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External Aids for Osteoarthritis

Introduction

We tend to search for ‘quick fixes’ for our aches and pains, but it is important to try non-medical treatments and lifestyle changes before we resort to medical and surgical interventions. There are numerous treatments for worn-out knees and hips which don’t require medication or surgery. Previously we have discussed exercise, as well as diet and weight loss. Read on to learn more about osteoarthritis and how to manage it with external aids.

What is osteoarthritis (OA)?

OA is a common cause of pain and altered joint function in adults.(1) The knee is the most common joint affected.(2) OA was previously considered to be the result of ‘wear and tear’, but current research suggests that underlying inflammation affects all components of the joint, including joint surface cartilage, nearby bone, the joint capsule and surrounding soft tissues.(3) Damage to the joint organ manifests as worsening pain, tenderness, reduced range of motion, bony swelling, joint deformity and instability.(4) Fortunately, experts suggest that walking aids and braces can contribute to the management of the pain and instability from OA of the knee and thumb.(5)


External aids for OA

The use of external aids in the management of knee, hip and hand OA is supported by science and expert consensus.(6) The goal of all external aids is to protect and alter the way that force moves through the joints affected by OA. Therefore, these external aids should be fitted by an experienced healthcare professional.


Aids for knee and hip OA

Valgus (unloader) knee bracing

Patients with medial tibiofemoral (bow-leg) joint OA benefit from a knee brace that shifts load from the inside of the knee (medial compartment) to the outside of the knee (lateral compartment).(7) The brace should be fitted correctly, worn regularly and made of a firm material.(7, 8) Some preliminary work suggests that soft knee braces can also improve pain and physical function, but more studies are needed.(9)

Medially-directed patellar taping

When pain originates from OA between the kneecap and the thigh bone, known as patellofemoral OA, careful taping of the kneecap to reduce load on the joint provides short term pain relief.(10, 11) There is also a small amount of evidence supporting the use of braces for patellofemoral OA if they are worn for at least 7 hours every day.(12, 13)


Walking aid

Use of a walking stick can help patients with knee OA who have reduced mobility, balance problems, recurrent falls or severe OA.(14) The walking stick should be held by the hand on the opposite side to the painful leg.

Foot insoles

Fitted foot insoles can also aid in joint realignment. Medial wedge insoles should be used for valgus knee (bow-leg) OA. Subtalar strapped insoles should be used for varus knee (knock-knee) OA.(6)


Aids for hand OA

There are a number of small studies that support the use of external devices for hand and thumb OA. These studies recommend joint protection techniques, special devices that reduce the load through the joint, heat-packs and in severe cases, specially-fitted splints.(6)


Recommendations

At Surecell, we recommend trying a variety of techniques to manage your OA. Adding an external aid, such as shoe insoles or a knee brace, to your nutrition and exercise plan could reduce pain and increase function in OA-affected joints.


Support available at Surecell

On top of exercise physiology, personal training, gym facilities and medical treatments such as platelet-rich plasma (PRP) injections, we offer a number of external devices that can be fitted to help you manage your joint pain. Feel free to contact our friendly staff by calling us on 03 9822 9996 or submitting an enquiry.


References

  1. Zhang Y, Jordan JM. Epidemiology of osteoarthritis. Clin Geriatr Med. 2010;26(3):355-69.

  2. Vos T, Flaxman AD, Naghavi M, Lozano R, Michaud C, Ezzati M, et al. 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. 2012;380(9859):2163-96.

  3. Loeser RF, Goldring SR, Scanzello CR, Goldring MB. Osteoarthritis: a disease of the joint as an organ. Arthritis Rheum. 2012;64(6):1697-707.

  4. Zhang W, Doherty M, Peat G, Bierma-Zeinstra MA, Arden NK, Bresnihan B, et al. EULAR evidence-based recommendations for the diagnosis of knee osteoarthritis. Ann Rheum Dis. 2010;69(3):483-9.

  5. McAlindon TE, Bannuru RR, Sullivan MC, Arden NK, Berenbaum F, Bierma-Zeinstra SM, et al. OARSI guidelines for the non-surgical management of knee osteoarthritis. Osteoarthritis Cartilage. 2014;22(3):363-88.

  6. Hochberg MC, Altman RD, April KT, Benkhalti M, Guyatt G, McGowan J, et al. American College of Rheumatology 2012 recommendations for the use of nonpharmacologic and pharmacologic therapies in osteoarthritis of the hand, hip, and knee. Arthritis Care Res (Hoboken). 2012;64(4):465-74.

  7. Moyer RF, Birmingham TB, Bryant DM, Giffin JR, Marriott KA, Leitch KM. Valgus bracing for knee osteoarthritis: a meta-analysis of randomized trials. Arthritis Care Res (Hoboken). 2015;67(4):493-501.

  8. Hunter D, Gross KD, McCree P, Li L, Hirko K, Harvey WF. Realignment treatment for medial tibiofemoral osteoarthritis: randomised trial. Ann Rheum Dis. 2012;71(10):1658-65.

  9. Cudejko T, van der Esch M, van der Leeden M, Roorda LD, Pallari J, Bennell KL, et al. Effect of Soft Braces on Pain and Physical Function in Patients With Knee Osteoarthritis: Systematic Review With Meta-Analyses. Arch Phys Med Rehabil. 2018;99(1):153-63.

  10. Hinman RS, Crossley KM, McConnell J, Bennell KL. Efficacy of knee tape in the management of osteoarthritis of the knee: blinded randomised controlled trial. BMJ. 2003;327(7407):135.

  11. Cushnaghan J, McCarthy C, Dieppe P. Taping the patella medially: a new treatment for osteoarthritis of the knee joint? BMJ. 1994;308(6931):753-5.

  12. Callaghan MJ, Parkes MJ, Hutchinson CE, Gait AD, Forsythe LM, Marjanovic EJ, et al. A randomised trial of a brace for patellofemoral osteoarthritis targeting knee pain and bone marrow lesions. Ann Rheum Dis. 2015;74(6):1164-70.

  13. Hunter DJ, Harvey W, Gross KD, Felson D, McCree P, Li L, et al. A randomized trial of patellofemoral bracing for treatment of patellofemoral osteoarthritis. Osteoarthritis Cartilage. 2011;19(7):792-800.

  14. Jones A, Silva PG, Silva AC, Colucci M, Tuffanin A, Jardim JR, et al. Impact of cane use on pain, function, general health and energy expenditure during gait in patients with knee osteoarthritis: a randomised controlled trial. Ann Rheum Dis. 2012;71(2):172-9.


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