Moderate Exercise May Reduce Knee Pain

People suffering from chronic knee pain may benefit from starting a daily home-based exercise program, according to a new study in British Medical Journal (2002;325:752–6). The findings of this study suggest that following a specific exercise program for the knee may help reduce pain, decrease stiffness, and improve physical function.

Chronic knee pain in adults is often due to osteoarthritis, a progressive degeneration of the cartilage in the knee joint. As the cartilage wears down, inflammation and swelling occur, which lead to pain, joint stiffness, and limited mobility. Conventional treatment is designed to reduce inflammation and pain by taking oral anti-inflammatory or analgesic medications such as acetaminophen (Tylenol®), ibuprofen (Advil®, Motrin®, Nuprin®), indomethacin (Indocin®), or other nonsteroidal anti-inflammatory medications. However, taking these medications on a long-term basis may result in a peptic ulcer or liver problems. Some physicians recommend surgery to remove debris in the joint, but arthroscopic surgery has recently been found to be ineffective as a treatment for osteoarthritis. This home-based exercise program may eliminate the need for analgesic or anti-inflammatory medications

In this two-year study, 600 men and women older than 45 years with knee pain were assigned to one of four treatment groups: (1) daily exercise therapy, consisting of muscle strengthening exercises on both knees for 20 to 30 minutes (2) monthly telephone calls, (3) daily exercise therapy and monthly telephone calls, or (4) no intervention. The therapy performed was a series of knee strengthening exercises using graded elastic bands, starting with low resistance and working up to higher resistance bands. Questionnaires were given at the start of the study and periodically thereafter, to measure pain, stiffness, and physical function.

Compared with the no-exercise groups, the exercise groups experienced a significant improvement in knee pain. Joint stiffness and physical function were also notably improved with exercise. These benefits were seen after six months of treatment and were maintained throughout the study. Improvement in symptoms was associated with the degree of compliance to the exercise program, with those who strictly adhered to the program having the greatest benefit.

Studies have shown that various nutritional supplements, including glucosamine sulfate, chondroitin sulfate, niacinamide (vitamin B3), S-adenosyl-methionine (SAMe), and vitamin E may also be useful in treating knee pain from osteoarthritis. Herbs such as cat’s claw (Uncaria tomentosa), devil’s claw (Harpagophytum procumbens), ginger (Zingiber officinale), and boswellia (Boswellia serrata) may also be beneficial. Consult a physician or nutritionist for the appropriate amounts to take.

Darin Ingels, ND, MT (ASCP), received his bachelor’s degree from Purdue University and his Doctorate of Naturopathic Medicine from Bastyr University in Kenmore, WA. Dr. Ingels is the author of The Natural Pharmacist: Lowering Cholesterol (Prima, 1999) and Natural Treatments for High Cholesterol (Prima, 2000). He currently is in private practice at New England Family Health Associates located in Southport, CT, where he specializes in environmental medicine and allergies. Dr. Ingels is a regular contributor to Healthnotes and Healthnotes Newswire.

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