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Knee Osteoarthritis and Physiotherapy

Arthritis is one of Canada's most common chronic conditions and is a leading cause of pain, physical disability and use of health care services (Arthritis in Canada Report). Osteoarthritis (OA) is the most common type of arthritis, affecting an estimated 10% of Canadian adults. Osteoarthritis results from the deterioration of the cartilage in one or more joints. This deterioration leads to joint damage, pain, and stiffness. Unfortunately, there is no cure for OA. Treatments exist to decrease pain and improve mobility, and include medication (e.g. analgesics, anti-inflammatory drugs), exercise, physiotherapy and weight loss. In severe cases, the entire joint - particularly the hip or knee - may be replaced through surgery. Acetaminophen and nonsteroidal anti-inflammatory drugs (NSAIDs) are commonly used to treat osteoarthritis. Unfortunately, these medications can be harmful to your stomach and you should talk to your doctor for more information.

Fortunately, a Physiotherapist can help. Physiotherapists are university trained health professionals that treat a variety of musculoskeletal injuries/conditions. Physiotherapists have advanced understanding of how the body moves, what keeps it from moving well and how to restore mobility. Physiotherapist’s treat osteoarthritis of the knee through a variety of methods including specific exercises to strengthen the knee and leg, mobilizations of the knee and surrounding joints and use of in clinic bikes and treadmills. We also design home exercise programs consisting of low impact cardio (biking, walking and swimming) and strengthening exercises.

There has been recent scientific evidence to support the use of physiotherapy for people with osteoarthritis of the knee. The study consisted of 83 men and women with knee pain and osteoarthritis that were randomly allocated into two groups. Patients in group 1 received manual therapy/mobilizations of the knee and specific exercises all provided by a Physiotherapist. Group 2 received placebo ultrasound of the knee. All patients in each group attended 2 times per week for a total of 4 weeks.

After 1 month, 2 months and 1 year, the physiotherapy group had significant improvements in their knee pain and walking tolerance as compared to the placebo group. Also, 20 % of the patients in the placebo group had to undergo a total knee replacement (8 of them) as compared to 5 % of the patients in the physiotherapy group (2 of them).

Therefore, only 4 weeks of manual Physiotherapy and a supervised exercise program by a Physiotherapist may delay or prevent the need for a knee replacement.

You can see a physiotherapist at either a hospital or private practice. Physiotherapy is a direct access profession therefore a doctor’s referral is not required. However, some insurance companies may ask for a doctor’s referral in order for you to be reimbursed.

Study Reference:

Deyle, GD et al. Effectiveness of manual physical therapy and exercise in osteoarthritis of the knee. A randomized, controlled trial. Annals of Internal Medicine. 2000; Feb 132(3): 173-81.

Rob is a licensed physiotherapist with the NB College of Physiotherapists. He is the owner of Advantage Physiotherapy in Fredericton, NB. Rob also has an Honour’s degree in Kinesiology and is a Certified Exercise Physiologist.

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