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What if I told you that much of what you know about knee osteoarthritis is completely wrong? In this video, we'll uncover the truth behind the top 8 myths about knee osteoarthritis that many people, including yourself, likely believe. These myths can prevent you from effectively managing your condition and living a full and active life. By the end of this video, you'll have a clear understanding of what actually works and what doesn't. I will provide you with the tools to reduce pain, improve mobility, and enjoy a better quality of life despite having knee osteoarthritis.

Myth #1: Exercise Worsens Osteoarthritis

Hey everyone, Dr Jeff Peng here. Let’s tackle the first myth head on: “Physical activity exacerbates joint pain and accelerates degradation in osteoarthritis.” There’s a prevalent belief that running or exercising contributes to the development of arthritis, but this just isn’t true. For instance, a major survey among marathon runners - who, if the myth were true, would exhibit exceptionally high rates of arthritis - found no link between their running history and an increased risk of arthritis.

In fact, engaging in gentle, low-impact exercises like swimming, walking, and cycling can significantly benefit those with knee osteoarthritis. These activities strengthen the muscles around the knee, improve flexibility, and reduce stiffness, which ultimately enhances joint function and reduces pain. I recommend doing at least 30 minutes of light cardio every day.

Additionally, strength and resistance training exercises are crucial for managing knee osteoarthritis. Our muscles provide support and stability to the joint. Stronger muscles are more able to improve joint mechanics, which can then lead to significant improvements in both pain and function. I recommend incorporating a lower body resistance training program two to three times a week, with particular emphasis on developing the gluteal muscles and quadriceps.

It's important to note that experiencing a mild amount of pain during exercise is acceptable and doesn't necessarily mean you're worsening your condition. In fact, exercising can be quite beneficial as movement helps lubricate the joints. As you become more active, you'll likely start to feel better. I advise my patients that a pain level of up to 3 maybe 4 out of 10 is acceptable and encourage them to work through this discomfort.

Myth #2: Osteoarthritis Only Affects the Elderly

The second myth we need to debunk is the belief that "osteoarthritis only affects the elderly." It's true that osteoarthritis is more common in older adults due to the natural wear and tear of joints over time. However, this condition is not exclusive to the elderly.

Osteoarthritis can affect people of all ages. Several factors can increase the risk of developing osteoarthritis at a younger age. Joint injuries, for instance, can lead to early onset of osteoarthritis, especially in athletes or individuals who have experienced significant trauma to their joints. Obesity is another critical risk factor, as excess weight puts additional stress on the joints, particularly the knees, leading to faster joint deterioration. Furthermore, a family history of osteoarthritis can predispose individuals to the condition, regardless of their age.

Another crucial point is the prevalence of patellofemoral pain syndrome and anterior knee pain, which are the most common causes of knee pain in young adults. Studies have shown that these conditions increase the risk of developing worsening cartilage damage over time. This highlights the importance of early intervention and proper management of knee pain in young adults to prevent long-term damage.

Myth #3: Osteoarthritis is Purely a Wear-and-Tear Disease

Now, let's move on to the third myth: "Osteoarthritis is purely a wear-and-tear disease." Many people believe that osteoarthritis is simply the result of joints wearing out over time, but this understanding is incomplete and overlooks the complexity of the condition.

While it's true that the natural wear and tear of joints can contribute to osteoarthritis, there are several other significant factors at play. We are now learning that osteoarthritis is as much a metabolic disease as it is a wear-and-tear disease. This means that metabolic factors such as high blood sugar, high triglycerides, high cholesterol, high blood pressure, and increased body fat contribute significantly to the development and progression of osteoarthritis.

High blood sugar and high triglycerides can lead to systemic inflammation, which not only worsens the pain and symptoms of osteoarthritis but also accelerates the degeneration of joint tissues. Similarly, high cholesterol and high blood pressure are linked to inflammatory processes that can exacerbate joint damage. Increased body fat, particularly around the abdomen, produces inflammatory cytokines that contribute to chronic inflammation throughout the body, including the joints.

Genetic factors also play a crucial role; if you have a family history of osteoarthritis, you are more likely to develop the condition yourself. This suggests that there are inherited traits that can make your joints more susceptible to osteoarthritis.

So, while wear and tear are part of the equation, osteoarthritis is much more than that. By considering the genetic, metabolic, and biochemical factors, and incorporating a healthy diet, we can take a more holistic approach to treatment and management, ultimately improving outcomes for those living with this condition.

Myth #4: Diet Has No Effect on Osteoarthritis

This leads us nicely to the next myth we need to debunk: "Diet has no effect on osteoarthritis." Many people believe that what they eat doesn't impact their osteoarthritis, but this couldn't be further from the truth. In reality, diet can play a significant role in managing osteoarthritis, particularly through its effects on inflammation.

Osteoarthritis is influenced by metabolic factors, and one of the best ways to address these factors is through your diet. Nutritional choices that reduce inflammation can help manage symptoms and slow the progression of the disease. An anti-inflammatory diet is essential for anyone dealing with osteoarthritis.

To manage osteoarthritis effectively, it's crucial to stay away from added sugars and saturated fats. These foods can worsen inflammation, leading to increased pain and further joint damage. Instead, focus on incorporating anti-inflammatory foods into your diet. This means eating plenty of vegetables, fruits, lean meats, whole grains, and healthy fats like those found in fish, nuts, and olive oil.

By transitioning to a diet rich in anti-inflammatory foods, you can take a proactive step in managing your osteoarthritis. Not only will this help reduce pain and improve joint function, but it can also enhance your overall health and well-being.

