Non-Operative Management of Arthritis with Dr. Ronald Hillock- Part One

Osteoarthritis is one of the most common conditions I am asked to evaluate and treat. It is estimated that 27 million Americans are currently living with the pain of osteoarthritis. Patients seeking treatment for the arthritis represent about 25% of all visits to primary care clinics(1). Globally there are about 250 million who live with the daily pain of Osteoarthritis (OA), which is roughly 3.6% of the world’s population(2).

If you or a loved one has been diagnosed with OA of the knee or hip (or both) there are several non-operative medical treatment options that should be used before considering surgery. These options are weight loss, medications, exercise through physical therapy, injections, alternative medicine in the treatment of osteoarthritis, and bracing and foot wear.

Non-Operative Management Option 1: Weight Loss

Weight Loss has been proven to reduce pain related to OA in lower extremity joints in many studies (3).

I am sad to say, most of my patients are very over weight. This is a product of our lifestyle and too much inexpensive food. Studies have shown the single greatest factor in weight control is diet. You are what you eat. There are no bad foods, just bad behavior.

When you walk your heel strikes the floor and energy is transferred through something called the ground reaction force. Walking on a level surface at a standard cadence the ground reaction force for each heel strike is between 3 and 5 times your total body weight… think about that for a minute. Do the math, 20lbs weight loss results in up to 100lbs reduction in the ground reaction force at standard walking speeds. You will feel that difference and your joints will thank you for lightening their load. Talk to you primary care provider about weight loss methods. Talk to your family about lifestyle modifications to meet the goal of weight loss.

Relative comparison of reaction forces for standard activities

• Cycling: 1.2 times body weight at the knees
• Walking: 3 to 5 times body weight at the knees
• Stair climbing: 5 to 7 times body weight at the knees
• Running: 15 times body weight at the knees

References

1 “Table 9: Estimated prevalence of moderate and severe disability (millions) for leading disabling conditions by age, for high-income and low- and middle-income countries, 2004”. The Global Burden of Disease: 2004 Update. Geneva: World Health Organization. 2008. p. 35.

2 Vos T, Flaxman AD, Naghavi M, Lozano R, Michaud C, Ezzati M et al. (December 2012). “Years lived with disability (YLDs) for 1160 sequelae of 289 diseases and injuries 1990-2010: a systematic analysis for the Global Burden of Disease Study 2010”. Lancet 380 (9859): 2163–96. doi:10.1016/S0140-6736(12)61729-2. PMID 23245607

3 Cibulka MT, White DM, Woehrle J, Harris-Hayes M, Enseki K, Fagerson TL, Slover J, Godges JJ (April 2009). “Hip pain and mobility deficits—hip osteoarthritis: clinical practice guidelines linked to the international classification of functioning, disability, and health from the orthopaedic section of the American Physical Therapy Association”. J Orthop Sports Phys Ther 39 (4): A1–25. doi:10.2519/jospt.2009.0301. PMID 19352008.