Osteoarthritis: treating a mysterious disease with exercise

knee osteoathritisThis time I decided to write about a medical condition that will probably start destroying my joints as I get older. If you are still young and fit you probably have no idea what I am talking about, but if you are in your late forties, then you might be more familiar with the terms arthritis and osteoarthritis. Actually, osteoarthritis (OA) is the most common form of arthritis. It causes pain, swelling, and reduced motion in the joints. It can occur in any joint, but usually affects the hands, knees, hips or spine. It is commonly thought that OA is an inevitable part of getting older and this is quite true. OA usually develops in people over 45 years of age, although younger people can also be affected. Sadly, we know more about how to deal with OA than the pathology behind and how to diagnose the disease. Through this post I want to highlight some risk factors related to OA development and I will also try to present in short some exercise and lifestyle guidelines for people who are trying to deal with joint pain as a result of OA.

At the beginning of this year I had the chance to attend a very interesting lecture about the diagnosis of OA. Do you know what the main medical tool used worldwide for the diagnosis of OA is? The answer is X-ray scanning. X-ray scanning is fast and the cheapest method for OA diagnosis. But what they are not telling us is that X-ray scanning is actually a very inaccurate tool for OA diagnosis. Now, it is well documented that an X-ray might show that you are suffering from OA but in most of the cases this might be wrong. Many physicians and radiologists believe that magnetic resonance imaging (MRI) is a more accurate tool for OA diagnosis, but of course MRI is a much more expensive method. Actually, some of the best surgeons in the world operate on people with OA based on pain and not by taking into account the clinical tests. So, now you can start getting a better idea of what is happening. I don’t want to go into more detail on this, since scientists are still debating the best clinical examinations for OA, while the insurance companies refuse to pay more money. Therefore, once again it comes back to us, our lifestyle and how we are taking care ourselves. Going back to our main theme;

The main risk factors for osteoarthritis include:

  • Getting older
  • Joint injury
  • Being overweight

If you have not yet invented the drug for a long and healthy life then we have to forget the “getting older” risk and move to the remaining two. Actually the risks “joint injury” and the “being overweight” are interrelated. And from my point of view the last two are also related to the “getting older” risk anyway. I am saying this because I believe that by staying thin or at a normal weight we place less pressure on our joints (low injury risk), and therefore we keep our joints young. This is how I see all 3 main risks for osteoarthritis as interrelated. Actually, a review study done in 2007 showed that that disability could be significantly improved when weight was reduced over 5.1%, or at the reduction rate of 0.24% per week. Clinical efficacy on pain reduction was present, although not predictable after weight loss. Meta-regression analysis indicated that physical disability of patients with knee OA and overweight diminished after a moderate weight reduction regime. The analysis supported that a weight loss of 5% should be achieved within a 20-week period—that is, 0.25% per week. Consequently, we can support that body weight plays an important role in osteoarthritis prevention and pain relief.

I want to finish my post by giving some useful resources for people, who suffer from osteoarthritis. The new guidelines from the Osteoarthritis Research Society International (OARSI) recommend exercise treatments and lifestyle guidelines as appropriate for all individuals (listed in order from highest benefit-to-risk score to lowest): land-based exercise, weight management, strength training, water-based exercise, and self-management and education. For weight management, the OARSI guidelines make a specific recommendation of achieving a 5% weight loss within a 20-week period to be effective at treating knee OA.

Summing up, a physically active lifestyle, exercise and weight management are keys to minimizing the risk or the symptoms of osteoarthritis. And remember this; “soon, major evidence will relate osteoarthritis and metabolic syndrome and this evidence will change our entire approach to osteoarthritis as a disease”.

Since I am the first posting this year, I want to take the chance to wish you all a happy and healthy 2015! Stay tuned to the AAP blog because more interesting posts are coming up.

About Anastasios Rodis

Anastasios Rodis is an exercise physiologist at Aspetar Orthopaedic and Sports Medicine Hospital in Qatar. Anastasios holds a European Masters in Sport and Exercise Psychology (Lund Universitet, Sweden/Leipzig, Germany). He has also completed an M.Sc in Applied exercise physiology (University of Bangor, wales, UK) and a B.Sc in Sport Sciences (University of Portsmouth, UK). Anastasios has 15 years of athletic history in track and field. He has worked as a sport psychologist with elite Swedish swimmers. He has also efficiently cooperated as an exercise physiologist with Panathinaikos football club and worked with elite athletic teams, individual athletes as well as patients with musculoskeletal injuries. His main focus is the promotion of exercise and healthy lifestyle by using and combining both physical and mental techniques.
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