At Home Pain Management of Arthritis

Osteoarthritis is a joint disease where the protective cartilage on the bone ends degrade and can cause pain, stiffness, and other limitations. This disease has been impacting an increasing number of people in recent years. The most common type is knee osteoarthritis (KOA), which impacts about 1 in 10 people. Symptoms can make day-to-day life more difficult and with no cure, the ultimate solution is a total knee replacement surgery, which can be costly and risky. While medication may help, they can come with their own side effects. Home-based exercise has not been studied to its full scope, but it can be an effective treatment with many benefits.

This article summarizes a meta-analysis (Si et al. 2023) on existing research regarding home-based exercise’s impact on quality of life, managing pain, and its use in everyday life. 

Methods

Si et al. analyzed trials conducted in adult patients over the age of 40 diagnosed with KOA who completed a home based exercise program. Twelve 12 research studies representing 1442 individuals across a number of countries were evaluated. The pain, quality of life, and physical function outcomes were measured using various trustworthy scales. People who had knee surgery; a mental, neurological, or deadly illness; or were already using other treatments were not included. The exercises were tested through formats such as exercise booklets and smartphones, and they included supervised and unsupervised exercises. 

Results 

The study found that home-based exercise had a significant effect on pain, physical function, and quality of life. When compared with no intervention, home based exercise significantly reduced pain and significantly improved physical function. When compared with health education alone, participants receiving the home-based intervention experienced significantly less pain and significantly better physical function. When compared with clinic-based exercise, the home-based exercise led to significant improvements in pain, but there was no significant improvement in physical function. When compared to treatment with medication, there were no significant differences in either pain or physical function. Overall, the type of treatment significantly influenced outcomes for both pain and physical function.

Discussion

This study showed that exercising at home can reduce knee pain associated with KOA, improve physical function, and improve quality of life. Since muscle and joint problems can increase the risk of other long-term health concerns, at-home exercise may also prevent additional complications. Experts recommend exercising at least three times a week for the best results to build muscle strength, improve blood flow, reduce inflammation, and protect joint structure. These exercises are personalizable, based on ability, level, and doctor’s advice. Some examples include strength training, stretching, aerobic exercise, and tai chi. At-home exercise may be more effective than clinic-based exercise and medication due to cost-efficiency and decreased stress. 

Limitations

Although home-based exercise may improve overall physical movement, these results apply only to individuals who have not undergone knee replacement surgery. More research is needed to determine if home exercise would help patients after knee replacement surgery. Second, only English studies were included which may limit generalizability to other populations. Lastly, most of the studies examined strength-training, so less is known about the effects of other exercises such as balance and aerobic training.  

Summary

This study implies that home-based exercise reduces knee pain and improves mental and physical wellness. It’s convenient for people with KOA, especially for those with limited access to clinics. It works better than no treatment or education alone, and just about as well as medication and clinic-based exercise. However, more needs to be known about exercise length and intensity, as patients need specific guidelines to tailor their treatment. Technology could be a useful tool in supervising exercise, such as smartwatches or smartphone apps.

While more research is still needed, home-based exercise appears to be a safe, practical, and effective approach to treat knee osteoarthritis.

Written by Ava Muter, Sameeha Lalani, Stephen Leach, Vibha Gowda

Edited by Abhilasha Borad, MD

References

1. Si J, Sun L, Li Z, Zhu W, Yin W, Peng L. Effectiveness of home-based exercise interventions on pain, physical function and quality of life in individuals with knee osteoarthritis: a systematic review and meta-analysis. Journal of Orthopaedic Surgery and Research. 2023;18(1):503. doi:https://doi.org/10.1186/s13018-023-04004-z