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Child Orthopedics
Spine - Cervical
Spine - Lumbar
Spine - Thoracic

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My doctor keeps telling me that the research shows activity and exercise is the ticket for early osteoarthritis of the knees. When I exercise it hurts more so how can this be helpful?

Conservative care for the early stages of osteoarthritis does indeed include exercise. Before beginning a program of increased activity and exercise, efforts are made to reduce the pain and inflammation. Antiinflammatory drugs are used when painful knee symptoms first start. Once the symptoms are under control, then an exercise program is more manageable. As your physician has mentioned, many high-quality studies have confirmed that exercise is helpful in reducing pain and improving function. Muscle strengthening is especially helpful in reducing pain. So even before your pain is completely gone, exercise can begin. Aerobic exercise contributes to long-term improvements in function. Of course, these programs only work if the patient does them consistently. Once the exercises are stopped, the pain returns and the patient loses ground quickly. The management of knee osteoarthritis often includes other tools to help enhance correct alignment and restore function so that exercise is possible. Knee braces can be helpful for some people. Former athletes who have hurt themselves while in action and who want to remain active may benefit from a knee brace. Patients who benefit the most from knee bracing have arthritis on one side of the joint (unicompartmental arthritis) and don't want (or are too young for) a knee replacement. Bracing helps redistribute the weight and load placed on the joint so that it isn't all on one side. This type of biomechanical unloading doesn't work forever but it can delay the need for surgery while still allowing activity. There are some studies that support the use of foot orthoses (inserts placed in the shoe to correct leg alignment) for patients with medial compartment arthritis. The medial compartment is the side of the knee joint closest to the other knee. Uneven wear on the joint is caused by misalignment of the bones. Placing a specially designed wedge inside the shoe helps shift the foot and realign the knee. The result is to redistribute weight evenly across the entire joint and unload the medial side of the joint. Knee movement, especially repetitive motion that is part of your preferred activity is made easier by some of these other tools. If you are trying to exercise but are stopped by your pain, go back to your physician to get better pain control. Then exercise will be easier to incorporate into your daily life.


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