A promising new study suggests that walking could stave off knee pain in people with osteoarthritis.
The researchers surveyed over 1,000 people ages 50 and older with osteoarthritis of the knee, the most common type of arthritis in the United States. Some initially experienced persistent pain, others did not. After four years, those who started without frequent knee pain and walked at least 10 times were less likely to have new, regular bouts of stiffness or pain around their knees and had less structural damage in their knees. The study suggested that people with knee osteoarthritis who have bowlegs might particularly benefit from walking.
The research offers the potential for an easy — and free — way to tackle one of the most common causes of knee pain in older adults.
The results represent “a paradigm shift,” said Dr. Grace Hsiao-Wei Lo, an assistant professor at Baylor College of Medicine in Houston and the study’s lead author. “Everyone is always looking for some drug. This underscores the importance and likelihood that osteoarthritis interventions could be something else, including good old-fashioned exercise.” The research suggests exercise may help treat osteoarthritis in other joints, like the hips, she added. Hands and feet.
Osteoarthritis, sometimes referred to as “degenerative arthritis,” affects more than 32.5 million adults in the United States and occurs when articular cartilage breaks down and the underlying bone begins to change, according to the Centers for Disease Control and Prevention. The risk of developing this disease increases with age, and about a third of people over 60 have osteoarthritis of the knee, said Dr. Lo. Many patients take medications like ibuprofen or naproxen to manage the pain, she added, which in large doses can lead to kidney problems and ulcers.
Instead, they may be able to turn to training. For decades, health professionals saw walking primarily as a way to improve cardiovascular health, said Dr. Elaine Husni, a rheumatologist at the Cleveland Clinic, who was not involved in the study. In recent years, however, physicians have sought low-impact workouts to treat conditions such as depression, cognitive impairment, and mild osteoarthritis. But the new study shows that walking can also work as a preventive measure, said Dr. Lo, and suggests that people at higher risk of developing the condition might want to incorporate a regular walk into their routine. For example, said Dr. Lo herself that because of her findings, she should walk more because her mother suffers from osteoarthritis.
The study began in 2004 and documented participants’ initial knee pain using X-rays to assess their osteoarthritis. The researchers then asked participants to document their exercise habits and check their symptoms at regular follow-up visits, asking how often their knees hurt.
After four years, 37 percent of study participants who did not walk (excluding occasional trips to the train or grocery store) developed new, frequent knee pain, compared with 26 percent who walked.
Of course, researchers can’t say definitively that walking staved off knee pain, and it didn’t appear to relieve existing pain. Self-assessments can be less accurate than fitness trackers or pedometers. And the researchers didn’t track the distance or frequency that people walked, nor did they recommend strategies for how and when people with osteoarthritis should incorporate walking into their exercise routines.
Still, the results reinforce what clinicians already know about managing osteoarthritis. Consistent exercise can help build muscle mass and strengthen the ligaments around joints with osteoarthritis, said Dr. Husni. Walking is a low-intensity, low-impact exercise that allows people to maintain the strength and flexibility critical to healthy joints, she added.
“It’s an intervention anyone can do,” she said. “You have no excuse. You can do it wherever you are.”
However, those who are already in pain should be careful not to overdo the exercise, said Dr. Justen Elbayar, a sports medicine physician in the Department of Orthopedic Surgery at NYU Langone Health, who was also not involved in the study. Walking long distances might make pain worse in some patients with severe arthritis, he said — but for those with lesser amounts of arthritis, “it’s one of the best exercises you can do.”
He recommends that people start with a small, short walk and gradually build up the distance over time. The goal of the exercise is to provide muscular support for an arthritic knee, he said, and to get the joints, tendons and tissues used to walking.
He also suggested wearing supportive shoes, drinking plenty of water during a walk, and resting frequently when tired or new to it. After a long walk, icing the knee can also help reduce discomfort, he added.
While walking the street may not repair cartilage or relieve existing pain, exercise offers a compelling and accessible option for fighting off the more intrusive aspects of osteoarthritis, said Dr. Lo. Finally, she added, “It doesn’t cost a penny to walk.”