massage, Myotherapy and Dietetics have been an exciting addition in recent years, with Podiatry and Exercise Physiology being added in 2022.

Fitwise Physiotherapy | Armadale

The Fitwise team has now grown to include 18 amazing practitioners and 12 wonderful administrative team members and is still growing!

Libby and Gen have always loved providing a holistic service, treating a variety of conditions in consultations and providing exercise appropriate for different life stages. The community of clients that are part of the Fitwise family, (some who have been part of the journey from the very beginning – over 17 years ago), are the biggest reason they do what they do. For Gen and Libby, it is a privilege to be part of these wonderful people’s lives.