Sunday, April 13, 2014

The Best Initial Treatment for Knee Arthritis (Part 1)

What is the best initial treatment for knee arthritis?

The answer is diet and exercise.

It isn't easy but diet and exercise are highly effective at reducing pain and improving function.  In a recent study of about 400 patients the combination of diet and exercise decreased pain scores by 45%.  This is impressive because most injection therapies improve pain by 30-40% and often only last 6 months.  This study showed benefits up to 18 months.   Patients who also completed both a diet and exercise program were able to walk 136 feet more than patients who only dieted during a 6 minute walking test. (Messier et al JAMA 2013)  This is a simple and inexpensive way to treat a problem that affects 10 million Americans and millions more worldwide.

Too often patients and clinicians fail to select this strategy.  Patients often do not recognize how overweight they are and may even get angry if their physician points it out to them.  Physicians lack the time and tools to appropriate help patients begin an diet and exercise program.  With 69% of Americans either overweight or obese, it is very likely that weight reduction should be part of most knee arthritis treatment plans.

So, here are some suggestions to get started.
(Always check with your own physician before beginning any program.)

Give your knee a pain rating from 0-10 overall as a baseline measurement.

1.  Weight yourself and calculate your Body Mass Index.  (BMI Calculator)
     Be honest about the weight.  Record your weight daily.

2.  Set a goal to lose 5 pounds in two months and KEEP IT OFF.

3.  Lose weight by trying the One Less Diet (TM)
     One less dessert, one less sugary soda, one less beer, one less bagel, etc
     Use any other safe and effective means to lose weight.

Weekly, update your pain rating for your knee.  After two months, compare your baseline weight and pain to your new weight and pain.  You may find that if you simply lose weight your knee will begin to feel better.  The side effects of losing weight will also be good for your heart and your waistline.

In the next post, we will discuss a simple exercise plan.


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