Osteoarthritis: Exercise as Medicine
For people with hip and knee osteoarthritis (OA), high-quality research shows that exercise therapy is very helpful in decreasing pain and improving movement in these joints. The phrase, Exercise as Medicine, has been used for some time – but not just for OA, for some twenty five other long term health conditions too.
OA is the most common cause of arthritis and a major public health problem. It was first thought of as simply ‘wear and tear’ affecting cartilage within joints. Common misbeliefs focused solely on mechanical (load-related) or occupation-related reasons for these joint changes. However, our knowledge of this condition has advanced considerably.
OA is a condition mediated by and affecting the entire ‘synovial joint organ’, which means it affects much more than just cartilage. It includes not only fibrocartilage and hyaline cartilage, but also the bone below this area (subchondral bone) and the soft tissue which lines the joint (synovium). More recently, a central theory of the cause of OA is that of chronic, low-grade inflammatory processes not only promoting OA symptoms, but also accelerating OA progression.
Many risk factors come into play when considering the cause of OA, as outlined in the Arthritis Research UK information leaflet.
Exercise as Medicine
It is widely known that exercise should be an integral part of standard care for people with knee and hip OA. Raising your physical activity levels is effective in achieving good outcomes.
Exercise should consist of:
There are also many other important non-surgical treatment options available to those who suffer with OA.
At Physioimpulse we have a Gait analysis and Biomechanic assessment service which enables us to assess your foot mechanics and create custom made insoles to reduce the pain of OA affected joints and enable more effective rehabilitation.
Some people struggle to exercise efficiently due to high pain levels so we also provide Ostenil injections which"lubricate" the joint and can provide up to 9 months of pain relief.
Other Non-Surgical Treatment Options
Here at PhysioImpulse, we want to support you to keep active and manage your OA as best able.
Take home Message:
Stay active and exercise!
Arthritis Research UK (2018) https://www.arthritisresearchuk.org/arthritis-information/conditions/osteoarthritis.aspx [Accessed online 2nd September 2018]
Exercise Is Essential for Osteoarthritis: The Many Benefits of Physical Activity Journal of Orthopaedic & Sports Physical Therapy, 2018 Volume:48 Issue:6 Pages:448–448.
Liu-Bryan, R. and Terkeltaub, R., 2015. Emerging regulators of the inflammatory process in osteoarthritis. Nature Reviews Rheumatology, 11(1), p.35.
Osthoff, A.K.R., Niedermann, K., Braun, J., Adams, J., Brodin, N., Dagfinrud, H., Duruoz, T., Esbensen, B.A., Günther, K.P., Hurkmans, E. and Juhl, C.B., 2018. 2018 EULAR recommendations for physical activity in people with inflammatory arthritis and osteoarthritis. Annals of the rheumatic diseases, 77(9), pp.1251-1260.
Pedersen, B.K. and Saltin, B., 2015. Exercise as medicine–evidence for prescribing exercise as therapy in 26 different chronic diseases. Scandinavian journal of medicine & science in sports, 25, pp.1-72.
Physioimpulse Chartered Physiotherapists