The Arthritis Antidote
Dear Colin: I’m 54 years old and recently diagnosed with knee osteoarthritis. It hurts to climb stairs, kneel to pick up my grandkids and garden (which kills me because I love it). My doctor has given me knee injections and prescribed an anti-inflammatory, but nothing’s really helped. I don’t want surgery. What else can I do?
– Helen D.
My answer is a confident “plenty” but before making recommendations, I assume that osteoarthritis (OA) is the only diagnosis for your knees and you have been cleared medically to exercise.
OA is the “wear and tear” joint disease and on x-ray, looks like joints are collapsed (right x-ray) compared to normal (left x-ray). Despite compelling research to the contrary, physicians often choose a “band-aid” approach with patients who have OA using injections and/or costly medications, both of which can have annoying side effects and inconsistent outcomes because neither addresses the key issue: lowering forces on joints. Further, many patients opt for total knee replacement, which costs ~$12,000, lasts 10 to 15 years and post-op physical therapy is needed anyway. How about trying physical therapy first to try and avoid surgery?
There are physicians who downplay or even discourage exercise to treat OA, believing it may worsen a patient’s condition. This not only contradicts a tsunami of research but it also promotes a sedentary lifestyle, opening the door to additional costly health problems such as obesity, depression and diabetes. Additional medications are then prescribed to combat these unnecessary diseases, driving up health care costs.
Therefore, Helen, my answer to your question focuses on a cost-effective, long-term solution that emphasizes 4 key areas:
- Resistance training (RT). Strengthening muscles in a safe range of motion restores muscles’ shock absorption ability, reducing joint forces and pain.
- Stretching. Stretching your thigh and hamstring muscles 15-20 minutes daily helps increase flexibility across the knee, reducing joint forces and pain.
- Endurance exercise. Building endurance via any low-impact activity (e.g., walking, cycling, elliptical machine) that you do daily for 15-30 continuous minutes decreases body fat, while further reducing joint forces and pain.
- Mindset. If you let it, OA can be a debilitating condition. I’ve seen patients in physical therapy with the worst OA you can imagine but because they were strong mentally (i.e., committed to exercise) and had a supportive doctor, they were able to function normally with minimal pain.
I must caution you: RT exercises must be done properly to not aggravate symptoms. Remember that technically correct exercise is the most powerful medication, while haphazard and uncontrolled exercise can seriously worsen OA.
Until then, walk daily for at least 15 minutes as long as you don’t get pain and/or joint swelling.
Colin practices physical therapy at c.h. Physical Therapy.