Myth #5: Osteoarthritis is Only About Joint Pain

Let's address the next myth: "The only symptom of osteoarthritis is joint pain." While joint pain is a prominent and well-known symptom of osteoarthritis, it is far from being the only one. Osteoarthritis can manifest in various ways, affecting not just the joints but also overall mobility and quality of life.

In addition to pain, osteoarthritis often leads to stiffness, particularly after periods of inactivity, such as waking up in the morning or sitting for long periods. This stiffness can make it difficult to move the knee and perform daily activities.

Swelling is another common symptom. Inflammation within the joint can cause it to become swollen, tender, and warm to the touch. This swelling can vary in intensity and may come and go with flare-ups. 

Osteoarthritis can also result in a decreased range of motion. As the joint structure deteriorates, it can become harder to move the joint through its full range of motion. This limitation can affect your ability to perform everyday tasks, such as bending, walking, or reaching.

So, remember, osteoarthritis is more than just joint pain. It includes stiffness, swelling, and decreased range of motion. All of these can negatively affect quality of life. Being aware of these symptoms can help you better manage your arthritis and seek appropriate treatments to maintain an active and fulfilling life.

Myth #6: Only Medications Can Manage Osteoarthritis Pain

Now, let's debunk myth number 6: "Prescription or over-the-counter medications are the only ways to manage osteoarthritis pain." While medications can play an important role in managing osteoarthritis symptoms, they are not the only option, nor are they the best option. In fact, there are several non-medical treatments that can be highly effective in managing osteoarthritis pain and improving quality of life.

Systematic reviews and meta-analyses have found that exercise and physical therapy is just as effective at reducing pain and improving function when compared to medications such as ibuprofen and naproxen. These exercises can help reduce pain, improve mobility, and prevent further joint damage. 

Lifestyle modifications are also crucial in managing osteoarthritis. Maintaining a healthy weight is one of the most important steps you can take. For those carrying around some extra body weight, studies suggest losing 5% of body weight yielded improvements in pain, self-reported disability, and quality of life. A 10% weight reduction had a moderate to large impact on those same outcomes.

Dietary supplements can also play a role in managing pain and symptoms related to arthritis. Two of the best studied dietary supplements that can treat symptoms related to osteoarthritis include Boswellia serrata as well as Turmeric and its active component curcumin. Studies suggest that the effects of these supplements were just as strong as taking non steroidal anti-inflammatory drugs such as ibuprofen and naproxen, but without the associated side effects.

So, remember, managing osteoarthritis pain is not limited to prescription or over-the-counter medications. Exercise therapy, lifestyle modifications, and dietary supplements can be highly effective in reducing pain and improving your quality of life. By incorporating these strategies into your routine, you can take a proactive approach to managing osteoarthritis and enjoy a more active, fulfilling life.

Myth #7: Radiographic Severity Always Correlates With Clinical Severity 

Myth # 7 is "More severe arthritis on x-rays means more severe symptoms." Many people believe that the extent of joint degeneration visible on x-rays directly correlates with the level of pain and functional impairment they experience. However, this is not always the case. 

The reality is that the severity of arthritis seen on x-rays does not always match the degree of symptoms experienced. While x-rays can show the extent of joint degeneration, the level of pain and functional impairment individuals experience can vary widely. Several factors influence symptoms, including muscle strength, activity level, and individual pain tolerance.

For instance, some patients with significant radiographic changes may have minimal to no symptoms. These individuals might have strong muscles supporting their joints, high activity levels, and a higher pain tolerance, allowing them to function well despite the visible joint damage. On the other hand, others with only mild changes on x-rays may experience considerable pain and difficulty with daily activities. 

This is also really important when it comes to deciding who ultimately needs a knee replacement surgery. X-rays alone do not determine the need for knee replacement surgery. Someone with severe radiographic knee osteoarthritis might still be able to run, hike, and engage in athletic activities if their symptoms are effectively managed non-surgically. In fact, undergoing knee replacement surgery in such cases may lead to worse overall outcomes. Instead, use your symptoms as a guide to manage your arthritis. Don't let your x-ray results dictate how you should feel.

Myth #8: Osteoarthritis Cannot Be Prevented

Let's debunk the myth that "there is nothing you can do to prevent osteoarthritis from getting worse." Many believe osteoarthritis is an inevitable part of aging, but this isn't necessarily true. While you can't change genetic risk factors, proactive steps can significantly reduce your risk.

Maintaining a healthy weight is crucial. Excess body weight adds stress to your joints, particularly the knees and hips, accelerating wear and tear. Achieving and maintaining a healthy weight through a balanced diet and regular exercise can reduce joint stress and lower your osteoarthritis risk. Additionally, newer GLP1 agonist medications such as Ozempic and Wegovy have been shown to help achieve significant weight loss, which may slow the progression of arthritis.

Regular physical activity is another key factor in preventing osteoarthritis. It keeps your joints flexible, strengthens surrounding muscles, and promotes overall joint health. Engaging in low-impact exercises like walking, swimming, and cycling is beneficial as these activities provide necessary movement without excessive strain on the joints.

Platelet-rich plasma injections might also modify the disease and slow arthritis progression. A study comparing PRP injections to saline placebo showed that PRP led to an almost 50% reduction in arthritis progression over five years, according to MRI scans taken before and after treatment.

Remember, there are many treatments that not only alleviate arthritis symptoms but can also slow its progression. However, understanding these treatments can be challenging, and healthcare providers often offer conflicting advice. That's why it's important to watch this deep dive video, where I'll clarify the most common treatment options and highlight those that are scientifically proven to be effective.

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