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How To Lose Weight With Osteoarthritis Of The Knee

It Can Be Disheartening


But then you have to remember how much more disheartening and frustrating it is for the patient. So you focus on the task. You learn from your mistakes. You build up your knowledge, as well as your skills and resources, and you form a partnership with the patient.

Dr Jill Thistlethwaite

As a result, Dr Thistlethwaite has improved her approach to her patients weight management over time. When I was a less experienced GP, it was all black and white. I would just tell patients what they needed to do and expect theyd get it done, she says.

However, as I got more experienced, I learnt to see people as individuals. It was in the mid-1990s that it became clear for me that as with medication adherence, just telling a patient what to do is rarely successful in the longer term.

This approach has enabled Dr Thistlethwaite to identify that osteoarthritis is an opportunity for her to discuss and monitor weight loss with her patients over time.

The development of early stage osteoarthritis can be a trigger to help patients with the motivation required to lose weight. It can also help them be more agreeable to exercise if you provide an updated understanding of osteoarthritis that its not a wear and tear disease and that exercise will not cause damage to the joint, says Dr Thistlethwaite.

For patients with advanced osteoarthritis who are waiting for joint replacement surgery, its not too late to stress how beneficial weight loss is, she says.

Weight Loss Is Core Osteoarthritis Treatment

Being overweight or obese is the single most important risk factor for knee osteoarthritis .5 People who are obese are twice as likely to develop knee OA compared to non-obese people the lifetime risk is 20% compared to 11%.6

And weight loss stands tall among OA management options. Whereas oral analgesics only have an adjunctive role ,7 international guidelines recommend weight loss as a core treatment.8-10

A 2007 meta-analysis of 4 randomised controlled trials found a weight reduction of 6.1 kg reduced self-reported pain and disability with pooled effect sizes of 0.20 and 0.23 respectively.11 These effect sizes were small, but clinically significant and comparable to the modest effect sizes from NSAIDs .5,12 A subsequent 2013 RCT that found similar results has added strength to these findings.13

All these studies were conducted on knee OA, however, which makes it difficult to generalise the results to the hip. While the link between obesity and hip OA is less well established, guidelines are clear that weight loss is recommended for OA in general due to the associated general health benefits, particularly for patients with concurrent chronic diseases.7,9,14

Its this overlap of management of OA and other chronic diseases that Dr Thistlethwaite has found provides an opportunity for helping patients get started with weight loss.

Weight Loss Will Help You Feel Better And Help Your Joints

The more weight you lose, the more benefits your knee osteoarthritis will get, the Arthritis Care & Research study found. While everyone in the study who lost pounds saw improvements, people who dropped 20 percent or more of their body weight got an extra 25 percent reduction in some osteoarthritis disease markers compared with people who lost from 10 to 20 percent.

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Diet And Exercise Advice

Once a patient is motivated to lose weight, the first-line management is usually diet and exercise. But which one is better?

The answer is theyre better together. A 2013 RCT of 339 patients with knee OA found that while the amount of weight loss achieved by exercise alone was 2 kg, and for diet alone 9 kg, diet and exercise combined achieved a loss of nearly 11 kg.13

Fortunately, the recommendations for what to eat and drink, and what exercise to do, are closely aligned between OA-specific and general weight loss guidelines. They include the following advice.

What Causes Osteoarthritis In The Knee

Prevent Osteoarthritis by Losing Weight

Before looking at how to manage osteoarthritis in the knee, its a good idea to understand how that pain started in the first place with a little anatomy 101.

Rubbery and flexible connective tissue known as articular cartilage covers and sits between bones that meet in your knee. The slippery tissue cushions the joint, serving like a shock absorber as you walk, run, jump and otherwise move around the world.

That cartilage takes a beating, though, and small tears naturally develop as the malleable material grows more rigid over time. The articular cartilage in your knee eventually starts to flatten and stiffen like an old chair pad.

