The Effect of Local Cold Compression upon Pain and Movement Restriction among Patients with Knee Osteoarthritis

                                                   http://austinpublishinggroup.com/nursing/

Treatmentand care of musculoskeletal system diseases, which increases with aging, play a crucial role in maintaining health and improving quality of life. One of these diseases is osteoarthritis prevalence of which is very high-particularly- among those over 50 years. OA is the most common form of arthritis and is defined as degenerative joint disease caused by inflammation, stiffness, and eventually by cartilage loss. Knee OA is a widely prevalent joint disease over the world. In the USA, OA affects nearly 40 million women and men. It is estimated that this ratio, which almost makes up 15% of the general population, will rise to 18.2% by 2020; in other words, 59.4 million Americans will be affected. It is alsoestimated that by 2030 there will be 67 million people diagnosed with OA in the United States. “Turkey Osteoarthritis Study (2005)”, is considered as the most extensive study in Turkey on this issue, it is stated that one man versus three women is OA patient. However, the study done with 3755 OA patients in nine provinces does not shed light on the ratio of the population affected by OA. The knee osteoarthritis rate in Turkey is reported to be 14.8%. The most crucial clinical signs of knee OA are pain, movement restriction and joint stiffness. 

The aim of knee OA treatment is to control pain, movement restriction and other symptoms; to slow disease progression; to increase and to maintain patients’ movement function. It is widely accepted that no methods can prevent the disease completely. Therefore, patients should protect themselves from side effects of the treatments. In many cases, pharmacological and non-pharmacological methods can be employed together as these are the best ones in pain control. Local hot or cold compression, which is a non-pharmacological method, has been used for a long time for reducing pain, stiffness and swelling among OA patients. Generally; physiological effects of hot are vasodilatation, increase in capillary permeability, acceleration of cell metabolism, muscle relaxation, acceleration of inflammation, reducing pain by relaxing muscles, sedative effects and reducing joint stiffness by decreasing synovial fluid. In a study done by Mazzuca et al. heat-retaining knee sleeve was compared to cotton elastic knee sleeve and the difference between was found statistically insignificant. In this study, patients continued pharmacological treatment. Physiological effects of cold are vasoconstriction, slowing down in cell metabolism, local anesthesia, reduce in blood flow, oxygen, metabolite flux to the site and waste products. Therefore, local cold compression exerts such effects as reducing/terminating pain, preventing edema and slowing down inflammation process by providing local anesthesia therapeutically. Therefore,importance of cold compression among arthritis patients has been emphasized.