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Archive for the ‘Lifestyle Modification’ Category

Heavy Impact

March 23, 2011

Osteoarthritis affects more than 10,000 Americans annually. This degenerative joint disease makes basic tasks incredibly painful for those with severe cases. New studies have shown that weight can play a big culprit in the on-set of osteoarthritis.

Doctors at the Johns Hopkins Arthritis Center have found that an obese woman of average height who loses 11 pounds reduces her risk of knee osteoarthritis by 50 percent. That may seem unlikely, until you look at the numbers. A 10 pound weight gain adds an increase of force on the knee by up to 30-60 pounds, per step. That means if you’ve added on 20 pounds it’s like you’re putting the force of an entire other person onto your knees. Simple tasks like exercising and taking joint supplements can help reduce the effects of osteoarthritis.



Knee OA

Knee OA

The Annals of Internal Medicine reported this month that Americans over 50 with knee osteoarthritis lose about 86 million “quality-adjusted life-years”.  A computer simulation called the “Osteoarthritis Policy Model” examined the effects of knee OA and obesity.  The simulation compared adults between the ages of 50 to 84 and divided them into four groups:  obese patients, patients with Knee OA, obese patients with knee OA, and people without knee OA who aren’t obese.

Obese patients with knee OA lose twice as many “quality-adjusted life-years” compared to the group that wasn’t obese and didn’t have knee OA.  The groups that faired the worst were black and hispanic women.  The authors of the publication wrote, “the disproportionate burden these conditions impose on black and hispanic women suggests that future studies should investigate tailoring prevention and treatment strategies to sex and racial or ethnic subpopulations.”



There are alternatives to taking medication for osteoarthritis. While there is no cure for osteoarthritis, many of the treatments we will briefly describe have been successful for people living with this degenerative condition. The first osteoarthritis treatment you may want to try is hot and cold therapy. Placing a hot compress to your joints will increase blood flow to the region and soothe inflammation. Applying a cold compress has a numbing effect on nerves that are sensitive to pain.

Another osteoarthritis treatment to try is a lifestyle change. Try changing your eating habits and kicking bad habits like smoking and drinking excessively. Increasing exercise will also help increase blood flow to your joints. Weight loss will also alleviate pressure on your joints since heavy people tend to stress their joints out faster than people in healthy weight ranges. These relatively minor, unobtrusive treatments can have a significant impact on the pain associated with osteoarthritis.



Avoid Surgery

Avoid Surgery

Dr. David Hunter from New England Baptist Hospital in Boston and University of Sydney in Australia recently published a study in Arthritis Care & Research.  “Quality of Osteoarthritis Management and the Need for Reform in the US” is research aimed at drawing attention to the fact that health care professionals in the United States often treat the pain and try to increase function in arthritic knees, but seldom try to improve joint structure or try to work with patients on long-term solutions.

The authors of this study recommend conservative treatment options for knee OA, especially avoiding pharmacological solutions.  “Weight management and exercise programs tend to be overlooked by clinicians,” said Dr. Hunter.  “These conservative approaches are beneficial to patients who adhere to weight-loss and exercise programs.”

The study examined prior research on treating osteoarthritis of the knee and found that up to 30% of surgeries are inappropriate!  And as we discussed on this blog arthroscopy should be avoided as a treatment option for knee OA – it doesn’t work yet orthopedic surgeons still perform the operation – every day.

Weight loss and exercise are the best treatment options for knee OA – how many more studies have to be conducted on the subject?  Joint health supplements, and knee braces are conservative treatments that will help you get up and moving.



Heart Healthy Diet

Corticosteroids are often prescribed for knee osteoarthritis.  This article is one in a series about the common side effects of this medication.

Steroids can increase the rate at which your arteries harden (atherosclerosis).  This could increase your risk of heart disease.  This risk is probably more likely if you are taking corticosteroids for more than twelve months or if you are taking a large dose.

Make sure your blood pressure and cholesterol are checked regularly.  Follow a heart healthy lifestyle.



OA Lifestyle

OA Lifestyle

This is a continuation of our series of articles from the American Academy of Orthopedic Surgeons’ Full Guideline for the Treatment of Knee Osteoarthritis.

Recommendation I – The AAOS suggests patients with symptomatic knee osteoarthritis take part in self-management educational programs and incorporate activity modifications into their lifestyle.

The evidence shows that self-management results in pain relief.  Making changes like walking instead of running, losing weight, and various lifestyle modifications will make knees feel better.



This is a continuation of our series on the Osteoarthritis Research Society International (OARSI) recommendations for the management of hip and knee osteoarthritis published in the Journal of Osteoarthritis and Cartilage.

OARSI - OA Education

OARSI - OA Education

Recommendation II

All patients with hip and knee osteoarthritis should be educated about their condition.

The focus of education for patients with knee osteoarthritis should be self-help and patient-driven treatments rather than relying on medical professionals.  The importance of lifestyle choices such as weight loss, diet, and exercise need to be stressed.  Also an emphasis on reducing the amount of drugs a patient takes is important.

This recommendation is based on expert opinion, common sense, and economic consideration.  The research team gave this osteoarthritis treatment option a Strength of Recommendation score of 97%.

W. Zhang Ph.D., Moskowitz M.D., et al. OARSI recommendations for the management of hip and knee osteoarthritis, Part II: OARSI evidence-based, expert consensus guidelines. Osteoarthritis and Cartilage. (2008) 16, 137-162.


Causes of OA

Causes of knee pain

It is estimated that women comprise 60% of the 27 million people in the United States that have osteoarthritis (OA).  Why?

Generally men will develop OA at a younger age than women.  But at 55 women begin to develop OA with an increased frequency and severity.  The reasons are biological, anatomical, and fashion related.

Women generally have a higher percentage of body fat than men.  So they carry more weight relative to their skeletal structures.  More weight means more wear and tear the knees absorb with every step.  Also researchers believe that estrogen helps protect cartilage.  At menopause when estrogen levels drop, so does the protection for the cartilage.  So as women age, their knees take more abuse with less protection.

In addition, women have wider hips than men and the tendons surrounding their knees are more lax.  The hourglass shape helps facilitate child birth but puts females at a bio-mechancial disadvantage to men in regards to how weight is distributed across their knee joints.

Fashion must also be figured into the OA equation.  Most men don’t wear high heels.  A Harvard study explained that high heels were shown to strain the knees and stress the surrounding anatomy.

Add genetics.  Heredity certainly plays a role.  There is a good chance that the daughter of a woman with Knee OA will have Knee OA herself.