Walking can prevent knee pain in people with osteoarthritis, study says

A promising new study suggests that walking can prevent knee pain in people with osteoarthritis.

The researchers looked at more than 1,000 people age 50 and older with osteoarthritis, the most common type of arthritis in the United States. Some were already experiencing persistent pain at the start of the study, and some were not.

After four years, those who started out without frequent knee pain and walked for exercise were shown to be ten times less likely to have new, frequent episodes of knee stiffness or pain, and to have less structural knee damage.

The study suggested that people with knee osteoarthritis who have bow legs may especially benefit from walking. The research offers an easy, free way to tackle one of the most common culprits of knee pain among older adults.

for dr. Grace Hsiao-Wei Lo, assistant professor at Baylor College of Medicine in Houston and lead author of the study, the findings represent a paradigm shift.​

“Everyone is looking for some kind of drug solution. Our results emphasize the importance and likelihood that osteoarthritis interventions could be something different, including good old-fashioned exercise.” She added that research suggests that exercise can help manage osteoarthritis in other joints, such as the hips, hands and feet.

Sometimes described as wear and tear arthritis, osteoarthritis affects more than 32.5 million adults in the US. According to the CDC (Centers for Disease Control and Prevention), it occurs when the cartilage in the joints breaks down and the underlying bone begins to change.

The risk of developing the condition increases with age, and about a third of people over age 60 have osteoarthritis of the knee, Lo said. Many patients take medications like ibuprofen or naproxen to treat pain. In high doses, these drugs can cause kidney problems and ulcers.

Instead, people may perhaps turn to physical exercise. For decades, health experts have viewed walking as primarily beneficial to cardiovascular health, said Cleveland Clinic rheumatologist Elaine Husni, who was not involved in the study.

But in recent years they’ve turned to low-impact exercise to treat conditions like depression, cognitive impairment and mild osteoarthritis.

The new study shows that walking can also work as a preventative measure, Lo said, and suggests that people at higher risk of developing osteoarthritis would do well to incorporate regular walking into their daily lives. Dr. Lo said that in her own case, for example, based on the findings of the study, as her mother has osteoarthritis, she herself should walk more.

The study began in 2004 and documented the participants’ usual knee pain, using radiographs to assess their osteoarthritis.

The researchers then asked the participants to document their exercise habits and review their symptoms at regular return visits, asking how often they felt pain in their knees.

After four years, 37% of participants who did not walk to exercise (apart from the occasional trip to the grocery store or train station) began to experience new and frequent knee pain, versus 26% of participants who walked.

Of course, the researchers cannot state unequivocally that walking prevented the onset of knee pain or reduced pain that was already present.

Self-assessment may not be as accurate as pedometers or fitness tracker watches. And the researchers didn’t monitor distances walked or frequency of walks. Nor did they recommend strategies for how and when people with osteoarthritis should incorporate walking into their exercise routine.

Even so, the results reinforce what doctors already know about how to control osteoarthritis. Consistent movement can help build muscle mass by strengthening the ligaments around joints with osteoarthritis, said Dr. Husni. She explained that walking is a low-intensity, low-impact exercise that allows people to retain the strength and flexibility that are crucial to maintaining healthy joints.

“It’s an intervention that anyone can do,” she said. “You have no excuses. You can walk wherever you are.”

People who already have knee pain should be careful not to exercise too much, said Dr. Justen Elbayar, a sports medicine specialist who works in the department of orthopedic surgery at NYU Langone Health and was not involved in the study.

Walking long distances can exacerbate pain for people with severe arthritis, he said. But for those with milder osteoarthritis, “it’s one of the best forms of exercise you can do.”

He recommends that people start with short walks and gradually increase the distance covered. The purpose of the exercise is to give muscular support to an arthritic knee and let the joints, tendons and tissues get used to walking.

Elbayar also suggests wearing shoes with good support, drinking plenty of water while walking, and taking frequent rest breaks if you get tired or aren’t used to walking. After a long walk, applying ice to the knee can also ease discomfort.

According to Dr. Lo, a light walk on the street will not be able to repair cartilage or remedy pain already present, but physical exercise is an attractive and affordable option to prevent the more uncomfortable aspects of osteoarthritis. After all, she pointed out, “walking doesn’t cost a penny.”

Translation by Clara Allain