And when that cartilage stops absorbing the shock well, you notice.

Factors that lead to osteoarthritis in your knee include:

  • Aging.
  • Injury, which can lead to early deterioration.
  • Excess weight that puts added strain on your knees. For every 3 lbs. of weight you have, you put 10 lbs. of pressure on your joints, notes Dr. Orlandi.
  • Genetics.

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Maintaining Weight May Be Better

Not only does using BMI as a determinant limit surgical access, Godziuk said, but it can risk patients health, since short-term weight loss that cant be maintained has few benefits, and could potentially be harmful.

We tell patients to go lose weight, to lower their BMI, but it can be harmful to have that blanket recommendation. What were suggesting is that maybe we dont tell them to lose weight, but help them to prevent weight gain. Maybe thats a better message to send to patients, and through that we can also support them to improve their body composition and overall health.

Godziuk, who started her career as an exercise physiologist, said working in pediatric obesity helped her understand the need for more research in this area.

I could see clinically, when I worked with adolescents, that BMI was a poor measure for them, and I know its a poor measure in adults. When we just rely on these simple metrics, I could see that there was this gap. And its so important from a rehabilitation perspectiveto help patients live with osteoarthritis and manage it, including if they have obesity as well.

Practitioners should be aware of the lack of evidence for weight loss before surgery and reconsider recommendations about BMI, Godziuk said.

We do such a good job of looking more in depth into all other areas of a persons health, but to distil obesity down to BMI, were missing some information.

Do Partial Squats Or Use Elastic Bands

The goal is to build lean muscle mass so you burn more calories. This is even more critical when youre trying to lose weight with arthritis, because as muscles grow stronger, they provide greater joint support and help reduce the load and stress on painful joints. Studies show strength training helps reduce pain from arthritis and eventually improve function as well, says Millar. Talk to your doctor or physical therapist about the safest strength training exercises for you.

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Obesity Is A Risk Factor For Incidence And Progression Of Osteoarthritis And Negatively Influences Disease Outcomes

Obesity is widely acknowledged as a risk factor for OA, with every 5kg of weight gain conferring a 36& increase in the risk of knee OA . There is evidence that the risk accumulates with increased exposure to high BMI throughout adulthood, with an association between BMI and later knee OA starting as early as 20 years in men and 11 years in women . In addition, body weight influences the severity of OA obese individuals have significantly more severe joint degeneration in the knees compared with normal weight or underweight individuals . Data from a casecontrol study have also indicated a strong association between increasing BMI and surgical replacement of hip and knee joints .

Of note, obesity and OA collectively reduce mobility. This can initiate a vicious cycle of events: reduced activity, further weight gain and decreased muscle strength, leading to increased joint problems and disease progression . Hence, weight loss is a primary goal in obese individuals with OA.

Talking To Arthritis Patients About Weight Loss

Exercises for osteoarthritis of the hip and knee

Weight loss eases arthritis pain and improves the quality of life of adults living with arthritis, especially if they are overweight or have obesity.

More than 58 million US adults have arthritis. Among adults with arthritis, 39 million are overweight or have obesity.

Healthcare professionals can counsel their arthritis patients to lose weight if they are overweight or have obesity. Research suggests that patients who receive weight counseling from a healthcare professional are almost 4 times more likely to attempt weight loss than those not receiving counseling. Adults with arthritis can decrease pain and improve function by being at a healthy weight. Weight loss is a non-drug way to manage arthritis and ease joint pain.

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Lose Weight To Ease Your Knee Pain

Thats because extra pounds put stress on your knees which can cause damage and lead to pain.

If you are overweight and have knee pain, here is some encouraging news: you dont have to lose a great deal of weight to make a significant difference in your pain level. Although moving toward a healthy weight should always be your goal, the fact is, losing just a couple of pounds could improve your knee pain significantly. And losing just a little bit of weight can have a positive ripple effect: if you have less knee pain, you may find it easier to exercise and continue to lose weight and improve your health.

