Osteoarthritis (OA) is one of the leading causes of disability in the world with knee arthritis estimated to affect around 250 million individuals worldwide including 1.9 million Australians. This figure is expected to increase to 3 million Australians by 2032. So what exactly is osteoarthritis?
Osteoarthritis is commonly abbreviated to arthritis or more simply, OA. It is an inflammatory condition that can affect any joint, but is most commonly present in the knees, hips, lower back, neck, fingers and big toe. In a normal joint, there are layers of cartilage lining the ends of the bones that help the joint to move with no friction. In a joint affected by Osteoarthritis, this cartilage is damaged, which can cause an inflammatory response by the body including pain and swelling. As the joint continues to be damaged, new bone may begin to form around the joint. These bony growths are known as osteophytes. These growths can be problematic if they: begin to restrict the movement of the joint, rub against other bones or tissues, pinch nearby nerves or break off and begin to float around in the joint causing more issues.
There is currently no cure for OA, so treatment is focused on the management of the condition which includes relieving pain and reducing symptoms.
Some of the risk factors for the development of knee OA includes:
What is the effect of Knee OA?
The condition can be quite debilitating depending on the severity of the arthritis. Tasks such as climbing stairs, stooping to pick something up off of the ground, standing up from the toilet or even just rolling over at night when trying to sleep can be quite painful and difficult to perform.
For many, the effects of Knee OA can take its toll on lifestyle activities. Being able to play golf or lawn bowls, playing with the grandkids or just generally enjoying your retirement can be a challenge. After all, how good can a retirement be if you cannot move the way you want to without experiencing pain.
So if there is no cure, what can we do about it?
The American Association of Orthopaedic Surgeons (AAOS) have a summary of recommendations available that contains a list of evidence based treatment recommendations. What is clear is the role that exercise plays in the treatment of knee osteoarthritis. Strengthening exercises and low-impact aerobic exercises are strongly recommended for the treatment of Knee OA. Weight loss for patients with a BMI over 25 is generally recommended. The use of non-steroidal anti-inflammatory medication and topical agents is strongly recommended.
Interestingly, when analysing all of the evidence based research available into the treatment modalities of knee arthritis, there are several common remedies that are being offered that lack compelling evidence into their efficacy. The AAOS cannot recommend the use of glucosamine, electrotherapeutic treatment, manual therapy, acupuncture, some knee braces or wedge insoles.
So what does this mean? The most effective intervention for knee osteoarthritis before surgical intervention appears to be exercise based with the additional aid of non-steroidal anti-inflammatories. What kind of exercise? The evidence would suggest that a combination of strength, aerobic and flexibility training is most likely to improve pain and function of the osteoarthritic knee.
You can’t cure Knee Arthritis, but you can greatly reduce the pain you experience and reclaim some ability to perform tasks and activities of daily living.
Of course, every exercise program should be individualised, taking into account the age of the patient, the severity of the OA, the current mobility of the joints and any additional conditions. Please contact a health care provider to see if exercise is suitable for you.