Osteoarthritis of the knee- it’s not wear and tear

I am currently prepping my webinar for later this week on osteoarthritis (OA) of the knee and I thought that it would be good to share some thoughts and my expertise on this area for my readers.

OA knee is very common and as the population ages we will see more people developing this condition. Age does not necessarily mean that you will develop arthritis- and we know that arthritis is multi-factorial in its nature. We also know that the world has an increasing obesity issue and this is going to worsen over coming decades with people living longer. Obesity may have a double negative and detrimental affect on joints- including the knee. Firstly the mechanical affect of being overweight increases the amount of loading through the knee joint- this can increase the risk of developing OA as well as increasing its progression once established. We know from studies that weight loss is the most effective treatment for OA knee- even a few kilos can make a significant difference. Exercise of course is very important for our health and can help weight loss. However, in my experience with patients it is diet and calorie control that is most needed to achieve sustainable weight loss. The other mechanism that obesity can affect our joint health by is that of inflammation. Obesity is associated with inflammation and a higher level of inflammatory chemicals- these may also lead to cartilage breakdown and subsequent OA.

Of course weight loss is important in itself- but also a diet should be ant-inflammatory in nature to help our joint health. The western diet is very high in processed foods and often has a poor balance in omega fats. The resultant inflammation is not only bad for joints but may be associated with many chronic health issues- heart disease, diabetes and cancer to name a few. Therefore avoiding processed foods and eating a healthy diet is so important. In addition some of my patients will also take specific food supplements. One of the most widely used is turmeric (curcumin is the active ingredient)- up to 1000mg per day is usually advised as a supplement in addition to normal dietary intake. In some Asian cuisine where turmeric is used more often, a lower dose of supplement is advised.

So what about exercise and OA knee? Running is bad for your knees isn’t it?

Well actually no it is not. There is no evidence that running increases your risk of OA of the hip or the knee in the vast majority of people. For very elite runners who do a very high mileage each week there may be a possible slight link to OA hip but for 99.99% of us this does not apply. In fact studies have shown that exercise- including running- is good for arthritis- and not just because of possible weight loss effects. Exercise is good for us as it reduces inflammation in our body. This means it can help arthritis plus a whole multitude of chronic diseases including cancer, high blood pressure, diabetes, stroke and heart disease. Exercise is also hugely beneficial for mental health too.

In summary, OA knee does not inevitably mean it is wearing and tearing- leading to definite need for knee replacement. Our joint health is under the influence of many different factors. Keep exercising to prevent its onset and even if diagnosed with OA -many forms of exercise are still possible. Eat healthily to ensure that you reduce inflammation in the body and ensure not just quantity of life, but quality of life too…

Dr Michael S.Burdon

Consultant in Sport, Musculoskeletal and Exercise Medicine

July 2020.

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