A promising new study suggests that walking could prevent knee pain for people with osteoarthritis.
Researchers surveyed more than 1,000 people aged 50 and over with osteoarthritis of the knee, the most common type of arthritis in the United States. Some had persistent pain at first, while others did not. After four years, those who started without frequent knee pain and walked to exercise at least 10 times were less likely to experience new regular attacks of stiffness or pain around the knees and had less structural damage to the knees. The study suggested that people with osteoarthritis of the knee who have bent legs could especially benefit from walking.
Research offers the potential for an easy and free way to combat one of the most common culprits of knee pain among older adults.
The findings represent “a paradigm shift,” said Dr. Grace Hsiao-Wei Lo, an assistant professor at Baylor College of Medicine in Houston and lead author of the study. “Everyone is always looking for some kind of drug. This highlights the importance and likelihood that osteoarthritis interventions may be something different, including good old exercise.” Research suggests that exercise may help control osteoarthritis in other joints, he added, such as the hips, hands and feet.
According to the Centers for Disease Control and Prevention, osteoarthritis, sometimes referred to as “wear and tear” arthritis, affects more than 32.5 million adults in the United States and occurs when articular cartilage ruptures and bone underlying begins to change. The risk of developing the disease increases with age, and about a third of people over the age of 60 suffer from knee osteoarthritis, Dr. Lo said. Many patients take medications such as ibuprofen or naproxen to treat the pain, he added, which can cause kidney problems and ulcers in large doses.
Instead, they may resort to exercise. For decades, health experts saw walking primarily as a way to increase cardiovascular health, said Dr. Elaine Husni, a rheumatologist at Cleveland Clinic who did not participate in the study. In recent years, however, doctors have sought low-impact workouts to treat conditions such as depression, cognitive impairment, and mild osteoarthritis. But the new study shows that walking can also act as a preventative measure, Dr. Lo said, and suggests that people who are most at risk for developing the disease may want to incorporate regular walking into their routine. For example, Dr. Lo herself said that according to her findings, she should walk more because her mother has osteoarthritis.
The study began in 2004 and documented participants ’initial knee pain, using x-rays to assess their osteoarthritis. Researchers then asked participants to document their exercise habits and review their symptoms at regular follow-up visits, asking them how often their knees hurt.
After four years, 37 percent of study participants who did not walk for exercise (excluding the occasional train ride or grocery store) developed new, frequent knee pain compared to 26 percent who walked.
Of course, researchers can’t definitively say that walking prevented knee pain and did not appear to reduce existing pain. Self-assessments may be less accurate than fitness trackers or step counters. And the researchers did not track how far or how often people walked, nor did they recommend strategies on how and when people with osteoarthritis should incorporate walking into their exercise routines.
However, the results reinforce what doctors already understand about how to manage osteoarthritis. Constant movement can help build muscle mass by strengthening the ligaments around the joints that have osteoarthritis, Dr. Husni said. Walking is a low-intensity, low-impact workout that allows people to maintain the strength and flexibility that are critical for healthy joints, he added.
“It’s an intervention anyone can do,” he said. “You have no excuse. You can do it wherever you are.”
However, those who are already in pain should be careful not to overdo the exercise, said Dr. Justen Elbayar, a sports medicine specialist in the Department of Orthopedic Surgery at NYU Langone Health who also did not participate in the study. Walking long distances can aggravate pain in some patients with severe arthritis, he said, but for those with smaller amounts of arthritis, “it’s one of the best exercises you can do.”
He recommends that people start with a short, short walk, gradually increasing the distance over time. The goal of the exercise is to provide muscular support to an arthritic knee, he said, and allow the joints, tendons and tissues to acclimate to gait.
He also suggested wearing running shoes, drinking plenty of water during a walk, and resting frequently if tired or new. After a long walk, freezing your knee can also help relieve discomfort, he added.
While a walk down the street can’t repair cartilage or cure existing pain, exercise offers a compelling and affordable option to avoid the more intrusive aspects of osteoarthritis, Dr. Lo said. After all, he added, “walking doesn’t cost a dime.”