Osteoarthritis, a large international journal puts the effect of exercise into perspective with low and often temporary benefits
Long touted as the number one treatment for osteoarthritis, exercise is undergoing serious re-examination. For millions of people affected by this degenerative joint disease, we repeat that we must move to reduce pain and preserve mobility. A vast international analysis has now qualified this promise.
A great summary that really measures the effect of exercise in osteoarthritis
The researchers compiled data on osteoarthritis of the knee, hip, hand and, more rarely, the ankle, in adults with an average age of around 63, mostly women. Five reviews totaling 8,631 participants and 28 additional randomized trials (4,360 patients) were reanalyzed on the same scale of 0 to 100 for pain and function.
For the knee, exercise provides, in the short term, an average reduction in pain of approximately 11 to 12 points out of 100 compared to a placebo or no treatment. The authors point out that a change of less than 8 points is considered clinically irrelevant and that, in longer or larger trials, these benefits further diminish.
Weak, often transient effects compared to other osteoarthritis treatments
For the hip, the difference with the absence of treatment is around 7 points out of 100, which remains considered negligible, while the hand shows a small effect of around 10 points. Looking at all the data, the researchers write: “We found largely inconclusive evidence on exercise in osteoarthritis, suggesting negligible or, at best, small and short-lived effects on pain and function compared with placebo or no treatment.“, write the authors in RMD Open.
The results appear generally similar to those obtained by patient education, manual therapy, analgesics, intra-articular injections of corticosteroids or hyaluronic acid and even knee arthroscopy. On the other hand, some tests show that in the long term theexercise relieves less than osteotomy or total prosthesis surgeries. “Our results challenge the universal promotion of exercise therapy as the sole first-line treatment priority to improve pain and physical function in all patients with osteoarthritis.“, summarize the authors.
Limited benefits, but a place to be specified for the exercise
For Tim Schleimer, first author of the study, “These results call for a more realistic perspective: the symptom relief provided by exercise appears small and probably not long-lasting, suggesting that continued exercise would be necessary at least to maintain these modest benefits.“. He also insists on the need for a shared choice between doctor and patient, taking into account other options. Several specialists also point out that physical activity improves the heart, weight and mood beyond osteoarthritis.
This research does not suggest that physical activity is without value, but it does challenge the idea of a standardized approach. She emphasizes the importance of adopting a more subtle approach to treatment, setting realistic expectations with patients and integrating exercise as part of a more comprehensive, personalized treatment plan, rather than presenting it as a quick fix for pain relief.