Hip and knee osteoarthritis: why exercise is the best treatment

Written by Ky Wynne, physiotherapist at LifeCare Prahran Sports Medicine

Osteoarthritis (OA) is a highly prevalent condition worldwide, and has a significant impact on the people who suffer from the condition. OA results from the breakdown of articular cartilage which can lead to swelling, pain, stiffness, and excess fluid in the surrounding tissue. The most common joints affected by the condition are the hips and the knees [1]. When discussing the impact of knee and hip OA, it is important to look at a number of factors including pain, quality of life and the ability to work.

Studies conducted on rates of sick-leave show significant differences between people with and without osteoarthritis [2, 3], which is displayed in the figures below (figure 1).

People without OA_Sick Leave.png
People with OA_Sick Leave.png

Figure 1. Statistics comparing working and not working percentage in people with and without OA.

Furthermore, individuals with OA saw a 28% increase in pain (figure 3) and severe pain was reported 4.3 times greater than those without [4]. Figure 3 highlights this disparity.

People without OA_Pain.png
People with OA_Pain.png

Figure 3. Statistics comparing levels of pain experienced in people with and without OA.

Qualified research, clinical practice guidelines, and the Australian Physiotherapy Association all advocate for exercise and education as cornerstones of hip and knee osteoarthritis treatment [1, 5, 6]. Recently, there has been a number of news articles about knee and hip osteoarthritis published on sources including ABC and the Sydney Morning Herald. These publications provide information in the mainstream media reflecting the current research evidence regarding appropriate management and treatment. Links to the aforementioned articles are provided in recommended reading below.

One of the current forms of evidence-based exercise rehabilitation for knee and hip osteoarthritis is the GLA:D® program. GLA:D® stands for Good Life with osteoArthritis in Denmark, and is an education and exercise program developed by researchers in Denmark for people with hip or knee OA symptoms [7]. The program is based upon the best available evidence in how to manage hip and knee osteoarthritis. Data from over 10,000 participants in the GLA:D® program in Denmark showed some of the following results [8, 9]:

  • 59% reduction in fear of physical activity and exercise
  • 39% reduction in sick leave
  • 34% reduction in analgesic / anti-inflammatory medication usage
  • 32% reduction in symptom progression
  • 26% reduction in pain at the 3 month follow-up

These statistics show that GLA:D® is a beneficial approach to hip and knee osteoarthritis treatment. GLA:D® has recently become available in Australia, with a number of LifeCare clinics offering the program.

Experiencing hip and/or knee pain? Book an appointment today with one of our qualified physiotherapists, simply click the button below. 

Recommended Reading

References

[1] Bennell, K. (2013). Physiotherapy management of hip osteoarthritis. Journal of physiotherapy, 59(3), 145-157.
[2] Schofield, D. J., Shrestha, R. N., Percival, R., Passey, M. E., Callander, E. J., & Kelly, S. J. (2013). The personal and national costs of lost labour force participation due to arthritis: an economic study. BMC Public Health, 13(1), 188.
[3] LaTrobe University (2016). The cost of arthritis to Australia’s workforce. http://semrc.blogs.latrobe.edu.au/cost-arthritis-australias-workforce-time-something/.
[4] AIHW (2017). How does osteoarthritis affect quality of life? Retrieved from http://www.aihw.gov.au/osteoarthritis/quality-of-life/
[5] Australian Commission on Safety and Quality in Health Care (2017). Osteoarthritis of the Knee Clinical Care Standard. Retrieved from https://www.safetyandquality.gov.au/wp-content/uploads/2017/05/Osteoarthritis-of-the-Knee-Clinical-Care-Standard-Booklet.pdf.
[6] McAlindon, T. E., Bannuru, R., Sullivan, M. C., Arden, N. K., Berenbaum, F., Bierma-Zeinstra, S. M., ... & Kwoh, K. (2014). OARSI guidelines for the non-surgical management of knee osteoarthritis. Osteoarthritis and cartilage, 22(3), 363-388.
[7] LaTrobe University (2017). GLA:D – Best first treatment for hip and knee OA. Retrieved from http://semrc.blogs.latrobe.edu.au/glad-training/
[8] Skou & Roos (2015). GLA:D® Annual Report 2015. Retrieved from https://www.glaid.dk/pdf/Annual%20Report%202015%20GLAD.pdf.
[9] GLA:D® Australia (2017). Home – GLA:D AU. Retrieved from https://gladaustralia.com.au/.