Learning how to help yourself is an important part of living with arthritis. The American College of Rheumatology recommends a valuable five-step plan for people who have osteoarthritis of the knee to help reduce your pain.
Slim Down
If you're carrying excess pounds, shed them for your knees' sake. Anyone with one bad knee not only is likely to make that knee worse by being significantly overweight but risks having the other one go too.
Even a modest amount of weight loss can cut pain dramatically - by as much as 50%. The pain abates partly by easing the load on the knee joint. But there are also other mechanisms that doctors still don't fully understand. For example, weight loss also reduces your risk of osteoarthritis in the hand!
Get Strong
Strengthening muscles that support the knee can also reduce pain - plus being stronger makes daily activities easier as well as more comfortable. The muscles you need to strengthen are the quadriceps in the front of the upper thigh. Weak thighs may contribute to osteoarthritis by increasing instability in the knees and impairing reflexes that normally protect knees from the jolts we incur with every step.
Discuss this exercise with your doctor:
- Sit up straight in a chair with your feet shoulder width apart. Place a folded towel under your knees so your toes just brush the floor.
- Slowly raise one foot - counting "1, 2, 3, up" until your leg is straight in front of you with your toes gently pointed back toward your body. Pause for a breath as you tighten and then release your thigh muscle. Then count "1,2, 3, down" as you slowly lower it to the floor.
- Do this five times for each leg.
- Over a period of weeks, build up to three groups of 20 repetitions each on both legs. And then build to doing it several times a day.
- Then buy yourself one-pound ankle weights - decrease your repetitions and only do what's comfortable.
Research has shown that quadricep muscle strength can be increased by 100% within six weeks even in the very elderly - and that reduces the pain of knee osteoarthritis.
Once you've got your thighs into shape, you will find other forms of exercise easier - so you can strengthen your whole body - walking, swimming, dancing, low impact aerobics. Discuss it with your doctor and then take your pick.
Check Your Daily Habits
Are you doing anything that could make your knees worse? Small changes sometimes make a big difference. If you're a regular walker, for example, but your route is along cement sidewalks, a simple switch to grass could dramatically cut the impact on your knees. Or if you're doing a lot of bending to reach items in low cabinets, moving them to higher locations can ease a lot of stress.
Get Help
If you need more exercise help and knee trouble is disrupting your daily life, ask your doctor to refer you to a physical or occupational therapist. These experts can teach you special techniques and offer extra helpers - perhaps some shoe inserts to correct walking problems caused by the arthritic knee or "knee bands" (elastic or leather supports) or more complex orthopaedic supports to steady and stabilize the joint. (However, if you see ads for simple rubber band-like gizmos that go under the knee, don't buy without checking with your doctor first. These are only useful when strained knee ligaments are involved - unlikely with osteoarthritis.)
Use Adaptive Devices
If all of the above have not given you enough help, don't turn up your nose at a cane. Nobody wants to use walking aids, but they can be an invaluable way to take weight off a painful knee. Again, a physical therapist can show you how to get the most out of them. For example, many people don't realize that canes are used on the side opposite the painful knee.
If all of these approaches, combined with a simple analgesic, don't free you of pain, it may be time to think about stronger drugs or surgery. Discuss it with your rheumatologist.
