Precautionary Measures
Recognize when to stop or slow down to prevent pain caused by exercising too much. Ask your doctor or physical therapist about how to use canes and splints. These and other devices can help protect and take pressure off the joints. Splints or braces keep the affected joint in proper position during sleep or activity and provide extra support for weakened joints. Splints must be used only for limited periods because joints and muscles need to be exercised to prevent stiffness and weakness.
Cane
Proper use of a cane -- in the hand opposite of the painful hip -- can reduce the forces that bear down on the hip joint by more than 550% (Brand and Crowninshield 1980).
Patellofemoral Taping
Patellofemoral joint osteoarthritis affects the joint surfaces between the thighbone and the kneecap. It is very common and can cause considerable pain and disability.
A recent randomized trial compared three methods of taping the knee in patients who had knee pain, difficulty walking, and trouble climbing stairs. Within four days, patients whose knees were taped so that the tape pulled the kneecap toward the inside of the knee had a 25% reduction in knee pain compared to those whose knees were taped in a way that pulled the kneecap to the outside or in a neutral position (pulling the knee neither inward nor outward) (Cushnaghan et al 1994). The study also showed that patients were able to apply their own tape after minimal instruction, giving them a low-cost and easy means of treatment under their own control. For instruction, your primary healthcare practitioner may refer you to a physiotherapist.
Management
Keeping body weight down, or reducing when body weight is too high, can greatly relieve the stress on weight-bearing joints. Overweight men and women have a substantially increased risk of knee osteoarthritis, and women have a slightly increased risk of hip osteoarthritis.
For men in their 20s, weight control appears to be especially important. Men in the highest one-third of the body mass index (BMI) had three times the risk of knee osteoarthritis as men in the leanest one-third (Gelber et al 1999). Although there are no experimental studies showing that weight loss is a means of reducing osteoarthritis symptoms and slowing the progress of the disease, it is prudent to slim down if you are overweight. In addition, there appears to be a general, perhaps metabolic, factor in obesity that increases the risk of osteoarthritis in all joints (Oliveria et al 1999).
In one study, a group of overweight women who saw an average weight loss of 11 lb. reduced their risk of getting osteoarthritis symptoms in the knees by about 50% (Felson et al 1992).
Physiotherapy
Physiotherapy, or physical therapy, has been found to be effective in reducing pain, increasing strength, and improving the ability to function (e.g., Fisher et al 1993). Physiotherapists assess your muscle strength, how far your joints let you move your limbs, how well you can walk, and how well you are able to be physically active. Based on this assessment, you can learn many useful techniques with physiotherapy, including how to:
- maintain or improve the range of motion in painful joints
- strengthen the muscles that support your joints
- use heat and cold applications to reduce joint stiffness and pain
- use your joints with as little discomfort as possible
- use shoe inserts, canes, braces, crutches, walkers, and other helpful devices
- use splints to rest a sore joint temporarily.
