Physical activity level in patients with osteoarthritis

When we think of osteoarthritis (OA), we think of chronic “wear and tear” on a joint that has just plain worn out.  Many patients with arthritis become less and less active and that is actually the worst thing for an arthritic joint.

A study published in Arthritis and Rheumatism looked at the functional performance in 2589 adults with knee OA and found that there was a consistent relationship between physical activity level and better performance in these patients.

Patients with high self reported physical activity and a timed 20 meter walk test had better performance than patients who were not active.  Even a small increase in activity was related to better walking function.  Other studies have shown that active patients who engage in vigorous forms of exercise did not increase the risk of developing osteoarthritis of the knee.

We don’t know what causes OA.  It is the number one chronic disease and the most common form of arthritis. OA is characterized by a progressive loss of cartilage that is often accompanied by the development of bone cysts.  Swelling and stiffness occur and this causes pain when the joint is used.  It is undoubtedly genetic and is also related to obesity.  One wonders, however, if the weight gain came first or after,  since people with pain in their lower extremities (hips and knees) stop being as active.  Even small degrees of weight loss can help the symptoms, but it is hard to lose weight if one is sedentary so it is a vicious cycle.

What is important to preserve the joint and maintain good function is to continue to exercise.  A physical therapist can be invaluable in teaching exercises that do not load the joint but keep it mobile.  Building the muscle strength around the knee is critical, as is working on balance and  getting the extra weight off.  Even a 5-10 lb weight loss can make a huge difference on the joint load and help with pain and mobility.

If you have had pain, swelling and stiffness in your knees for 6 weeks or longer it may be Osteoarthritis.  Don’t ignore it.  Get it diagnosed and get with a good exercise program to keep your joints as healthy as possible.

Toni Brayer is an internal medicine physician who blogs at EverythingHealth.

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  • Anne Lawlor

    My 27 year old daughter has been diagnosed with osteo-arthritis, in both hips. She has 22q11 deletion syndrome (diagnosed at 15). She also got severe pain in her knee recently – turned out to be Osgood Shattlers.

  • http://ethicalnag.org/2011/01/15/osteoarthritis-treatment/ Carolyn Thomas

    Excellent essay, Dr. Toni. But it may be a hard sell convincing patients in pain to actually start moving those painful joints.

    A study reported in the January issue of the journal Arthritis Care & Research suggested that many doctors are disregarding standard medical guidelines to manage the joint inflammation condition of OA through lifestyle improvements (like EXERCISE or WEIGHT LOSS) – and instead relying on drugs and surgery.

    So is it the OA patient’s responsibility to get moving, or the physician’s to stop pushing drugs and surgery?

  • Gaby

    I have OA in my collarbone and it is mostly painful in the mornings when I first get up. I am of the camp that does not want to take medications, so I just deal with it. As the day progresses and I move my shoulder during normal activity, it is not as painful. After reading this, I think I will consider lifting weights. Thanks for the info.