By McKirven Ceus, MD | Sports Medicine & Family Medicine
Osteoarthritis is a chronic degenerative joint disease that affects millions of people worldwide. It is a slow progressive destruction of cartilage and bone that can cause significant pain, stiffness and decreased function. It generally occurs in people over 50 years old and the risk increases with age. The knee, a weight bearing joint, is the most commonly affected joint due to the constant forces that it has to endure over time. Unfortunately, there is no cure for knee osteoarthritis. The most definitive treatment is having a surgery to replace the knee joint with a prosthetic. However, there are different treatment modalities that can be done to help provide some pain relief and prolong the need for surgery or even avoid it all together.
Some of these treatment modalities include pharmacologic treatments such as acetaminophen (Tylenol) and nonsteroidal anti-inflammatories (NSAIDs) which include ibuprofen and naproxen. Tylenol is considered first line for osteoarthritis because it has fewer side effects and can help decrease pain. NSAIDs have an anti-inflammatory component that not only decrease pain but decrease the inflammation associated with osteoarthritis.
Weight loss in those who are overweight can also help treat knee osteoarthritis. Decreasing the pressure on the knee joint with just a few pounds of weight loss has been shown to improve both pain and function. Therefore, cardiovascular exercise and healthy dieting are highly encouraged in the management of knee osteoarthritis. Your sports medicine physician can prescribe an exercise regimen and help you with nutritional guidance.
The knee pain caused by arthritis can unfortunately be a double-edged sword. Exercise is medicine for the knee, but it can also be too painful to exercise. High impact exercises like jogging may be unbearable. Low impact exercise such as water aerobics and riding an exercise bicycle are highly recommended because they avoid the excess pressures on the knee and are less painful as a result.
Many patients and doctors a like do not realize the potential benefits of physical therapy. Quite honestly, among all the different therapeutic treatments for knee osteoarthritis, physical therapy can be the big difference maker. There are many treatment modalities within the scope of physical therapy such as strength training, flexibility training, manual therapy, aquatic therapy and electrical stimulation. The ultimate goal is to increase a patient’s quality of life through less pain and increased mobility. According to research, the best results are obtained with a physical therapy regimen of 3 times per week for at least 4 weeks. A physical therapist can provide a list of home exercises that can be done on days that you are not having supervised physical therapy. After physical therapy, it is important to continue doing some of these exercises regularly for ongoing benefit.