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People with osteoarthritis don’t have to let pain stop them in their tracks

What you need to know

People with knee osteoarthritis (OA) often don’t get enough physical activity, despite its many benefits. It’s often thought that people with more knee OA pain are less active. A 2019 study challenged this view, finding no link between knee pain and daily walking. This highlighted that solutions beyond pain management are needed to help people with knee OA keep moving to improve their symptoms and live well.

What is this research about?

There’s a saying in arthritis care that “motion is lotion”, referring to the many benefits of physical activity on joint symptoms and mobility. For people with knee osteoarthritis (OA), staying active can improve pain and quality of life. But they’re often less active than their peers without arthritis. One explanation for this could be because their joints are more painful, leading them to avoid the very physical activity that could help them feel better in the long run. But the research evidence behind this popular opinion was unclear. 

What did the researchers do?

Trainee Anthony Gatti worked with Dr. Monica Maly and their team to study physical activity in people with mild to moderate knee OA for up to three years. They measured participants’ average steps taken per day using a device similar to a fitness tracker, and measured pain in two different ways using questionnaires. Then they examined the relationship between these multiple measurements over time.

What did they find? 

Contrary to popular belief, pain in the knee affected by OA was not connected to how much the participants walked. People who were older or had a higher body mass index (BMI) walked less, and there was more activity in the summer, as expected.

How can this research be used? 

These findings suggest that to keep people with mild or moderate knee OA moving, we need to address barriers beyond pain control. This research also reinforces that physical activity and education should be integral components in knee OA management – pain control is not the only piece of the puzzle.

This information can be used in the design of educational materials and programs to support people with knee OA in staying active. It can also inspire further research into how to address other barriers to participating in physical activity for people with OA, and whether the barriers are different in people with more severe disease and symptoms.

What impact could this have?

By informing strategies that empower people with OA to stay physically active, this research could help improve quality of life for millions of Canadians dealing with this disease. Staying active can lead to healthier joints, improved mood and sleep, and many other benefits. Lifestyle management strategies to reduce pain and improve mobility may help some people avoid the need for medications or surgeries.

About the researchers

Anthony Gatti was supported with an Arthritis Society PhD Salary Award, working under the supervision of Dr. Monica Maly, who leads the Mobilize Clinical Biomechanics Lab at McMaster University and the University of Waterloo.

Researcher Reflection

Photography o Anthony Gatti

To me, the exciting finding of this study was that people seem to continue their habitual activity levels, regardless of daily changes in pain. This indicates that to increase physical activity, we should target changing long-term behaviour by addressing barriers to access and providing sustainable support systems such as group-based activities.

–    Anthony Gatti, McMaster University

 

Real-world Reaction

I completely agree with the idea that staying active is crucial to maintaining good health and quality of life despite the disease. I’ve been living with rheumatoid arthritis and osteoarthritis for 16 years, and I’ve never stopped taking part in activities, all the while respecting my limits (swimming, walking, yoga and cycling). This did not prevent me from having a bilateral knee replacement, but it does help me preserve my joie de vivre and quality of life. Even in my current situation, I continue to swim and walk within the limits of my abilities. 

–    Anne-Marie Bonneau, Arthritis Society Online Consumer Panel Member

People with osteoarthritis don’t have to let pain stop them in their tracks

Publication citation

Brisson NM, Gatti AA, Maly MR. Pain is not associated with steps per day in persons with mild-to-moderate, symptomatic knee osteoarthritis - a mixed models analysis of multiple measurements over 3 years. Arthritis Care Res (Hoboken). 2019.