Osteoarthritis (OA) is a growing public health concern as our population continues to age and obesity rates rise. It is a disease affecting joints such as the hips, knees, and hands. Joint pain due to OA can make moving and completing daily tasks difficult. Here are some tips you can try right now to improve pain and function.
1. Learn about the condition
Chances are if you are reading this you are already looking for things you can do to help with OA symptoms. The first step is understanding the nature of the condition and self-management strategies you can implement daily. It is also important to seek out proper medical advice when learning about your condition.
There are actually many different types of arthritis, the one we are highlighting in this article is osteoarthritis (osteo = bone). Osteoarthritis is the most common form of arthritis and is what many people refer to as the “wear and tear” type. However, if you are experiencing joint pain there may be other types of arthritis you are dealing which such as rheumatoid, reactive, or psoriatic arthritis. Although these are much less common forms of arthritis it is important to rule them out as their treatment may differ slightly.
When dealing with the much more common osteoarthritis, one misconception regarding the condition is that it will inevitably progress and cannot be treated. Another is that the only treatments available are injections or surgery. There are many treatment options that can slow progression and improve symptoms. Understanding this is the first step to help you manage the condition and continue to do the things you love.
2. Do strengthening exercises regularly
Improving muscle strength is an important aspect of exercise as weakness is common in those with OA. Although pain is a barrier to begin an exercise program, enhanced strength has been shown to lessen knee forces, reduce pain, and improve function (1) It is important to incorporate both hip and knee strengthening exercises as these muscles are often affected when mobility is compromised. Completing strengthening exercises for the hip and knee 3 times per week has been shown to reduce or delay the need for total hip replacements in individuals with OA (2).
3. Improve aerobic/cardiovascular endurance
Aerobic exercises such as walking and cycling improve cardiovascular health which reduces the likelihood of developing chronic diseases related to aging. These exercises are also great for managing OA symptoms. Improving cardiovascular health allows our bodies to more efficiently use oxygen and circulate blood. This helps reduce inflammation and improve the ability to complete activities of daily living. Canadian physical activity guidelines for adults is 150 minutes of moderate to vigorous activity (3). Moderate to vigorous activities are those that increase breathing rate and may cause you to sweat. If you are currently not taking part in aerobic activities a great place to start is with daily walking. Walking is a low impact and convenient. Other low impact activities include swimming and cycling.
4. Consider weight loss
The National Institutes for Health and Care Excellence (NICE) guidelines for the management of OA include weight loss as one of its core treatments (4). Weight loss is a strategy for individuals who are overweight to self-manage and reduce symptoms. Losing weight can help reduce the load on joints which will help reduce painful symptoms. Weight loss also helps reduce inflammatory markers which can lead to decreases in pain and swelling and lead to functional improvements. Research has shown that a 10% decrease in body weight in overweight individuals can have moderate to large clinical improvements in symptoms (5).
5. Talk to your doctor/ pharmacist about medication
If you are unable to manage symptoms with non-drug treatments alone there are several medications your doctor or pharmacist may recommend. Over-the-counter topical analgesics are often first recommended for OA (6). This includes creams or gels which may contain non-steroidal anti-inflammatory drugs (NSAIDs), or ingredients that heat or cool the area. If the creams do not help, pain relievers in pill form, such as Tylenol or ibuprofen may be recommended. These can help reduce pain which will improve the ability to complete daily activities. It is important to note that these should not be used for an extended period without consulting a physician.
References
1. Fransen M, McConnell S, Harmer AR, Van der Esch M, Simic M, Bennell KL. Exercise for osteoarthritis of the knee. Cochrane Database of Systematic Reviews. 2015(1).
2. Svege I, Nordsletten L, Fernandes L, Risberg MA. Exercise therapy may postpone total hip replacement surgery in patients with hip osteoarthritis: a long-term follow-up of a randomised trial. Annals of the rheumatic diseases. 2015 Jan 1;74(1):164-9.
3. Csep.ca. (2019). [online] Available at: http://csep.ca/CMFiles/Guidelines/CSEP_PAGuidelines_0-65plus_en.pdf [Accessed 18 Sep. 2019].
4. Nice.org.uk. (2014). Introduction | Osteoarthritis: care and management | Guidance | NICE. [online] Available at: https://www.nice.org.uk/guidance/cg177/chapter/Introduction#guideline-update-2014 [Accessed 19 Sep. 2019].
5. Atukorala I, Makovey J, Lawler L, Messier SP, Bennell K, Hunter DJ. Is there a dose‐response relationship between weight loss and symptom improvement in persons with knee osteoarthritis?. Arthritis care & research. 2016 Aug;68(8):1106-14.
6. Badlissi, F. (2019). Osteoarthritis - Symptoms, diagnosis and treatment BMJ Best Practice. [online] Bestpractice.bmj.com. Available at: https://bestpractice.bmj.com/topics/en-us/192/management-approach [Accessed 18 Sep. 2019].