Did you know that over 10% of Americans between the ages of 25-75 years have Osteoarthritis (OA)? It is actually the most common joint disease in the world. Some of the common risk factors for OA include increasing age, obesity (especially in the knee), and female sex (particularly in the hands and knees). Symptoms include pain, cracking of the joints, joint swelling, and functional limitation with decrease in the range of motion.
Non-pharmacological therapy includes various options including some that are home-based and low cost.
Exercise and physical therapy have a huge impact on OA. They have shown to decrease symptoms, improve function, and overall quality of life. The focus should include range of motion, aerobics, muscle strengthening and flexibility. Data from the national health and nutrition examination survey reveals that obese women had four times the risk of knee OA compared with non-obese women. For men, the risk increased to almost 5 times. Exercise also helps in weight reduction, which in itself may decrease disease progression in patients who are overweight. A win-win situation The Framingham Study reported that for a woman of normal height, for every eleven pounds weight loss the risk of knee OA dropped >50%. A recommended weight loss is 1-2 lb a week. More than that can be unsafe, so please be careful.!
Nutritional products such as glucosamine and chondroitin have yielded mixed results in studies that were conducted. Although, a report from the National Institutes of Health did suggest that glucosamine and chondroitin did not prove better than placebo in decreasing pain in most patients. But it is if the patients were suffering moderate to severe knee pain.
Education also serves as an important non-pharmacological therapy. Programs such as The Arthritis Self-Management Program have resulted in improvement and overall well-being of patients with OA. The program includes sessions focusing on various components including information about disease progression, medications, cognitive behavior techniques and much more. These programs are usually organized by the national arthritis foundation and more information can be found on their website.
Other therapies that may prove useful include minimizing wearing high-heels, insoles, assistive devices and bracing.
Many non-pharmacological therapies serve as adjuncts to pharmacotherapy. Before attempting any of the above, please discuss the various options with your healthcare provider.
Kanika Monga, MD, a graduate from the University of Texas- Austin and Paul L. Foster School of Medicine, is an Internal Medicine resident at the University of Texas Houston. She is also a recipient of AMA’s National Leadership Award.