Our Top 5 Treatments for Knee OA

Whether it be mild, moderate or severe knee osteoarthritis, here are our top 5 treatments. If you can incorporate these into your regimen, then you undoubtedly will see the benefits of less pain, better function and greater longevity for your knees.

1) Weight Loss: for every 1 pound a person is overweight, an extra 4 pounds of force are going through the knees. So, lose 10 pounds, and you have 40 pounds of less force on those knees. Lose 25 lbs, and 100 fewer lbs. of force! A recent study indicated that when those with knee OA lost 10% of their weight, their pain decreased by 50%

2) Healthy Eating with an Anti-Inflammatory Diet: healthy eating doesn’t always result in weight loss, but choosing the right foods often results in less inflammation in our body. This means less pain and a better environment for the joints. Choose fresh foods over processed ones. Reach for the fresh foods in the refrigerator more than packaged food in the pantry. Eat at home more and go out to restaurants infrequently. Fruits, vegetables, whole grains and lean meats should be the staples of your diet. Alcohol in moderation. Red meat, fried foods and processed food only on occasion and when necessary. Sodas rarely and watch out for artificial sweeteners.

3) Injections: these are often a faster path to relief for most patients. Platelet-rich plasma (PRP) injections utilizing your own blood and concentrated growth factors are the star of this category. Long-term benefits are most common with PRP. Hyaluronic acid injections (brand names: Orthovisc, Trivisc, Gelsyn, Euflexxa, etc.) are good options for many. At times, we combine the PRP and hyaluronic acid injections to boost the benefits. Steroid injections are the final option and can have great utility when a patient needs to feel better quickly such as during a flare or before a big trip.

4) Exercise/Physical Therapy: choose exercise you like, you will stick to, a variety and types that do not cause pain in your knee, both during and afterwards. Sometimes, it’s not just the type of exercise, but the intensity and duration. Find your “sweet spot,” meaning your knee might feel great if you walk a one mile but hurts if you go further. You can bike for 30 minutes, but beyond that causes swelling. So, stay below your pain threshold. Lower-impact options like biking, elliptical, rowing and swimming/aquatic exercises are often the best choices for most with knee OA. Physical therapy is often a good starting point to strengthen the muscles around the joints and to improve biomechanics, functional movement patterns and flexibility.

5) Supplements: our favorites are collagen, curcumin (the active ingredient of turmeric) and for more advanced knee OA, glucosamine and chondroitin. Others like fish oil may have benefits for the joints as well. The key here is choosing a high-quality brand and taking these on daily basis. Admittedly, they don’t help everyone, and you need to make sure that your physician knows you are taking these, especially if you are taking other medications and/or will soon have a medical procedure.

As always, let us know if we can be of assistance to you!

F. Clarke Holmes, M.D.

Why Does an Orthopedic Practice Care About a Patient's Weight?

Let’s talk weight. It’s not a fun topic to talk about, but necessary in the medical field. A poll taken earlier this year showed that 48% of Americans admit they have gained weight since the beginning of the Covid outbreak.

Why is this important to orthopedic providers? Weight is a contributor to orthopedic pain. Let me give you an example: there are two patients of the same age and gender with equal severity of knee arthritis. One maintains a healthy weight level, and the other has had a 10 lb. weight gain. For every one pound you’re overweight, there’s an estimated extra four pounds of force on the joints. Therefore, even though they have the same degree of arthritis, it is likely that the overweight patient is struggling more with flares of pain and dysfunction due to that extra 40 lbs. of force going through the knees. 

Not only does maintaining a healthy weight help orthopedic pain, it helps fight against high blood pressure, high cholesterol, diabetes, cardiovascular disease, sleep apnea and other sleep disturbances, gallbladder and liver disease, and mental disorders. Overall, a healthy weight has significant health benefits. 

All that being said, losing weight and maintaining a healthy weight isn’t easy, especially when life gets busy. We fall into routines, and it just never seems like there’s enough time in the day. Many people get caught up in the numbers on the scale. If monitoring this is motivational for you, keep stepping on the scale. If weighing yourself is discouraging, use other tools such as how are your clothes fitting, whether you feel better, and are you holding yourself accountable to feeding your body the fuel foods it needs while moving your body more. 

Weight management is 80% eating habits and 20% exercise, and impacting each of these is one huge factor: your overall mental approach to both. Let’s break down each. 

Eating Habits 

Wouldn’t it be nice if we could lose weight while frequently eating foods like sweets and pasta. That would be AMAZING. Unfortunately, that’s not reality. But it doesn’t mean you can’t eat the deemed “unhealthy foods,” or that healthy foods can’t taste good. Another factor to consider is that eating healthier tends to be more expensive.

-limit unhealthy foods and then control the portion sizes when you do splurge. Another good tip is if you know you’re going out for that pizza for dinner, eat healthier for breakfast and lunch. 

-use a free calorie tracking app such as MyFitness Pal. The amount of calories needed depends on age, size, height, gender, and activity level. A calorie deficit is needed to lose weight, but that doesn’t mean you have to always be hungry. It’s all about the foods you choose! Eat foods that keep you full and choose healthy snacks in between. 

-intermittent fasting doesn’t work for everyone. If you’re interested, try fasting from 8 p.m. until 12 p.m. the next day. Black coffee and water are still acceptable to drink during this time. 

-drink plenty of water. The amount will be different from everyone. Drinking an excess amount of water can drop your body’s sodium levels, so don’t go overboard. 

-be mentally prepared on how to approach that dreaded spiral when opportunities to consume unhealthy food present themselves and then have the mental fortitude to decline the temptations.

-don’t go to the grocery store when you’re hungry. This increases the likelihood of buying unhealthy foods. We all know if it’s in the house, it will get eaten. 

-limit eating out or if you do eat out, make healthier choices. 

-incorporate color into every meal, as more color often means more fruits and vegetables. 

-eat when you are hungry, not necessarily simply because it’s meal time, and stop when you are full. 

-if you want to follow or need the accountability through a weight management program, consider Weight Watchers or Noom.

-if you overeat at a meal, move on and don’t shame yourself.

-fueling your body with healthy food choices can also help combat full body inflammation. Here is a link to one of our favorite resources on anti-inflammatory foods that we like to share with our patients. 

https://www.drweil.com/diet-nutrition/anti-inflammatory-diet-pyramid/dr-weils-anti-inflammatory-food-pyramid/

*Eating habits are not a “one plan fits all”*

Exercise

Our biggest tip is to just keep moving! Find an activity that gets you moving and that you enjoy physically and mentally. At least 3-4 times a week. Choose an activity that gets your heart rate up and cross train with strengthening. You don’t have to spend hours in the gym. 

-set a timer every hour at work to get up and walk around. Take a walk during your lunch break. 

-get a sit-to-stand desk and alternate every 30 minutes to 1 hour. “Sitting is the new smoking.”

-find a routine and stick to it. Choose a few different activities you can alternate. 

Finally, here are the main keys to successful weight management: consistency, maintaining a positive mindset, positive reflection, smart food choices while also allowing yourself to eat what you want in moderation, and get moving. It’s definitely not easy, but the overall improvement in your physical or mental health will be well worth it. 

If you have found success in losing or maintaining a healthy weight, let us know what helped you!

Taylor Moore, FNP-C

Impact Sports Medicine and Orthopedics