Exercise has long been seen as the most effective non-surgical way of alleviating osteoarthritis symptoms. Yet a new study suggests that may not be the case. So if you’re suffering from osteoarthritis, what are you supposed to do with this information? YKC’s Nick London shares his opinion.
If you have osteoarthritis in the knee joint, knee resurfacing (aka a knee replacement) is the treatment that probably leaps to the front of your mind. But for numerous reasons, it’s definitely not the first recourse for knee surgeons.
All operations carry risks. It’s only when the benefits of having the procedure outweigh the risk of doing it that your consultant is likely to recommend partial or total knee resurfacing.
That doesn’t mean that there are no treatment opportunities between the onset of osteoarthritis and knee replacement, though. Painkillers, injections, physiotherapy, weight loss and more can all be effective in alleviating symptoms.
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The benefits of exercise?
To that, we can add one more non-operative ‘treatment’: exercise. Exercise has long been recommended to help minimise weight, strengthen the muscles around the knee and aid function (that is, keep the joint moving and help prevent stiffening up).
Arthritis Foundation still says, “Exercise is considered the most effective, non-drug treatment for reducing pain and improving movement in patients with osteoarthritis.”
But what if that isn’t true?
A new study published in RMD Open and reported in the BMJ Group has found that “the effectiveness of exercise therapy to ease the symptoms of osteoarthritis is likely minimal, short lived, and probably no better than no treatment at all.”
Recognising the frequency with which clinicians recommend exercise, the report adds: “An emerging body of evidence has questioned the extent and durability of its effects.”
Which begs the question, who’s right?
To exercise or not to exercise?
As in all things, there’s a degree of nuance in this. This is certainly an interesting study, but I have to balance these findings with my own experience.
I know many patients with significant arthritis that limits their daily activities and their quality of life who have responded to strengthening programmes when supported by expert, professional physiotherapists. It is equally true to say that the effect is often short-lived.
I would also suggest the general fitness of patients when they begin exercising is a factor. Somebody who is already exercising and, but for the osteoarthritis, is already fit and strong, is likely to find exercises aimed at their osteoarthritis to have very minimal effect.
In contrast, someone who hasn’t exercised for years, and who therefore has relatively poor musculature, may find exercise (when combined with standard weight-modifying activities) can have some effect in delaying the need for surgical treatment.
Walking aids may also support the effectiveness of exercise in osteoarthritis sufferers, whether that’s walking poles for an athletic fell walker or a simple walking stick, although it is for patients themselves to try all of the above and self-assess their effectiveness.
Try six to eight weeks of exercise
What this study tells me is they patients should try strengthening programmes for six to eight weeks. Then, they need to be honest with themselves. If exercise isn’t allowing them to get back to the activities that they wish to do, it’s worth seeking advice as to whether they’re approaching a time where surgical treatment is going to be more beneficial.
The broader benefits of exercise
It’s important to note that while the study questions the benefits of exercise in alleviating osteoarthritis symptoms, it doesn’t question the broader benefits of exercise – quite the contrary:
“Exercise does have other health benefits, and some patients may prefer it,” it acknowledges.
So there remains much benefit in exercise for your general health. But for osteoarthritis? It seems that is more of an individual matter. Try it over six to eight weeks. Try it under the supervision of a physiotherapist. But if it’s not working for you, please get in touch or phone us on 03453 052 579.
> Discover more about Nick London
> Discover more about osteoarthritis, symptoms & treatments
> Discover more about partial or total knee replacements
Prof. Nick London
Private appointments weekly at The Duchy Hospital Harrogate & Nuffield Hospital Leeds
What Is Osteoarthritis?
What does osteoarthritis look like? What are the symptoms? And short of surgery, how do you treat it?
What Is A Partial Knee Replacement?
As we explore here, your knee has three major compartments
Why YKC?
YKC surgeons perform more knee replacements than almost anyone else. Discover why that matters.