Weight and knee pain

Maintaining a healthy weight is important for your overall wellbeing. It reduces your risk of heart disease, diabetes and cancer. But did you know it also eases the pain of arthritis and helps your medicines work better?
According to the Centers for Disease Control and Prevention (CDC), 72 percent of Americans are overweight or obese. The agency also reports that almost 23 percent of overweight and 31 percent of obese Americans have doctor-diagnosed arthritis. That adds up to a lot of people whose joints could feel better by shedding extra pounds.
Here are some ways reaching and maintaining a healthy weight can help ease your arthritis.
Reduce pressure on your joints. A key study published in Arthritis & Rheumatism of overweight and obese adults with knee osteoarthritis (OA) found that losing one pound of weight resulted in four pounds of pressure being removed from the knees. In other words, losing just 10 pounds would relieve 40 pounds of pressure from your knees.
Ease pain. Multiple studies show that losing weight results in arthritis pain relief. A 2018 study published in Arthritis Care and Research went further to find that losing more weight – to an extent — results in more pain relief. The study of overweight and obese older adults with pain from knee OA found that greater weight loss resulted in better outcomes than losing a smaller amount of weight. Losing 10–20 percent of starting bodyweight improved pain, function, and quality of life better than losing just five percent of bodyweight.
Reduce inflammation. Fat itself is an active tissue that creates and releases pro-inflammatory chemicals. By reducing fat stores in the body, your body’s overall inflammation will go down. A 2018 article published in Autoimmunity Reviews explained that obesity can activate and sustain body-wide low-grade inflammation. This inflammation can amplify and aggravate autoimmune disorders, such as rheumatoid arthritis, psoriatic arthritis, lupus and their associated comorbidities (like heart disease).
Reduce Disease Activity. Losing weight can reduce the overall severity of your arthritis. A 2018 study published in International Journal of Clinical Rheumatology reviewed the records of 171 RA patients and found that overweight or obese people who lost at least 5 kg (10.2 pounds) were three times as likely to have improved disease activity compared to those who did not lose weight. A smaller 2019 study published in Arthritis Research & Therapy found that short-term weight loss in obese people with psoriatic arthritis (PsA) yielded “significant positive effects” on disease activity in joints, entheses, and skin.
Improve Chance of Remission. Several studies have shown that being obese reduces your chance of achieving minimal disease activity or remission if you have RA or PsA. A 2017 review article published in Arthritis Care and Research analyzed data from more than 3,000 people with RA and found that obese patients had lower odds of achieving and sustaining remission compared with non-obese people. A 2018 article in Joint, Bone, Spine analyzed several studies totaling more than 3,800 patient records. The authors found that obesity “hampered the effects of anti-TNF agents” and showed that the odds of reaching a good response or achieving remission were lower in obese than non-obese patients taking anti-TNF biologics.
Lower Uric Acid Levels and Chance of Gout Attack. A 2017 analysis of 10 studies, published in Annals of Rheumatic Diseases, found that weight loss was beneficial for obese or overweight people with gout. Overall, people who lost weight had lower serum uric acid levels and fewer gout attacks.
Slows Cartilage Degeneration in OA. A 2017 study published in Radiology assessed magnetic resonance images (MRIs) of osteoarthritic knees in 640 overweight or obese people. Participants who lost weight over 4 years showed significantly lower cartilage deterioration. The more weight lost, the lower the rate of disease progression.
Weight loss is a tough endeavor, but if you are overweight, no single action can provide as many positive effects on the body. Not only does it lower your risk of developing diabetes, heart disease, sleep apnea and certain types of cancer, but it helps your arthritis as well. Talk to your health care provider about starting a weight loss program

To Help Knee Osteoarthritis, Lose as Much Weight as Possible

Shedding 10 percent of your body weight if you are overweight or obese can improve your knee arthritis symptoms. And losing even more brings extra, dramatic benefits.

That’s the conclusion of a new study published today, June 18, 2018, in the journal Arthritis Care & Research, by researchers at Wake Forest University.

“For overweight and obese adults with knee osteoarthritis (KOA), substantially greater weight loss, achieved safely, brings with it additional benefits,” says study coauthor Stephen Messier, PhD, professor of health and exercise science at Wake Forest University, in Winston-Salem, North Carolina.

