In practice, many patients are referred to an orthopaedic surgeon when they complain of pain and an inability to perform their normal work or sporting tasks. Often, they are told that they are too good for a joint replacement and to return when their symptoms have become worse. This can lead to the perception that nothing further can be done - and that the patient must give up the painful activities.
This often leads them to become progressively more sedentary and, in many cases, gaining body weight; both leading to increased overall health risks.
We are often asked if someone should stop running due to some x-ray changes suggestive of arthritis to preserve their knees . If symptoms are manageable, we encourage them to keep some form of running in their life, as it has so many health benefits. In relation to recreational running and osteoarthritis risk, the risk of osteoarthritis and arthritis progression is higher being sedentary and a non-runner . This is largely due to the association of higher body weight plus the lack of impact forces, which can be cartilage protective. In a study looking at 125,000 people, only 3.5% of recreational runners had hip or knee arthritis; compared with those who were sedentary and did not run having a higher rate (10.2%) of hip or knee arthritis.
In reality, there are a large number of simple interventions that can have a huge impact on a pain. Education is an essential part of an effective treatment plan. It is important to explain that their symptoms may well improve with treatment despite them having an abnormal x-ray with some degree of arthritis. This is often very helpful as many assume that they will not get better and resign themselves to ongoing disability and inactivity.
Encouraging activity, even when it is a little painful, is almost always a good idea. Targeted rehabilitation programmes, which incorporate muscle strengthening and non or partial weight-bearing exercise, can be very effective treatments.
Weight loss is also a key strategy. Losing between 5-10% of body weight, generally though a combination of optimal nutrition and exercise, has been shown to reduce pain by approximately 50%. This compares with an average improvement of 25% with regular anti-inflammatory medication usage. Orthotics and braces can also help improve pain and allow patients to remain active.
As there are a large number of treatment options available it is important that a treatment plan is targeted to each individual patient and direct the overall management plan.
So, don t hang up the running shoes or give up on your goals just yet. You may have heard the phrase exercise is medicine and as with osteoarthritis this is true with education, exercise and an individualised plan often making a considerable difference to your daily symptoms and function.
