IS YOUR HEALTH CARE PROVIDER GETTING THE MESSAGE ON HOW TO TREAT KNEE ARTHRITIS? by Krista Leake PT, DPT, ATC
Knee osteoarthritis (OA) is a common formof arthritis that affects the knee and is commonly known as wear- and-tear arthritis.The prevalence of knee osteoarthritis (OA) in the U.S. has risen dramatically in the past several years. The amount of people diagnosed with knee osteoarthritis has nearly doubled in a 7-year period! KneeOA typically develops slowly andworsens over time. Knee OA is a major public health issue because it can cause pain and stiffness, reduce physical function, and diminish one’s quality of life. Several
low. If PT and Lifestyle interventions were emphasized at a more optimal rate in clinical practice, reliance on pain medication may reduce.” Why does this matter? Managing knee OA through lifestyle factors and PT may minimize the continuous need for pain medication and delay the need for knee surgery and other
professional medical organizations have developed research-based treatment guidelines that promote treatment without medication and surgery and recommend physical therapy (PT) and lifestyle modifications as first line treatment. Despite these guidelines being around since 1995, people that seek treatment from a physician are still largely treated with medications and are offered only symptom management. Is your health care practitioner getting the message? If you complain to your doctor about knee pain fromarthritis you aremore likely to get a narcotic or opioidmedication than offered PT and advice. PT and lifestyle interventions remain underutilizedwhile reliance on drug treatment, including opioids, continues to rise. A study published in the journal Arthritis Care &Research looked at what patients were offered at their medical appointments for treatment of knee OA. Visits to orthopedists and primary care physicians for knee osteoarthritis were reviewed and the authors tracked referrals to physical therapy, lifestyle counseling, and prescriptions written for NSAIDs (Nonsteroidal anti-inflammatory drugs) and narcotics (opioids) for an 8-year period. As time went on for the 8-year period, the trend was that patients were referred less to physical therapy, offered less advice on lifestyle changes, and there was an increase in prescriptions for both NSAIDs and narcotics. Rates of NSAID referralsmore than doubled and prescriptions for narcotics tripled. The authors wrote “In conclusion, PT and Lifestyle Counseling seem to be underutilized to manage patients with knee OA, with no trends in improvement over time, while painmedication use has significantly increased in this cohort.This contrasting trend suggests that knee OA is primarily managed from a perspective of symptom control and not from the perspective of improving physical function, fitness, and overall well-being. Even though PT and Lifestyle interventions for knee OAhave been included as part of guideline-based care as early as 1995, the utilization of these recommendations as recent as 2013-15 by physicians continues to remain Qr/HYHO+DUG Qr/HYHO+DUG VISIT A CENTRA LOCATION NEAR YOU!
invasive procedures such as knee injections. Long-termbenefits of PT and lifestyle changes reduce declines in health typically seen over time. Pain is a common symptom of knee OA and exercise has been proven by research to assist with pain management and improving physical functioning. It is all over the news that we are having an opioid crisis, so it is nice to know there are other options to helpmanage the pain. A study published in the Physical Therapy Journal found that manual therapy, the skilled passive movement of the joint provided by a physical therapist, is effective and safe for improving pain, stiffness, and physical function in knee osteoarthritis patients. Combining exercise and manual therapy was even better. The exercise and manual PT combined with traditional medical care was found to improve pain and physical function verses the group that just received usually medical care. The group that just received usual medical care only deteriorated significantly over the 2-year follow up period. Both nondrug PT interventions are safe and effective for people with osteoarthritis ranging from mild to severe joint degeneration. In addition, a review of 26 high quality studies found that various strengthening exercise programs that combined strength, coordination, balance and functional exercise were generally effective for improving knee osteoarthritis symptoms. Physical therapy was found to be beneficial in terms of reducing pain, alleviating stiffness and improving function in patients with knee osteoarthritis. If you are suffering from knee osteoarthritis don’t think that taking medication is your only option. There is a lot of research and evidence that certain lifestyle changes, exercise, and physical therapy not only help reduce the symptoms of pain and stiffness but that they will improve overall health and function. A physical therapist will design a program that is unique to you and assist you on getting on the right path to improve your quality of life. To schedule an appointment with one of our highly skilled physical therapists call 434.200.7600 or visit us at rehab.centrahealth.com. KWWS VXGRNXFRP Qr/HYHO+DUG
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