Welcome to the second part of our three-part blog series on Knee Osteoarthritis (OA). This series will tell you everything you need to know about the condition; the symptoms, stages, treatments, and bracing options available to you. You can read part of the series here. Today we’ll discuss non-surgical treatments for OA that can help ease the pain, reduce symptoms and slow OA progression.
If you suffer from knee OA, there are many treatment options available to you. It is important to keep in mind that OA is a degenerative disease, so any treatments aim to slow down joint degeneration, reduce pain, regain mobility. As of today, there is no cure for knee OA. But, depending on the severity of your condition, treatments could include any of the following.
OA bracing helps obtain better alignment of the knee; taking pressure off of damaged areas to relieve pain and restore function. A study showed that knee bracing can be effective with “31% of participants taking fewer over-the-counter anti-inflammatory drugs, and 35% taking fewer prescription anti-inflammatory drugs after six months of wearing the brace.” Braces do the following:
- Decrease pain
- Protect the joint – slowing further degeneration and preventing further injury
- Allow return to function in a safe manner
- Provide proprioceptive (feedback) information so you can avoid potentially aggravating positions or activities
- Delay or avoid surgery
Therapeutic bracing can be beneficial at any stage of OA. The style or type of brace prescribed by your physiotherapist can vary depending on both your lifestyle and how far your OA has progressed. Your physiotherapist will also tell you when you should and should not wear a brace. Types of braces include:
OdrA™ Knee Brace – Custom Fit Off Loading Knee Brace
Custom fitted knee braces offer clinically relevant pain relief and improve mobility without the potential discomfort associated with some off the shelf models. The Canadian designed OdrA knee brace, for example, offers exceptional fit, support and clinically proven pain relief. It is considered the best “Wear and Go” brace on the market.
How it works
Designed for active people with medial (inside) knee pain, which is 90% of people with knee OA. Off loading knee braces like OdrA are a great non-operative, non-invasive treatment option for knee OA. 3 point off loading knee braces for knee OA work by increasing the space between the joint, improving the angle where the bones meet and reducing the overall pressure on your knee joint.
OdrA uses patented distraction-rotation hinges to immediately reduce pain and improve gait (the way you walk or stand). The inside hinge elongates while the external hinge rotates the joint to reduce compression while reducing pain and discomfort. Better yet, the hinges never touch your skin (unlike other off the shelf option) meaning your can wear it longer without risk of chafing or other skin irritations. These unique hinges are what reduces pain and could reduce further damage as well as progression into further stages of OA.
OdrA’s Unique Advanced Technology
The OdrA knee brace is so effective that in clinical studies 76% of patients showed a clinical improvement in pain, a further ⅓ of patients stopped taking oral medications for pain relief. Better yet, the OdrA™ knee brace has been awarded the Gold Standard in bracing in a clinical trial from Ornetti et al. This is because the brace is so comfortable that 94% of patients still use it after 1 year and wear it longer than other braces, 6 hours per day, 6 days a week on average!
Why is it so comfortable and easy to wear? Because certified OdrA clinicians use state of the art fitting technology to produce an offloading brace specifically designed to address your unique imbalances. With an OdrA brace you get:
- Instant and lasting pain relief
- Modifiable shell for exceptional fit and comfort
- Lowest profile brace that can be worn under clothing
- Clinically effective and non-invasive
- Most cost effective solution
- Covered by most insurance companies
3 Point Off Loading Knee Brace
Off loading braces are also available off the shelf, meaning that while they are fit to your needs they are not built using 3D scanning technology. So, while patients can hugely benefit from off the shelf bracing options, they can potentially feel bulky, uncomfortable, ill-fitting, and cause skin irritation. This may be why some patients do not report wearing their off the shelf brace regularly.
Compression Knee Brace
Recommended for patients in the early stages of OA, compression sleeve knee braces are best for patients with stable knee joints but are experiencing mild pain, discomfort, or swelling. These type of braces apply gentle compression to reduce pain and swelling in the joint. Compression braces are usually combined with strengthening exercises to help stabilize the knee joint and further reduce pain.
Bi-lateral Hinged Knee Brace
Hinged knee braces are recommended for patients with mild joint instability (usually occurring in the second or third stages of OA). Made of neoprene with a built in a metal hinge, these braces offer both compression (from the neoprene) and joint support (from the metal stays).
Acetaminophen is shown to have mild effectiveness in treating pain and discomfort associated with OA. A greater relief is felt when acetaminophen is combined with other drugs such as ibuprofen.
If little or no relief is felt with acetaminophen, then your physician may recommend a Nonsteroidal anti-inflammatory drug (NSAID). These pain relievers can be taken orally or used as a topical treatment and are primarily used to ease joint pain. NSAIDs are considered a short-term solution to OA pain as they do present significant side effects such as heart attack and stroke.
Injections into the knee joint are a common OA treatment. Injection therapies do require maintenance as they dissipate after a time, meaning you will have to get these injections regularly. There are two types of injections available for OA. One is a corticosteroid injection. However, recent studies have shown it to be ineffective as a treatment option.
The other injection available for knee OA is viscosupplementation, in which a lubricating solution containing hyaluronic acid is injected into the joint. These injections add to the current joint fluid to increase lubrication and add some cushioning to the joint. While viscosupplementation can reduce pain and improve joint lubrication, it is still recommended that patients seek out rehabilitation such as physiotherapy to increase muscle strength and improve range of motion.
Supervised exercises have proven effective in managing OA knee pain at all stages of degeneration. Physiotherapy focusing on muscle-strengthening and aerobic conditioning can help patients manage pain and improve range of motion. Depending on your treatment plan your physiotherapist may use any combination of:
- Strengthening, endurance, range of motion, stretching and balance exercises
- Pain control modalities or techniques
- Functional retraining
- Education for activity modification and brace or gait aid use
Full Knee Replacement
A full replacement of the knee joint is a very invasive treatment for OA and is considered a last resort. For more information about joint replacement surgery, see the Arthritis Society here.
Don’t let knee pain hold you back from doing the activities you love, book an assessment with a physiotherapist to find the treatment option that’s best for you.