Osteoarthritis (OA) is most common in the knees and hips, followed by other joints like ankles and hands. For many people, the diagnosis of osteoarthritis in one of their joints feels like a life sentence of inactivity and inevitable slow descent into frailty. Often, the diagnosis comes after several months or even years of increased joint pain, and some kind of loss of function that results in a doctor requesting an X-ray. Once the joint is shown to be damaged, there is a common thread of “well, do what you can!” and “If it hurts, stop”. Anti-inflammatory medications and other pain medications may also be prescribed, which can have little or no impact on current or worsening pain. Unfortunately, these common coping strategies often result in a downward spiral of function due to decreased use of the joint, weakening muscles and joint instability; all of which results in increased pain during movement. This combination causes the person to use the joint less and less and.….. You see where this is going.
What Has Changed? Over the past decade, there has been a movement to change both the mindset and the treatment of osteoarthritis. Scientists and therapists alike have become more aware of the mechanisms of joint maintenance and what we can do to conserve strength without risking any additional joint damage. The current research shows that the connective tissues inside the joints (i.e. meniscus, joint surface, etc.) are actually supported by movement and consistent loading and off-loading of the joint in low to moderate impact activities like walking and strength training serve to protect and maintain the joint’s integrity. This change in mindset is in large part attributable to a group of researchers out of Denmark. Over the last 5 years they have enrolled more than 30,000 participants in their research called GLA:D. These participants joined supervised exercise and education groups all over Denmark that were tailored to managing the symptoms of osteoarthritis of the knees and hips. Denmark is too far away for you to travel for OA management and that is why Bone and Joint Canada and The Arthritis Society have brought the training and certification program here to Canada and more recently, British Columbia to train Physiotherapists and Kinesiologists here at home.
But Moving Hurts! Most of us are conditioned to see pain as potential damage and for that we reasonably choose to stop doing whatever hurts, because it feels like we are doing more harm than good. However, the pain that is associated with osteoarthritis is more often related to weakness, instability and poor movement patterns, not increased damage to the joint. Ultimately, when done well, movement is a balm, not a bust.
So how can we get more active without intolerable pain? Since there is no known cure for OA, our best strategy is to manage the symptoms and improve function. As we said above, the best approach for treatment is NOT premature surgeries but treatment that includes specific exercises for strengthening, mobility and balance along with education. The GLA:D program provided by a trained Physiotherapist and Kinesiologist are best suited to guide you through specific and appropriate exercises to help you manage your symptoms and improve function. Following 7-weeks of the GLA:D exercise and education program, participants reported more than 25% reduction in symptoms when measured right after the program and 1 year following the programs completion. So by participating in the program you are likely to have long-term lasting symptom reduction. Participants also reported an overall increase in activity, reduction in pain intensity and use of pain killers and fewer lost days of work.
To learn more about hip and knee pain, check the Esquimalt Rec guide to see when we are offering our next free education session!