One Pound Off the Body = Four Pounds Off the Knees!

In 2005, researchers found that if an overweight or obese person with knee osteoarthritis loses one pound, that equates to four pounds of pressure taken off the knees. That means losing just 5 pounds will take 20 pounds of pressure off your knees. Increase that to 10 pounds, which feels achievable to most people, and youve just removed a full 40 pounds of pressure off your knees.

How Being Overweight Leads to Cartilage Damage and Knee Pain

If you dont lose excess weight, it continues to put stress on your cartilage, wearing it down. Cartilage is a rubbery tissue that works like a shock absorber, protecting the ends of your bones and reducing friction on your joints. When this cartilage in your knee joint becomes worn down, it limits the knees normal movement and can cause pain.

Are Any Investigations Necessary

Plain radiography is the first-line imaging modality for the assessment of knee pain in this patient population. The EULAR group considers plain radiography the current gold standard for structural assessment of knee osteoarthritis. Magnetic resonance imaging is not required to make the diagnosis of osteoarthritis, nor is it helpful in making decisions about currently available interventions. Inappropriate use of magnetic resonance imaging is costly and can result in the detection and treatment of incidental meniscal tears. Degenerative meniscal tears are very common in patients with osteoarthritis and do not require operative treatment.

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What Are The Mechanisms Linking Obesity And Osteoarthritis

Understanding of the mechanisms by which obesity predisposes the onset and progression of OA has evolved over time. Initially, the link between OA and obesity was considered purely biomechanical . In fact, on closer inspection, the mechanisms linking obesity and OA appear to be more complex and multifactorial . Relative loss of muscle mass and strength over time also contributes to the onset of OA in obese individuals. Although muscle as well as fat mass increases with weight gain, overall, the volume of muscle mass remains relatively low and inadequate to match the loads placed upon it .

Research On Weight Training And Osteoarthritis

Exercises for Osteoarthritis Knee Pain

A systematic review and meta-analysis published in 2020 analyzed the effects of strength training on muscle mass gain in older adults with osteoarthritis. Focusing on older people is significant because they are commonly affected by muscle weakness as well as osteoarthritis. The results showed that strength training was beneficial in increasing the lean muscle mass and muscle size in older adults with osteoarthritis.

Peak muscle strength normally occurs in your mid-20s and is maintained into your 60s. However, strength declines. By the time you are 80 years old, your strength is about half that of a normal young adult. The loss of muscle mass and strength that occurs with age is called sarcopenia.

Muscle weakness is also common with osteoarthritis, especially of the knee extensors. Muscle weakness occurring with osteoarthritis is linked to an increased risk of functional limitations and disability. Muscle strength, especially knee extensor strength, has been found to be protective against developing functional limitations in those with osteoarthritis.

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Is Diet Or Exercise Best For Losing Weight With Knee Osteoarthritis

Both work well, especially together! Definitely approach weight loss with both a diet plan and a fitness plan. Combining the right diet plan with appropriate exercise, along with learning tools that change ingrained behaviors, is the best way to lose significant weight, according to the National Institutes of Health .

Losing weight slowly is best for the body, the NIH says. A reasonable time period is six months to drop 10 percent of your body weight.

How To Get Rid Of Knee Pain & Arthritis Naturally

A common health issue these days every one of you is facing is having pain in your knees. This condition is quite painful, and one you get pain in your knees, it is not easy to get rid of this issue fast. Because of knee pain, you are unable to move. Also, it becomes difficult for you to carry out daily routines of your life. Sometimes, the pain is extreme, and even, it is not easy to bear it. There are many causes of arthritis or knee pain. People look for the medications, and also, they follow many homemade methods. But, it is not easy to get a relief quickly. In this video, I am going to share with useful home remedies to get rid of knee pain and Cure arthritis pain naturally.

