I have Arthritis, so PT can’t help....right?

I can totally understand the concern that when you have pain in your knee and an x-ray shows arthritis that the only real remedy is a joint replacement. For many people, a joint replacement is the correct next step, but this is not the case for everyone. While it is true that physical therapy will not be able to “fix” or change the arthritis in your knee, but it has been shown through many high quality research studies to significantly help reduce pain and improve function. After all, isn’t less pain and improved function what we are really trying to achieve?

In 2014, Knoop et al. conducted a study comparing individuals with varying severities of knee osteoarthritis. They found that with the exception of several rare findings on imaging, all grades of osteoarthritis can benefit from supervised physical therapy. One, of several, proposed mechanisms, is significant quadriceps (thigh) muscle weakness as a result of pain and arthritis in the joint. This decreased strength, likely leads to decreased stability in the joint. Research by Lewek et al., in 2014, is consistent in showing quadriceps muscle weakness in individuals with osteoarthritis. More importantly, their research concludes that with a guided exercise program, these study participants were able to significantly improve their quadriceps strength. These findings are supported by a systematic review and clinical guidelines published in the American Academy of Orthopaedic Surgeons. They found good evidence supporting the use of quadriceps strengthening, among other non-operative interventions, to be helpful for individuals with total knee arthritis.

This is not to conclude that everyone with knee arthritis will be pain free and running if they would only do physical therapy. In fact, many individuals are going to need a total knee replacement to achieve their goals, but maybe they can feel better and move better until the day comes that they decide it is time. So before assuming that since your x-ray showed arthritis that you are destined to be in pain until you have surgery, give PT a try!

 

 

American Academy of Orthopaedic Surgeons. Treatment of osteoarthritis of the knee (non-arthroplasty). Rosemont, IL: American Academy of Orthopaedic Surgeons; 2008

Lewek MD, Rudolph KS, Snyder-Mackler L: Quadriceps femoris muscle weakness and activation failure in patients with symptomatic knee osteoarthritis. J Orthop Res, 2004, 22: 110–115.

Knoop J, Dekker J, van der Leeden M, et al. : Is the severity of knee osteoarthritis on magnetic resonance imaging associated with outcome of exercise therapy? Arthritis Care Res (Hoboken), 2014, 66: 63–68.