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Ease of Joint Pain through Lifestyle Changes
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Ease of Joint Pain through Lifestyle Changes

Three basic elements should be understood when dealing with the patient. The first is: How do we optimise the performance of the patient, individual or the athlete, even before they become a patient?

Sport is a health-enhancing experience, and the benefits of participating in sports cover so many different aspects of our wellbeing ranging from psychological, to physical and physiological effects. It is important to understand that as human beings, we are hard-wired to be active and as a result, many believe that the ability to exercise is the only true fountain of youth. Exercise benefits our overall wellbeing and definitely enhances our quality, therefore it is essential that we have functional and pain free joints so that we can continue to benefit from its great effects.

The second aspect to consider is the prevention of problems, which can be achieved by maintaining an active lifestyle. The prevention of muscle imbalances and the avoidance of injury are paramount to achieving this second goal. While the third aspect, which is how to optimise the care of the athlete or patient, is intimately intertwined with the prevention of injury. In terms of optimizing the care, if the patient develops an injury despite good preventive strategies then cartilage repair and cartilage regeneration techniques become critical for the maintenance of the joint and prevention of end stage arthritis that could occur years after a traumatic event.

How do we achieve all this? If we can reduce anterior cruciate ligament injuries, we can reduce the incidence of the associated cartilage injuries by the same degree. This in turn could potentially lead to a reduction in the amount of post-traumatic arthritis that we have to deal with.

The first line of defence is prevention and then this is closely followed by the early treatment of cartilage injury when it occurs. There are many ways of optimally restoring the cartilage when it has been removed by trauma, regular wear and tear, overuse injuries, or even in conditions such as osteochondritis dissecans. Nonoperative techniques play a key role in the prevention and early treatment cartilage injuries.

Intended audience

This information is aimed at patients who have been identified as needing lifestyle changes as a result of joint pain. It is designed to offer an overview of what the procedures entail, as well as briefly discuss the advantages, disadvantages and expectations you should have when undergoing such procedures.

Why are lifestyle changes so important?

Looking at the big picture, about 30 years ago the average life expectancy was approximately 65 years. This meant that physicians were working in a so-called 0–60 framework. If you reached a point where your joint broke down, you had a joint replacement surgery and that would serve as the definitive procedure to treat the arthritic problem.

Due to the many advances in modern day medicine, the average life expectancy is now pushing 83 years, which is significantly higher than the 69 years it was in 1979, and it is even closer to 84 years in many countries. Therefore, physicians are now employing a 0–90 strategy that is aimed at keeping our joints functioning optimally so that we can continue to maintain an active lifestyle even as we age.

Sometimes, a joint does require replacement surgery, but the great thing about the current technology is that people can still maintain their recreational or athletic lifestyle even though they have had a hip or knee replacement, which is very important in terms of overall health.

The whole focus of lifestyle modifications is to better manage a joint by strengthening and protecting it, while allowing the patient to maintain a relatively active lifestyle. Generally lifestyle medications can play a vital role in delaying the need for surgical interventions such as a joint replacement for many years, which help the patient to avoid some of the possible limitations and complications associated with joint replacement surgery.

Who can benefit from lifestyle changes?

The whole population benefits from lifestyle changes. One of the major goals is to show how sport can be a health-enhancing activity, whether that be in a very industrialised nation or in developing countries.

What lifestyle changes make a difference?

With joint pain, the key issue is how to get back to living an active life and participating in regular aerobic exercise and performing muscle strengthening and range of motion activities. It is almost counterintuitive for the person with joint pain that they should be more active to have less joint pain. However, there are certain activities that make a big difference. Riding a stationary bike and swimming are activities that build muscles, including the heart muscle, to make you healthier and help you lose body weight. Being overweight places added stress on your joints and weight loss can be an easy, but key component of the lifestyle modifications that one makes. Diet and providing your body with the proper nutrients go hand in hand with an exercise program and will allow you to lose weight in a healthy manner and provide a means for maintaining that weight loss in the future. The Osteoarthritis Research International (ORASI) expert panel on managing hip and knee arthritis highly recommended the use of lifestyle modification activities such as weight loss, aerobic exercise, strengthening and stretching programs for people with symptomatic knee and hip arthritis in their review of the available high quality literature.

There are also a variety of products that can supplement and enhance the lifestyle modifications changes you make. Although more studies are needed, some researchers believe that taking glucosamine chondroitin substrates {link} gives the cartilage cells more of an opportunity to make the cartilage healthy, and protect the cartilage to some degree. It is also believed that injectables such as HA {link} and PRP {link} have a significant positive effect on the joint to protect and facilitate joint function. However, these claims have not been fully validated in the literature and more detailed discussion on this can be found below. Furthermore, people with pain in their joints can benefit from taking routine anti-inflammatory drugs and possibly from an intra-articular steroid injection.

There is a whole battery of measures that really make a difference in terms of enhancing lifestyle when a person has joint pain and you should consider discussing your options with your healthcare provider.

What are the potential gains for patients?

By engaging in lifestyle changes, your joint works better. If the joint works better today, you develop benefits for your heart, your cholesterol and triglyceride levels, your longevity, your brain function, and your cardiovascular system.

Every system is improved by exercise on a daily basis, and that really comes back to the concept that we have been hard-wired to be active. Humans are the true survivors in the battle of the fittest, with respects to Charles Darwin’s theory of survival of the fittest. It is the same today as it was 100,000 years ago, when the people that were selected were the best hunters, or the fittest. If we can leverage that part of our hard wiring, we can definitely reap the benefits in terms of a longer and higher quality of life in which our joints remain functional and pain free.

Further reading
  • Zhang W, Moskowitz RW, et al. OARSI recommendations for the management of hip and knee osteoarthritis, Part II: OARSI evidence-based, expert consensus guidelines. Osteoarthritis and Cartilage (2008) 16, 137-162.
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