Osteoarthritis (OA) is the most common form of arthritis, affecting an estimated 302 million people worldwide, and is a leading cause of disability among older adults. The knees, and hips, are the most commonly affected joints. OA leads to pain, stiffness, swelling, and loss of normal joint function (2019 American College of Rheumatology/Arthritis Foundation Guideline for the Management of Osteoarthritis of the Hand, Hip, and Knee).

Recommendations for physical, psychosocial, and mind-body approaches for the management of osteoarthritis of the knee, and hip.

Strongly recommended: Exercise, Weight loss, Tai Chi, Knee brace (tibiofemoral knee brace), Cane, Self-efficacy and self-management programs.

Conditionally recommended: Yoga (for the knee), Cognitive Behavioral Therapy, Balance Training, Patellofemoral Braces, Acupuncture, Thermal Interventions, Kinesiotaping (for the knee).

Strongly recommeded against: TENS (transcutaneous electrical nerve stimulation)

Conditionally recommeded agaist: Modified Shoes, Wedged Insoles, Massage, Manual Therapy with / without exercise, Pulsed Vibration Therapy

Knee X-ray and Pain

Radiographs have long been considered as the reference standard for the assessment of OA, for more than four decades. To date, the majority of studies have reported that radiographic OA (ROA) is poorly correlated with knee symptoms, and most risk factors for ROA are not strong predictors of knee pain. Pain perception is complex, however, and knee pain is frequently associated with non-OA variables, such as psychosocial factors, education, economic statusas well as local pathology (Radiographic Knee Osteoarthritisand Knee Pain: Cross-sectionalstudy from Five Diferent Racial/Ethnic Populations 2018).

Running does not increase symptoms or structural progression in people with knee osteoarthritis – Tom Goom (Physio Network 2018)

We can help reassure such people that they can continue to run without fear and that it may even lead to improvement in sympom“.

The current research in OA suggests 3 important things:

  1. Arthritic change within knee joints is very common even in those without pain, for example a study from Geurmazi et al. 2012, found 68% of people with no pain had evidence of cartilage damage on MRI.
  2. Running doesn’t appear to increase the risk of developing hip or knee arthritis.
  3. Running with knee OA doesn’t seem to hasten disease progression or worsen symptoms over a period of time.

Prescribed Exercise For Knee Osteoarthritis Via Skype? – R. S. HINMAN et al. 2017, American College of Rheumatology ( article reviewed by Dr Jarod Hall, Physio Network)

Key points

  • The finding of this study demostrate that both patients and physical therapist had mostly positive experience using Skype as a service delivery model for physical therapist-supervised exercise management of moderate knee osteoarthritis (OA).
  • Patients and therapists found skype consultations for knee OA to be efficient, effective, empowering, and surprisingly personal.

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