Please Knees, Don’t Seize! – Preventing Osteoarthritis

2009-10-05 | |
Last updated: 2009-10-05

With no respectable doctor having yet revealed a means of stopping the aging process, all of us are, at this moment, getting a little older. No kidding, you say… As we age, we all start to slow down and feel an increasing number of aches and pains, but for many people who develop osteoarthritis, there is more pain and stiffness than normal associated with maintaining a reasonable level of mobility.

Osteoarthritis is the most common form of arthritis and the risks of developing the condition increase as we age. However, it is not a disease caused by age. Instead it is the result of changes in the way our bodies create the cartilage that caps the ends of each of our bones. For some people, their bodies become less effective at making good quality cartilage that is thick enough to cushion the joints and smooth enough to allow the ends of the bones to move against one another with little friction.

When the joints are unable to move fluidly, pain can result and small pieces of cartilage can break off and float around in the joint of the knee causing irritation to the joint similar to having a rock in one’s shoe. As well, with the thinner cartilage on the ends of the bones, any irregularities in motion caused by weaker muscles or by odd shapes to the ends of the bone themselves can cause the cartilage in our joints to be worn out faster than our bodies can perform repair.

Of the joints affected by osteoarthritis, those that carry the most weight usually feel the effects of cartilage breakdown most quickly. These include the spine, hips, knees and feet.

Of these weight bearing joints, the knees are very commonly a source of problems for many people with as much as 12% of the population over the age of 60 having symptoms of osteoarthritis in the knee. As a result, in Canada, more than 38 thousand knee replacement surgeries are performed annually to deal with the problems of knee osteoarthritis. In the US, UK, and Australia, the numbers of knee replacement surgeries are 500 thousand, 65 thousand and 20 thousand respectively. The net effect of all these surgeries is a cost of tens of billions of dollars to our health care systems and of course to us.

Needless to say, there is a considerable industry behind knee replacement surgery and the options for replacement knees are many. However, in a significant number of cases, early preventative actions can avoid the need for this surgery. Unfortunately, far less funding is directed at prevention of the condition than treating it once it develops.

With that said, there is a growing body of evidence that surgery can be avoided and it is important for all us to be aware of the actions we can take. One study completed at the University of Melbourne found that regular cardiovascular exercise of as little as 20 minutes per week was sufficient to increase the amount of effective, defect-free cartilage in the joints. This is important because this level of activity is not a significant effort and yet may prevent the need for major surgery.

Another study that also suggests that surgery can be prevented was published in the Annals of Internal Medicine. In that study from 2000, the researchers found that physiotherapy and monitored exercise performed twice per week were able to improve the combined measurement of mobility, decreased pain and decreased stiffness of patients by more than 55%. From this overall improvement, we see that another option exists that enables patients to live with less pain and greater mobility without the need for surgery.

Lastly, in another study, published in the Osteoarthritis and Cartilage Journal, researchers found that weight loss of only 10% in obese patients improved the ability to use the knee by 28%. These findings suggest that the amount of excess weight we may carry can have a significant effect on the ability of those with osteoarthritis to retain mobility. This provides yet another compelling reason to avoid excess weight and to seek medical assistance if our own efforts are not successful.

One final factor that also needs to be addressed for prevention to be effective is for patients to take an active part in recognized knee pain and taking action. A study completed in the UK by the Hip and Knee Network found that 55% of those with knee pain had endured it for more than a year while some 22% had suffered from knee pain for more than 8 years without seeking assistance to resolve their knee pain. This is in a country with public health care. It is conceivable that in the US where there is the additional barrier of personal financial costs to seeking treatment that this number could be even higher.

These findings reiterate the need to communicate that it is of course impossible for the doctor to treat anyone who does not make their concerns known. If you are feeling knee pain, or any pain for that matter, let your doctor know as soon as possible.

While this article has talked about prevention, there is of course a great number of people for whom the damage in the knee is past the point of prevention. In another article, current and future surgical options will be covered.

Do you have knee pain? Have you had knee replacement or knee repair surgery? Were you ever told of the prevention option available? Share your story with others in the health forums or in comments here.

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Category: Disease Information, Disease Prevention, Health Risks

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