In the doctor’s surgery painkillers are usually prescribed, but there is another important aspect when treating this disease, exercise —a factor which is appearing increasingly in the Treatment Guidelines of the Scientific Societies devoted to dealing with these patients.
The European League Against Rheumatism, one of the most important Medical Societies on this subject, carried out an exhaustive study that concluded that apart from the cardiovascular benefits of exercise, patients with joint pain were able to experience improvement in their clinical symptoms by doing cardio exercises. There was also an improvement in those patients who did strength exercises.
Dr. Francisco Martínez Peñalver – Neolife Medical Team
Patients with joint pain are often reluctant to exercise for fear that the pain will increase or that the injury that causes it will worsen.
The arthritic/arthrosic pathology is one of the conditions most frequently encountered in the general practitioner’s surgery. The loss of quality of life that it produces, and in the case of osteoarthritis, the fact that it is a degenerative disease that doesn’t have any clearly effective treatment, produces a sequence of visits to the doctor in search of alleviating symptoms that are basically pain and functional limitation. Arthrosis manifests itself in outbreaks, in episodes of joint inflammation that are called arthritis, osteoarthritis or inflammatory arthritis without distinction.
In the doctor’s surgery painkillers are usually prescribed, but there is another important aspect when it comes to approaching the treatment of this disease, which often goes unnoticed. We are referring to exercise, which appears with increasing emphasis in the Treatment Guidelines of those Scientific Societies devoted to dealing with these patients.
Patients with joint pain are often reluctant to exercise for the fear that the pain will increase or that the injury that causes it will worsen. The European League Against Rheumatism (EULAR), one of the most important Medical Societies on this subject, carried out an exhaustive study that concluded that apart from the cardiovascular benefits of exercise, patients with joint pain were able to experience improvement in their clinical symptoms by doing cardio exercises. There was also an improvement in those patients who did strength exercises (1).
The recommendations of the American College of Sports Medicine and the American Heart Association (AHA) for patients affected by osteoarthritis advise at least 30 minutes of moderate physical activity at least 5 days a week, or 3 days at a higher intensity. These intervals can be completed in several sessions during the day. It is recommended that the sessions be cardio or strength exercises, rather than mixing the two types of exercise (2).
The EULAR group also recommends focusing on primary care physicians since, according to the data collected in their studies, they tend to fall very short on the subject of prescribing physical exercise and are very poorly trained when recommending the type of physical activity that may be suitable for each patient. With regard to the former, doctors should share the scientific knowledge about the benefits of exercise with the patient, while knowing how to use painkillers to help the patient adapt gradually to the sporting life. They need to learn motivating techniques so that patients become “hooked” on exercise, in short, primary care physicians need to be trained specifically in this area of knowledge, because in surveys conducted in this sector, ignorance about prescribing exercise is precisely the main reason for them being uncomfortable when it comes to recommending it.
Joint-friendly exercises, which are better tolerated by patients’ joints, include walking, swimming, cycling and certain types of collective classes. The most recent recommendations of the EULAR are that within those 5 days a week minimum training, 2 of them should be based on strength exercises.
The website of the Center for Disease Control and Prevention (CDC) in Atlanta includes a graphic document about the recommended daily exercises for patients suffering from arthritis. This document dates from 2008, and the CDC has committed itself to publishing the new guidelines before the end of this year (3).
(1) Rausch-Ostoff AK et al. 2018 EULAR recommendations for physical activity in people with inflammatory arthritis and osteoarthritis. Ann Rheum Dis. 2018 Sep;77(9):1251-1260.
(2) Thomas RJ et al. AACVPR/ACCF/AHA 2010 Update: Performance measures on Cardiac Rehabilitation for referral to cardiac rehabilitation/secondary prevention services. J Am Coll Cardiol. 2010 Sep 28;56(14):1159-67.