Related: Rheumatoid Arthritis vs. Osteoarthritis Knee Pain

Extra Weight Loss Equals Fewer Osteoarthritis Disease Markers

While everyone who lost weight got some benefits, people dropping 20 percent or more of their body weight saw an extra 25 percent reduction in some osteoarthritis disease markers compared with people losing from 10 to 20 percent, he says.

Related: What Does Arthritis Pain Feel Like?

Knee Arthritis Improvements Were Substantial With Weight Loss

The study tracked 240 overweight and obese adults who had knee pain and documented osteoarthritis. Those who lost at least 10 percent benefitted in a number of ways: They reported significantly less pain, had better knee function, were able to walk farther in a six-minute test, and had decreased inflammation and bone-on-bone compression.

The improvements exhibited what researchers call a “dose response,” which means the more people lost the better they did.

Related: 10 Essential Facts About Metabolism and Weight Loss

Losing Weight Correlated With Better Walking Ability

For example, those dropping between 5 and 10 percent could walk an average of 1,713 feet (522 meters) in six minutes by the end of the study, while those losing 10 to 20 percent went 1,778 feet (542 meters). Meanwhile, the over 20 percent group were able to get as far as 1,834 (559 meters).

Weight Loss Is Difficult When You Carry Extra Pounds

Of course, nobody is saying this level of weight loss is easy to achieve. Of the 240 people enrolled in the study, only 76 of them shed 10 to 20 percent, and just 31 people lost 20 percent or more.

Related: 21 Tips for Weight Loss That Actually Work

Osteoarthritis Tends to Worsen Over Time; Improvements Are Key to Overall Disease Management

Osteoarthritis is a condition where the joints become painful and stiff, especially in the morning. Depending on the severity, treatment options typically include medication, physical and occupational therapy, physical activity such as stretching, or surgery. Often, symptoms get worse over time.

Knee pain that gets in the way of everyday living may possibly even lead to depression.

Weight loss has long been known to play a role in improving the disease. For example, observational data from a study known as the Osteoarthritis Initiative linked greater weight loss with less cartilage damage, according to a study published in July 2016 in the journal Osteoarthritis Cartilage. But whether extra weight loss brings added gains hadn’t been documented in a clinical trial before.

Excess Weight Harms Many Body Parts

In addition to the benefits to knee arthritis found in this study, losing weight has been found to be helpful for overall health, as well as for many body parts.

A report published by the National Institutes of Health described how weight loss leads to decreased blood pressure, fewer unhealthy blood fats, more good cholesterol, and better balance for blood sugar levels, among other things.

The only downside of the weight loss found in this study was a slight reduction in bone-mineral-density (still above troublesome thresholds) — a finding the authors suggest is more than outweighed by the boost in lifestyle and reduction in pain.

Dropping Weight Slowly Is Important

Participants in this study lost their weight over an 18-month period. Because this was a reanalysis of the authors’previous study, published in September 2013 in the Journal of the American Medical Association, which examined whether diet, diet plus exercise, or just exercise resulted in the most weight loss (the first two groups did better than the last), participants lost the weight in a variety of ways.

Still, a program that combines the right diet plan and appropriate exercise along with learning tools to change ingrained behaviors is best for any significant weight loss effort, according to the NIH report. Medication and even weight loss surgery should also be considered for some people, the NIH says.

Losing weight slowly is best for the body. The NIH suggests that a reasonable time line is six months to drop 10 percent. Decreasing what you eat by 300 to 500 calories a day (500 to 1,000 calories if you’re severely obese) leads to a 1- to 2-pound weekly weight loss, a healthy rate.

Related: Is Weight Loss Surgery a Good Idea for People With Rheumatoid Arthritis?

Tips for Eating Better, Shedding Pounds

Mikel Bryant, RD, with the Mayo Clinic in Jacksonville, Florida, suggests that a good way to lose weight is to think about what you can add to your diet, rather than what you must take away. “Adding fruits, vegetables, and healthy grains can make you feel full,” she says. The best diets remain the Mediterranean diet and the Dietary Approaches to Stop Hypertension, or DASH diet, which are full of these healthy foods.

