What do you do if you’ve got osteoarthritis of the knee?

kneesFilm director Baz Luhrmann made a spoof graduation speech famous with his hit “Everybody’s Free (To Wear Sunscreen)” back in 1999. At the time, I wasn’t particularly worried about the line in that track: “Be kind to your knees, you’ll miss them when they’re gone.” But, you get older, knees become more of a focus, so what are you to do if you suffer from osteoarthritis of the knee (thankfully, I don’t…yet).

According to SBM, here’s what a massive scientific review of the various possible treatments has to say:

Exercise – strong evidence for effectiveness
Weight loss – moderate evidence for
Acupuncture – strong evidence against
Physical agents TENS, ultrasound, etc. – inconclusive
Manual therapy chiropractic, massage – inconclusive
Valgus directing force brace – inconclusive
Lateral wedge insoles – moderate evidence against
Glucosamine and chondroitin – strong evidence against
NSAIDs – strong evidence for
Acetaminophen, opioids, pain patches – inconclusive
Intraarticular corticosteroid injections – inconclusive
Hyaluronic acid injections – strong evidence against
Hyaluronic acid supplements – see above
Growth factor injections and/or platelet rich plasma – inconclusive
Needle lavage – moderate evidence against
Arthroscopy with lavage and debridement – strong evidence against
Partial meniscectomy in osteoarthritis patients with torn meniscus – inconclusive
Valgus producing proximal tibial osteotomy – limited evidence
Free-floating interpositional device – no evidence; consensus against

So knee sufferers, the bottom line seems to be, get some exercise and take painkillers if you need to. Dietary supplements, injections, alternative medicine BS and unproven surgical procedures seem to do nothing but cost you money. I’m particularly glad to see the scam that is glucosamine and chondroitin called out in the review as having strong evidence against them, I’ve written about that nonsense in the past several times having never seen any scientific report to suggest anyone is ever deficient or needs supplements.

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2 thoughts on “What do you do if you’ve got osteoarthritis of the knee?

  1. Thanks for your input Wendy. Everyone’s experience with different treatments will vary, of course, but doctors must work with science-based evidence from clinical trials in their recommendations, anecdote is not evidence, there has to be a “control” group using/taking placebo to preclude the placebo effect. If the placebo works then the pharma/surgical or other intervention would simply be a costly and potentially risky treatment with no benefits. Chronic use of NSAIDs is problematic, especially for those at risk of cardiovascular disease. When you say you haven’t tried “Acetaminophen, opioids, pain patches”, are you sure you’ve never taken paracetamol or paracodol and related painkillers?

  2. Thanks for focussing on Arthritis, David.

    I have Arthritis of spine, knees, feet, hands, hips. I have been living with arthritis for about 15 years.

    THINGS THAT HELP ME: SWIMMING, TAI CHI AND AQUACISE ARE GOOD FOR EXCERCISE AND KEEP ME MOVING.
    FREQUENT USE OF SPA TREATMENTS – STEAM, SAUNA, JACUZZIS, ARE VERY GOOD FOR MY BONES AND WELL BEING. WARM BODY TREATMENTS – LIKE HOT STONE MASSAGE

    BEING IN A WARM CLIMATE – JUST SPENT A MONTH IN IBIZA – THE WARM SUN MADE MY BONES FEEL GOOD

    My comments on your list:

    Weight loss – moderate evidence for – YES – I RECENTLY LOST 70LBS – IT HELPS
    Acupuncture – strong evidence against – ACUPUNCTURE IS GREAT FOR PAIN RELIEF – I RECOMMEND IT
    Physical agents TENS, ultrasound, etc. – inconclusive – NO USE AT ALL
    Manual therapy chiropractic, massage – inconclusive – BENEFICIAL – HANDS ON IS ALWAYS GOOD
    Valgus directing force brace – inconclusive – SOMETIMES I HAVE TO WEAR KNEE / HAND SUPPORTS
    Lateral wedge insoles – moderate evidence against – NOT ANY USE
    Glucosamine and chondroitin – strong evidence against – I HAVE SPENT A FORTUNE ON THIS RUBBISH
    NSAIDs – strong evidence for – I TAKE NAPROXIN – VERY VERY GOOD FOR PAIN, TAKEN ON REGULAR BASIS
    Acetaminophen, opioids, pain patches – inconclusive – NOT TRIED
    Intraarticular corticosteroid injections – inconclusive – JABS ARE NOT LONG LASTING – MINE DID ONE DAY!
    Hyaluronic acid injections – strong evidence against – NO EXPERIENCE OF THIS
    Hyaluronic acid supplements – see above NO EXPERIENCE OF THIS
    Growth factor injections and/or platelet rich plasma – inconclusive NO EXPERIENCE OF THIS
    Needle lavage – moderate evidence against NO EXPERIENCE OF THIS
    Arthroscopy with lavage and debridement – strong evidence against – EXCELLENT – WASH AND BRUSH UP! HAD BOTH KNEES DONE – PAIN RELIEF IMMEDIATLEY
    Partial meniscectomy in osteoarthritis patients with torn meniscus – inconclusive NO EXPERIENCE OF THIS
    Valgus producing proximal tibial osteotomy – limited evidence NO EXPERIENCE OF THIS
    Free-floating interpositional device – no evidence; consensus against NO EXPERIENCE OF THIS

    I wish there was more research. I am not happy taking painkillers long term.

    i live an active life and try to hide my poor mobility.

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