A promising new study indicates that walking may prevent knee pain in people with osteoarthritis (or osteoarthritis).
The researchers surveyed more than 1,000 people aged 50 or over with osteoarthritis, the most common joint pathology. Some had persistent pain at first, while others did not.
After four years, those who started without frequent knee pain and walked for exercise were less likely to experience periodic attacks of stiffness or pain around the knees and had less structural damage to them.
The study suggests that people with knee osteoarthritis who have bow legs may especially benefit from walking. The research shows the potential for an easy — and free — way to combat one of the most common culprits of knee pain among older adults.
The results represent “a paradigm shift”said Dr. Grace Hsiao-Wei Lo, an associate professor at Baylor School of Medicine in Houston and the study’s lead author.
“Everyone is always looking for some type of drug. This highlights the importance and the likelihood that interventions for osteoarthritis will be different with the inclusion of the good old exercise.”
Research indicates that exercise may help control arthritis in other joints, he added, such as those in the hip, hands and feet.
What is osteoarthritis
Osteoarthritis, sometimes called “wear and tear” arthritisaffects more than 32.5 million adults in the US and occurs when the cartilage in the joint breaks down and the underlying bone begins to change, according to the Centers for Disease Control and Prevention.
The risk of developing this disease increases with age, and about a third of people over the age of 60 have knee osteoarthritis, according to Lo.
Many patients take medications such as ibuprofen or naproxen to treat pain, which in large doses can lead to kidney problems and ulcers.
Those who are already in pain should not overdo the exercise. Photo Shutterstock.
Walk towards healthier knees
Instead, can resort to exercise. For decades, health experts viewed walking primarily as a way to improve cardiovascular health, said Dr. Elaine Husni, a rheumatologist at the Cleveland Clinic, who was not involved in the study.
In recent years, however, doctors have turned to low-impact exercise to treat conditions like depression, cognitive decline, and mild osteoarthritis.
But the new study shows that walking can also act as a preventative measure, Lo said, indicating that people who are at higher risk of developing the disease may want to incorporate regular walking into their routine. For example, Lo said that based on her findings, she should walk more since her mother has osteoarthritis.
The study began in 2004 and documented participants’ baseline knee pain using X-rays to assess for osteoarthritis. The researchers then asked the participants to document their exercise habits and review their symptoms at regular follow-up visits, asking them how often their knees hurt.
After four years, 37% of study participants who didn’t walk for exercise (not including the occasional walk to the train or grocery store) developed new and frequent knee pain, compared to 26% who did walk.
Obviously, the researchers cannot say with certainty that walking prevents knee pain, and does not seem to reduce existing pain. Self-assessments may be less accurate than motion trackers or step counters.
In addition, the researchers did not track how far or how often people walked, nor did they recommend strategies for how and when people with osteoarthritis should incorporate walking into their exercise routines.
However, the results support what doctors already know about treating arthritis. The constant movement can help build muscle massstrengthening the ligaments that surround joints with osteoarthritis, Husni said.
Walking is a low-intensity, low-impact exercise that helps maintain the strength and flexibility that are critical to joint health, he added.
“It’s an intervention that anyone can do,” he said. “There is no excuse. It can be done anywhere you are.”
However, those who are already in pain should be careful to do not overdo the exercisesaid Dr. Justen Elbayar, a sports medicine specialist in the department of orthopedic surgery at NYU Langone Health, who was also not involved in the study.
Walking long distances may exacerbate pain in some patients with severe osteoarthritishe said, but for those with milder ones, “it’s one of the best exercises you can do.”
He recommends that people start with a small and short hike, gradually increasing the distance over time. The goal of the exercise is to provide muscular support to the knee, she said, and allow the joints, tendons and tissues to acclimate to walking.
He also suggested using supportive footwear, drink plenty of water during the walk and take frequent breaks if you are tired or it is the first time you do it. After a long walk, icing the knee can also help ease discomfort, she added.
Although a walk down the street cannot repair cartilage or remedy pain existing system, exercise offers a compelling and affordable option to ward off the more intrusive aspects of osteoarthritis, Lo said. After all, she added, “walking doesn’t cost a dime.”
Dani Blum © New York Times
Translation: Elisa Carnelli