When Exercise Hurts

Many people with arthritis in their knees are advised that exercise can help them. Well, some might reply, it’s easy for you to say, but it hurts!

Although exercise therapy has been proven to be one of the best ways to treat knee arthritis, too many patients are unable to exercise because of the severe pain involved. What to do?

Recently, researchers in the Netherlands released a study that outlined a way for people with knee arthritis to regain their ability to exercise. They enlisted 49 participants: 42 women and seven men, with a median age of 64 and all rated 7 or above on the Numeric Rating Scale (a measurement that ranks pain on a scale of 1 to 10).

The therapy began with six weeks of analgesic medication such as acetaminophen, injections and NSAIDs (nonsteroidal, anti-inflammatory drugs such as aspirin, ibuprofen and celecoxib, sold under the name Celebrex). Following that six-week period, study participants took part in a two-part exercise program that lasted a total of 12 weeks. During the first six weeks, the patients had twice-weekly sessions aimed at building muscle strength and consisting of low-intensity exercise. In the next six weeks, the exercise intensity was increased and aerobic training (on a treadmill or cross-trainer) was added. Pain medications were used as needed.

Most of the patients (36) completed at least 80% of the exercise program. For those who didn’t complete the study, the researchers were unable to achieve sufficient pain reduction because the patients had especially severe arthritis symptoms. After the 18-week program of pain medication and exercise therapy, the researchers found improvements in pain were 30% from baseline and improvements in exercise ability were 17% from baseline.

The study, although encouraging, is considered preliminary because further studies are needed to more rigorously compare the dosages of the pain medications used. Nevertheless, the new research clearly demonstrates that people with painful arthritis really can exercise, and when they do, their pain decreases while their mobility increases.

Joseph Gustaitis is a freelance writer and editor based in the Chicago area.

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