Osteoarthritis of the knee: to drug or not to drug?

4th Apr, 2022

Knee Osteoarthritis – a common cause of knee pain in Singapore

Osteoarthritis is the most common type of arthritis and one of the main chronic illnesses in Singapore. As a  degenerative joint disease, it affects 10% of our adult population and 20% of our elderly population. In fact, the rates of osteoarthritis increase sharply after the age of 50, which is significant in light of our ageing population. Other than age, other risk factors include gender (women are more likely to develop osteoarthritis), obesity, and genetics.

So what is osteoarthritis? Over time and repeated usage, the cartilage cushioning the ends of bones in joints breaks down, and the damage to the joints causes pain and inflammation. In its end stages, there may be significant loss of cartilage, causing the bones to come into contact with each other. This results in swelling, pain when putting weight on the joint, and loss of flexibility, which can hinder your day to day activities. Some may even experience disability, where they are unable to perform daily tasks. While osteoarthritis can affect any of your joints, it most commonly occurs in the hands, hips, knees, and spine.

How is Osteoarthritis traditionally managed? 

Traditionally, osteoarthritis is managed using a variety of methods – opioids, nonsteroidal anti-inflammatory drugs (NSAIDs), exercise, and joint injections are all ways to relieve symptoms. In more advanced stages of the condition, surgical intervention such as joint replacement can be considered as well.

NSAIDs are pain-relieving medications, and reduce inflammation by preventing the production of inflammatory chemicals in your body. Some common NSAIDs include aspirin and ibuprofen, which are readily available over-the-counter.

Opioids are pain-relieving drugs that effectively manage acute pain; however, it comes with side effects such as a risk of addiction at high doses.

Otherwise, injections of corticosteroids directly into the joint can reduce joint inflammation and pain by delivering the medication straight to the affected area. Most doctors give 1-2 injections per year to larger joints such as the hip or knee.

What’s new in the research for Physiotherapy with knee pain? 

A recent study published in the Journal of Orthopaedic and Sports Physical Therapy sheds new light on the matter; it aims to compare the efficacy of opioids, NSAIDs, and exercise therapy on the management of knee osteoarthritis pain by comparing results across 13 trials (around 1400 patients). 

“Exercise therapy was shown to have similar effects as NSAIDs and opioids, and was in fact ranked as the best treatment option. In general, low-impact aerobic activities such as cycling and exercising in water can help you keep fit, while muscle strengthening exercises can allow your muscles to better support the affected joints.”

In light of this, exercise therapy should be part of your first-line treatment to improve symptoms of your knee pain from osteoarthritis, empowering you to lead a healthy lifestyle instead of being stuck on painkillers that may not help you live a pain-free life.

It can be uncomfortable and difficult to begin your journey, but in the long run, exercise goes a long way in managing pain and improving your quality of life! Physiotherapy in Singapore is moving in that direction where we believe that exercise is medicine and it should be your first port of call. 

What type of exercises you might ask? 

Your Physiotherapists at PhysioX can help to design an exercise program that is well suited to your knee pain after assessing and identifying potential barriers of exercise. They will ensure that the exercises are adequate for you and be certain to ensure that you are able to perform them safely!

Let’s get moving! Don’t let the pain in your knee slow you down!

Book now or give us a call to schedule an appointment to see our Physiotherapist who will be able to partner you on your recovery for your knee pain and get you back to your activities!

Reference:

Similar Effects of Exercise Therapy, Nonsteroidal Anti-inflammatory Drugs, and Opioids for Knee Osteoarthritis Pain: A Systematic Review with Network Meta-analysis. J Orthop Sports Phys Ther 2022;52(4):207-216. doi:10.2519/jospt.2022.10490

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