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How Does Psoriatic Arthritis Affect The Knees

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One or both knees may be affected in people with psoriatic arthritis , a chronic inflammatory joint disease. PsA is a disease that presents with a diverse set of symptoms across the population affected by PsA. In some individuals, PsA is asymmetrical, affecting only one side of the body. For example, PsA may involve the right knee while the left knee is unaffected. PsA can also be symmetrical, affecting both sides of the body.1,2

In addition to affecting joints, PsA can also inflame the entheses, the attachment points of tendons and ligaments, and synovial tissue, the fluid-filled capsule found between the bones. When one or both knees are involved in PsA, the joint may be compromised by inflammation in all of these structures.1

Imaging tools often used for diagnosing PsA in the knees include ultrasound and MRI , which are more sensitive than x-ray to detect inflammatory changes in people with PsA. Ultrasound is useful for detecting structural changes and abnormal blood flow. MRI allows for visualization of soft tissue as well as bony changes.1,2

Does Weight Loss Have An Impact On The Progression Of Osteoarthritis

5 Proven Exercises for Knee Osteoarthritis or Knee Pain- Do it Yourself

While the short-term benefits of weight loss in obese patients with OA are undisputed, the effect of weight loss on the progression of OA remains a topic for debate. Some results have suggested a positive effect of weight loss on cartilage in non-OA subjects. For example, in a prospective study of obese adults recruited from gastric banding or diet and exercise programmes, weight loss was found to be associated with improvements in both the quality and quantity of medial articular cartilage .

However, other studies have indicated that weight loss does not alter the course of OA, and an association between symptom relief and altered course of structural damage remains to be shown. In the Arthritis, Diet and Activity Promotion Trial, no difference in joint space width was seen between patients treated with diet, exercise, diet plus exercise or healthy lifestyle . However, the authors noted that the relatively short duration of the intervention coupled with the number of subjects per group probably prevented the detection of meaningful differences in radiographic disease progression. Hence, more research is required in order to answer this interesting question.

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Start Working Out In The Water To Help Lose Weight With Knee Osteoarthritis

Whether you work with a therapist or on your own, the best way to begin an exercise program that youll stick with is to move without pain. For people with knee osteoarthritis, that means swimming, swimming, swimming, Lieberman says.

Moving in water which includes pool aerobics or swimming laps allows the joint to flex with no gravity or weight against it.

After youve built confidence and a bit of muscular heft, you can go on to other workouts, such as fast walking outside or on a treadmill, or using an elliptical at a moderate speed.

Listen to your body after you do any workout, Lieberman says. If you have pain that lasts more than a couple of hours after, stop and speak to your physician or physical therapist.

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Dealing With Knee Arthritis At Home

  • 1Lose weight if youre too heavy. As a general rule, people who are overweight or obese suffer more arthritis because of the increased amount of pressure on their joints especially weight-bearing joints such as the knees, hips and low back. Furthermore, overweight people are more likely to have flat feet and fallen arches, which promotes knock knees . Genu varum is hard on knee joints because it causes misalignment of the thigh and shin bones. Thus, do your knees a favor by losing excess weight. The best way to lose weight is by increasing cardiovascular exercise while decreasing your daily calories at the same time.
  • Most people who arent especially active only need about 2,000 calories daily to maintain their body processes and still have enough energy for some exercise.
  • Reducing your daily caloric intake by only 500 calories can result in about 4 pounds of lost fat per month.XTrustworthy SourceMayo ClinicEducational website from one of the worlds leading hospitalsGo to source
  • Swimming is a fantastic exercise for arthritis sufferers to lose weight because your body is buoyant and no pressure is put on your joints.
  • Apply moist heat first thing in the morning or after not using your knee for long periods of time. Avoid electric heat sources because they can dehydrate the skin and muscles around the knee.
  • Microwaved herbal bags work well for knee arthritis, especially the ones that are infused with aromatherapy because they tend to have relaxing properties.
  • Read Also: Can Knee Cartilage Be Rebuilt


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