Despite high quality evidence supporting exercise as a first line treatment for the management of osteoarthritis (OA) symptoms, typical management continues to prioritize short term strategies such as injections, medications, and/or surgery.
Exercise and OA by Cameron Faller
With OA resulting in a significant burden to both individuals and our society, long term solutions are pertinent. This new article dives into the concepts of why exercise can be beneficial for the management of OA which should shift our mindset towards conservative management first.
OA has been considered a whole person disease as two-thirds of people with OA also have chronic conditions resulting in low-grade systemic inflammation.
Locally, OA can increase peripheral sensitivity decreasing muscle strength, neuromuscular control, and loading tolerance in the joint.
Systemically, OA results in increased inflammatory biomarkers leading to higher states of pain and disability.
Exercise has been shown to improve peripheral structures such as cartilage health, muscle strength, and neuromuscular control which all add into improved tolerance to mechanical loading.
Centrally, less clear evidence exists, but points towards an overall improved response of endogenous inhibition of pain and decrease of systemic inflammatory biomarkers. Stronger evidence supports that exercise has been beneficial towards weight management in which reduces the cumulative loading in arthritic joints.
12 supervised exercise sessions have consistently shown the greatest benefit towards management of symptomatic OA. This further highlights the importance that conservative management can have in reducing the overall health care costs and improving the quality of life in individuals dealing with arthritic pain.
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