Mobility as Medicine: Strategies for Staying Active with OA Knee Pain

​It's a saying you have heard time and again: exercise is the best medicine. But if you have been diagnosed with osteoarthritis (OA), you may be wondering: are there strategies for staying active with OA knee pain? 

For everything from heart disease and high blood pressure, physical activity can play a pivotal role in helping the signs and symptoms of many common health problems. So, while it may seem tempting to stay at home on the couch, instead of taking a brisk walk or swimming a few laps, the long-term benefits of exercise tend to significantly outweigh the short-term discomfort. 

In fact, the U.S. Arthritis Foundation says exercise is the most effective non-drug treatment for reducing pain and improving movement in osteoarthritis. That's a hopeful message for  the approximately 27 million people who are living today with OA, including 14 million people who are living with the disease's most common form, knee OA. 

So, whether you were an athlete when you were younger, are still actively working out today, or never have been one to work out regularly, exercise can benefit the body, mind and spirit. 

Think of it this way: to help your knee OA pain, try using mobility as medicine.

Understanding Knee Osteoarthritis

Osteoarthritis (OA) is a painful condition that affects millions of people around the world. In fact, it is the leading cause of disability in Americans over age 65. Since the 1990s, the number of people with knee OA has tripled – and many are much younger. Today, the average person diagnosed with knee OA pain is just 56. 

While there is no single cause, OA is primarily caused by wear and tear on the joints. It tends to occur when the protective cartilage at the end of bones breaks down, resulting in pain, bone spurs, and swelling in the joints. 

Depending on your level of pain, disability and joint damage, you may be diagnosed with mild, moderate or severe OA.

And, although knee OA is extremely common and affects millions each year, there is still no proven treatment that can "cure" the disease. Some of the more popular approaches to treating OA knee pain include taking pain relief medications, using assistive devices such as the Unloader One® from Össur – a medically-prescribed knee brace – and exercising.  These approaches can be used together or separately.

Do Medications Work?

Many people seek relief for their OA knee pain by taking over-the-counter or prescription painkillers.

Doctors generally recommend starting with the mildest possible painkiller, but because OA is progressive, pain can grow over time. And no medication is 100% safe –whether prescribed by your doctor or bought directly in a retail pharmacy or market, pain medications can damage your internal organs if continuously taken for long periods of time. 

More importantly: are painkillers effective long-term for treating OA knee pain? 

Not always. A study of OA patients in France, Germany, Italy, Spain, and the UK found that nearly 75% of patients reported taking either prescription or over-the-counter medication, but only 30% of these patients reported satisfaction with the effectiveness of their OA medication.

There's another important concern:  heavier-duty prescription painkillers can pose a very real risk of developing a dependence or addiction. People may be especially susceptible to becoming dependent on painkilling medications known as opioids. According to the National Institute on Drug Abuse, highly addictive opioids include prescription medications such as oxycodone, codeine, fentanyl and morphine, as well as "street drugs" such as heroin.

Drug overdose deaths involving prescription opioid pain relievers have increased dramatically since 1999. Now, an estimated 116 Americans die from opioid overdoses every day, including at least 40 who die from prescription opioids.  The U.S. government has even called it "an epidemic." It also reports that nearly 80% of heroin users reported misusing prescription opioids prior to using heroin.

Not everyone will necessarily develop a prescription opioid addiction, but these figures are very startling. The bottom line on medications: talk with your doctor before you start taking any pain medication on a regular or daily basis. 

Unloader Bracing: A Biomechanical Solution to a Biomechanical Problem

Given the potential risks and side effects associated with painkiller medications, many people are seeking entirely different alternatives to stay active despite OA knee pain. 

A growing number are finding relief through osteoarthritis bracing, such as the Unloader One from Össur. Clinical studies have shown that people wearing unloader braces, which are designed to anatomically "unload" the bone-on-bone contact within the knee joint, have experienced reduced pain, and an increase in general health and function.

Another great perk? In a recent study, 35% of patients reported reducing their use of prescription and over-the-counter pain medications.

These are some of the reasons that professional medical societies like the Osteoarthritis Research Society International (OARSI) report that OA knee braces are effective in providing pain relief associated with knee OA and misalignment. The doctors who wrote the OARSI guidelines recommend that people try bracing before more extensive measures, such as total knee replacement (TKR) be considered.

Recommended Strategies for Staying Active with Knee OA Pain

So, whether you're training for your next half marathon, want to more comfortably walk the links during your weekly golf game, or just shopping without worrying about whether you can make it back to your car, talk with your doctor and medical team to identify the right regimen of treatment and physical activity for you. 

Try setting a goal of staying active and exercising on a regular basis, which will help strengthen your muscles and stabilize your joints. Here are some additional recommendations from the U.S. Arthritis Foundation: 

• Focus on three types of exercises: Flexibility, Endurance, and Strengthening

The U.S. Arthritis Foundation recommends that you focus your activities on three specific categories: 

1. Exercises involving range of motion or flexibility – such as gentle stretching
   
2. Endurance or aerobic exercises – such as jogging or swimming
   
3. Strengthening exercises – such as light weightlifting
   

• Try specific exercises considered beneficial for knee OA pain

The Arthritis Foundation also recommends these six specific exercises for people dealing with knee OA pain:

1. Mini squats
   
2. Quad stretches
   
3. Standing back leg slides
   
4. Forward knee bends in chair
   
5. Back knee bends in chair
   
6. Hamstring stretches
   

• Make healthy eating part of the solution

In general, being overweight is a risk factor for developing osteoarthritis. But carrying even a few extra pounds can make a difference - according to experts at Johns Hopkins, being only 10 pounds overweight increases the force on the knee by 30 to 60 pounds with each step. 

Work with your doctor or nutritionist to create a healthy eating plan. And remember that staying physically active coupled with maintaining a healthy body weight may help relieve stress in knee joints and help maintain greater muscle and joint flexibility. Plus, this can boost your mood and energy levels, thus improving your day-to-day quality of life. 

• Do things you enjoy

Whether you love salsa music, polka, or good old rock 'n roll, crank it up! Dancing is a great way to get moving.  If dancing is not your thing, try walking more. You don't have to scale Everest; a stroll around the block can do worlds of good. And you don't have to do it alone – on any given day, thousands of people are participating in programs like Silver Sneakers or Nifty After Fifty. Who knows? You might improve your mobility and build lasting friendships.

• Make mobility a daily practice 

Committing to eating well and exercising regularly is no easy feat – especially when you have a family to feed and laundry to fold, but if you aren't healthy and pain-free, you won't be much help to your family. Create a plan that you can turn into a routine, then stick with it. You deserve it, for yourself and for your loved ones.

• Keep track of your progress

It might also help if you set goals and track your progress, because a little accountability can go a long way toward helping you reach your fitness goals. Consider sharing your goals with a friend or family member and consider whether you want to start recording your activities in a fitness tracking app on your smartphone, watch, computer, or even a written log. 

No matter what approach you choose to stay mobile, the bottom line is: just like taking your daily vitamins or medications, you need to stay consistent in your daily physical activities to gain the greatest benefits.

Because when it comes to knee OA, there's another old saying that applies: use it or lose it. Doctors agree: the stronger the muscles around the joints are, the more they can take the strain and prevent excess load on joints such as the knee. And the less active you are, the less active you are likely to be on an ongoing basis, which only further magnifies the disability from knee OA pain. 

The best news is: You can start using mobility as medicine today.