The Single Best Treatment for Osteoarthritis

Physical Activity and Osteoarthritis

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While it is difficult to speak in absolutes, most physicians would agree that the best initial treatment for osteoarthritis (OA) is physical activity. The research supporting the effectiveness of exercisey mostly comes from the study of knee and hip osteoarthritis. As with most discussions of treatments in medicine, this statement comes with many caveats. Most importantly, the positive benefits of physical activity apply to the mild to moderate OA, and may not be as applicable in the case of severe or end-stage OA.

Current research suggests that physical activity is effective as a prevention strategy for delaying the progression of OA. If your OA has already to progressed to the most severe form with end stage cartilage erosion, preventive strategies can no longer offer much benefit. However, in the case of mild to moderate OA physical activity can offer great relief. A study out of University of North Carolina by Dr. Yvonne Golightly found that exercise programs are on average as affective in relieving pain as non-steroidal anti inflammatory (NSAIDs) medications. Furthermore, a review of 16 articles describing recommendations for management of osteoarthritis found that 12 of the 16 suggest physical therapy as a cornerstone initial therapy.

Another important aspect to consider is that many people with OA often have other medical issues. If you suffer from obesity, high blood pressure, or heart disease, physical therapy offers benefit to all those conditions in addition to helping relieve pain from osteoarthritis.

Most treatment guidelines, in the United States as well as in other countries, emphasize physical therapy as part of the approach for managing OA.

Physical activity is strongly advocated by Alberta’s Bone and Joint Health Institute, Better Management of Osteoarthritis initiative in Sweden, Good Life with Osteoarthritis in Denmark, the U.S. Bone and Joint initiative and many more.

  While a strong consensus exists regarding how helpful activity can be in managing OA, many questions remain unanswered. The current studies vary widely with which activities are investigated. In general the recommendation is for low impact activity that can be water or land based. That means that walking, cycling and swimming can help with the pain of OA, but high impact activities such as running may do more harm then good.

Another important question is whether there is risk with physical activity? After all, OA is the “wear and tear” of your joints. Would increasing your activity speed up the wear? While current research has not provided a definite answer, a recent study suggests that increasing activity helps prevent or decrease OA. A study published in the January 2015 issue of Osteoarthritis and Cartilage looked at the relationship between the amount of activity that women reported during their late 40s and early 50s and the development of joint pain in their mid to late 50s. The study found that women that reported more activity in their late 40s early 50s on average reported less joint related pain in their mid to late 50s.

This study has a lot of limitations, it looked at only women, included information on self-reported activity (which may not be accurate), and the researchers looked at self-reported joint pain which may also not be accurate. Keeping all those limitations in mind, the study still suggests that the more activity that you can do the better. Recent studies have also advocated for stretching, range of motion, and flexibility exercises.

Starting a new exercise routine can be hard, but I hope the research in this article will encourage readers to get out there and start walking, hiking, cycling, swimming or anything else to keep your joints feeling better for longer. 

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