Non-Surgical management of Knee Osteoarthritis

It is estimated that 1 in 5 Canadians suffer from chronic pain. Of those, chronic knee pain is thought to make up 10%; almost 700,000 Canadians. Osteoarthritis of the knee joint is one of the most common causes of knee pain. Associated with this is not only the pain, but also other affects on one’s life such as disability, loss of function, loss of work and a lower overall quality of life.

Osteoarthritis of the knee joint is one of the most common causes of knee pain.

Earlier this year, the Osteoarthritis Research Society International (OARSI) published revised guidelines for the nonsurgical management of chronic knee osteoarthritis. They identified five core treatments which were appropriate for all individuals regardless of age, past medical history or other contributing factors. These recommended treatments included: land–based exercise, weight management, strength training, water-based exercise, and self-management and education.

1. Land-Based Exercise

Activities that included a combination of strength training, cardiovascular exercise and range of motion (movement) exercise have been shown to improve pain scores and physical function. These results can be noted after starting a routine, however, it is important that the routine is maintained for the benefits to be preserved. Another activity that showed improvement in pain scores was participation in regular tai chi classes. Tai chi is an excellent way to improve balance, focus and movement through the joints. Tai chi classes are available throughout the Lower Mainland and can be found at the BC Tai Chi Society.

2. Weight Management

Following a moderate weight reduction in overweight people, pain and physical disability has reduced. In order for this to be beneficial, patient’s need to lose about 5% of body weight in a 20 week period.  There is also evidence to suggest that maintaining a healthy body mass index (BMI) can decrease pain and increase function. Find out your current BMI with this calculator.

3. Strength Training

Strength training is another treatment that has been shown to reduce pain and improve physical function in people suffering from chronic knee pain. The strength training programs included resistant–based lower limb and quadriceps (thigh) strengthening exercises. Benefits were seen in both weightbearing and non-weightbearing exercises. There is currently no difference between individual or group programs.

4. Water-Based Exercise

Water-based exercise programs have been shown to improve range of motion and function of the knee joint. There are also noted improvements in the quality of life as reported by the person suffering from chronic knee pain. Only minor benefits were reported in reduction of overall pain scores. The Arthritis Society of British Columbia runs an excellent water based exercise program called Gentle Joints available at most local community centre pools.

5. Self-Management & Education

Self management refers to tasks that an individual must undertake in order to live well with a chronic condition. The tasks involved with self-management include; gaining confidence to deal with medical management, role management and emotional management. Self-management support empowers people to increase their skills and confidence in managing their conditions. Managing your condition includes regular assessment of progress and problems, goal setting and problem solving support. Self-management programs are available throughout the province of British Columbia and are free to participants and their families

Chronic pain is a condition that is very difficult to cure. With this in mind if is important to change the focus to managing the condition. Using the above techniques and combining them into your daily routine can help to maximize day to day function and improve quality of life. Living without pain is often difficult to achieve, however, you are able to control how WELL you live with pain.

Written by:
Dr. Aaron MacINNES, Anesthesiologist and Pain Specialist

Roland Fletcher, Registered Physiotherapist