Ooo, my knee!

September 18, 2009

(PhysOrg.com) -- Once we reach the age of 55 there's a 25 per cent chance that we will be suffering from bad knees. Of that 25 per cent, half will experience some sort of associated disability, such as difficulty carrying out everyday activities, and most of us will have reached for the painkillers.

However, experts at The University of Nottingham have just completed one of the largest and longest running studies of its kind which backs up international recommendations emphasising the importance of lifestyle interventions to ease those painful knees.

Tony Avery, Professor of Primary Care in the School of Community Health Sciences, said: “As a GP I often see patients with knee pain and it can really affect quality of life particularly when people find they cannot do their usual work, home or leisure activities. Often patients have to take drugs to help control the pain and yet these don't always work and sometimes have serious side effects.”

With funding of over £400,000 from the Arthritis Research Campaign researchers selected 389 patients from five general practices in Nottingham, to take part in the two year research project which has been published in the British Medical Journal (BMJ).

Participants were chosen if they were overweight and had reported that they were suffering from knee pain. They were randomised into four groups: one group was given an exercise programme aimed at strengthening the muscles around the knee; another group took part in a weight reduction programme; a third group combined the exercise program and the weight reduction programme; and a fourth group were given an advice leaflet (this acted as the control group).

Professor Avery said: “We have shown that the use of simple home-based exercises to help strengthen the knee can improve knee pain and also reduce the need for painkillers. Also, a weight reduction programme helped people to lose weight and also helped to improve mood.”

The exercise programme was effective at reducing knee pain when measured throughout the study and two years after the start of the study. The weight reduction programme helped people to lose an average of 3kg (almost half a stone) in weight and, while it did not improve knee pain, it did improve depression scores. The researchers also carried out a health economic analysis which showed that the combination of the knee strengthening exercise programme and the weight reduction programme was the most cost-effective way of treating knee pain — meaning that the benefits in terms of improvement in quality of life were considered sufficient to outweigh the costs to the NHS.

Dr Claire Jenkinson, lead researcher for the project, said: “We are extremely grateful to the patients who took part in this study and also to all the NHS staff, including general practices, for helping to make the study a success.”

Provided by University of Nottingham (news : web)