Osteoarthritis (OA) is a degenerative disease that affects the articular cartilage of the joint. As a result, there is a decrease in the joint space and an increase in boney development (commonly referred to as “bone spurs”). Onset typically takes years. Risk factors for developing OA include age, trauma, obesity and family history. It can develop in any JOINT but is most commonly seen in the knees, hips and hands. 


What does research say about exercising with arthritis?

• Exercise reduced pain, improved quality of life and increased performance in those with OA. Patients who had better outcomes were typically younger (Siew-Li Goh).
• Those who walked had less knee pain than those who didn't. The study also found that walking helped to slow the progression of OA in the knee (Lo).
• Patient outcomes were improved when exercise was combined with patient education (Goff).

What type of exercise should those with arthritis do? 

• Strength training
• Aerobics 
• Pilates
• Aquatics
• Walking

*All appeared to be helpful when performed for an hour (Raposo)


Takeaway:
Those with osteoarthritis should participate in physical activity. If pain is preventing you from exercising, try to find an activity you enjoy that causes minimal pain. If it is still challenging, reach out to a professional to create a plan to manage your pain. 

References
Goff, Anthony J., et al. "Patient education improves pain and function in people with knee osteoarthritis with better effects when combined with exercise therapy: a systematic review." Journal of Physiotherapy 67.3 (2021): 177-189.

Lo, Grace H., et al. "Association between walking for exercise and symptomatic and structural progression in individuals with knee osteoarthritis: Data from the Osteoarthritis Initiative Cohort." Arthritis & Rheumatology 74.10 (2022): 1660-1667.

Raposo, Filipe, Marta Ramos, and Ana Lúcia Cruz. "Effects of exercise on knee osteoarthritis: A systematic review." Musculoskeletal care 19.4 (2021): 399-435.

Siew-Li Goh, Monica S.M. Persson, Joanne Stocks, Yunfei Hou, Jianhao Lin, Michelle C. Hall, Michael Doherty, Weiya Zhang,Efficacy and potential determinants of exercise therapy in knee and hip osteoarthritis: A systematic review and meta-analysis, Annals of Physical and Rehabilitation Medicine,Volume 62, Issue 5, 2019,

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Inflammation is the body's immune response to an irritant (Informedhealth). White blood cells migrate into the tissues in an effort to “protect” the body from the irritant. Inflammation is categorized as acute or chronic. For an acute period of time inflammation is beneficial, however, chronic inflammation becomes harmful.

How does inflammation cause pain?
During the inflammatory process chemical mediators are released to signal white blood cells to the area. White blood cells release a byproduct that affects the nerves in the area to tell the brain that there is pain. For a short time, this is a protective mechanism. If a body part is injured, reducing movement decreases any further damage. However, long term inflammation to the body is very damaging (Omoigui).

Causes of inflammation: 

• Table Sugar (Havard Health).​
• Ultra-processed foods
• Alcohol
• High fat
• High intensity exercise
• Visceral fat (Kolb). 

*People at higher risk of increased dietary inflammation: male, older, post-menopausal women, those with higher BMI, and those with more body fat.

Ways to reduce inflammation:
Specific foods

• Fatty fish like tuna, salmon, sardines 
• Fruits & vegetables
• Walnuts & almonds
• Flax seeds
• High protein, high fiber, complex carbohydrate foods that help to slow digestion 
• (Havard Health)

Exercise

• Moderate intensity exercise. 
• Walking 

Sleep 

• Sleep promotes recovery and allows the body time to heal from stress. 
• Regulating your circadian rhythm 

Supplements

• Turmeric
• Omega-3 
• Vitamin C
• Zinc

Takeaway:
Inflammation is inevitable, and for short periods of time it is important and beneficial. The problem occurs when inflammation goes uncontrolled for extended periods of time. Take small steps each day to reduce inflammatory habits in your lifestyle. 

Resources 
Foods that fight inflammation - Harvard Health

InformedHealth.org [Internet]. Cologne, Germany: Institute for Quality and Efficiency in Health Care (IQWiG); 2006-. What is an inflammation? 2010 Nov 23 [Updated 2018 Feb 22]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK279298/

Kolb, H. Obese visceral fat tissue inflammation: from protective to detrimental?. BMC Med 20, 494 (2022). https://doi.org/10.1186/s12916-022-02672-y

Omoigui S. The biochemical origin of pain: the origin of all pain is inflammation and the inflammatory response. Part 2 of 3 - inflammatory profile of pain syndromes. Med Hypotheses. 2007;69(6):1169-78. doi: 10.1016/j.mehy.2007.06.033. Epub 2007 Aug 28. PMID: 17728071; PMCID: PMC2771434.