Bryant also recommends distributing calories more evenly throughout the day. “Rather than the typical American approach of skipping breakfast, grabbing a quick lunch, and then eating a big dinner because you’re hungry, eat more at the earlier meals and less at night,” she says.

Find Support to Help Achieve Weight Loss

Talk to your doctor about best strategies for you and your personal health challenges. And if you’re not finding weight loss success, don’t be afraid to reach out to a dietitian. “Weight loss is a tricky thing, with genetics, medication, and your environment all playing a role. Dietitians take everything into account and can individualize a plan, helping a person see what they’re doing right and where they can improve,” Bryant says.

A trained nutrition expert located near you can be found on the website of the Academy of Nutrition and Dietetics.

Don’t Shortchange Exercise and Movement to Help You Lose Weight

Exercise (with your doctor’s okay) should start gradually, eventually working up to 30 minutes or more of moderate intensity activity most or all days a week, the NIH report declares.

Related: How Much Exercise Is Enough for Weight Loss?

Consider Physical Therapy if You’re in Pain

Of course, if you have painful knee arthritis, you might fear working out. Getting assistance from a physical therapist can be helpful.

Weight Loss and Exercise Will Help Reduce Pain

“There may be an initial increase in pain, but if you slowly increase your exercise time, pain should be reduced and mobility increased,” Dr. Messier says. “The research is clear: Exercising and losing weight will reduce your pain by 25 percent,” the amount found in his study, he says.

Once the weight is gone, you’ll need to continue the combination of exercise and healthy eating in a maintenance plan in order to successfully keep it off, the NIH report advises.

For a chance for people living with knee osteoarthritis to gain more mobility and a better quality of life, the effort (and it certainly is effort) is surely worth it.

Obesity and Anterior Knee Pain

Overview:

Anterior knee pain (pain in the front of the knee during sitting and walking up and down stairs) is often a burden for those experiencing chronic knee pain. It is quite prominent at any age and may be worse and more common in the overweight population. It may be the result of inactivity, and/or muscle weakness. Obesity complicates this condition as the structures of the anterior knee including the patella experience increased forces up to five times our body weight. By focusing on muscle strengthening and weight loss, anterior knee pain can often be improved through non-surgical measures. Anterior knee pain in the absence of advanced arthritis is rarely improved with surgery (either scope or replacement).

Symptoms:

  • Knee pain over the front of the knee during activity, after activity,
  • Increased pain when resuming activity after sitting for long durations
  • Swelling, feelings of stiffness or decreased range of motion
  • Feelings of instability, usually when walking
  • Pain with bending of the knee, going up and down stairs

Treatments:

Depending on your history and physical exam, we will generally recommend an x-ray in the standing position to assess the amount of arthritis in your knee when you are putting weight on your joint. As long as there is no emergent orthopedic intervention needed we will generally recommend the following:

  • Muscle strengthening:

Your quadriceps muscles are vital to maintain the strength and stability of your knee joint. We would recommend starting out with a home exercise program and incorporating exercises that specifically strengthening these muscles. If needed, we may want you to undergo a dedicated strengthening program with physical therapy for a few weeks.

  • Weight loss:

Losing weight is a key element in decreasing your anterior knee pain. Your doctor can provide simple diet modifications and recommendations when you visit their office. If you have special diet concerns or other medical conditions that require a more tailored approach to weight loss, a referral can be made to a nutritionist, and in certain cases a bariatric surgeon.

Often weight loss can be difficult when it hurts to exercise. Exercising in the pool takes the pressure off your joints and still allows your muscles to become stronger.

  • Pain Control:
    • Over the counter pain medicine such as: NSAIDS (Advil, Motrin, Aleve, Ibuprofen, Naproxen), Tylenol
    • Ice, elevation, using a soft knee brace
    • Using a cane or hiking stick
    • Muscle strengthening and aerobic activity
  • Surgical Options:

If you have arthritis in your knee and you are questioning whether or not to have a knee replacement, we will not recommend surgery if your body mass index (BMI) is greater than 35 or 40. The risks of infection dramatically increase in patients whose BMI is greater than 35. For those whose BMI is greater than 40 the risks of surgery, including infection, stroke, heart attack, and even death continue to increase and the surgeon’s technical ability to perform the procedure is compromised. We do not want to put you at this risk and will recommend weight loss through diet or possibly bariatric surgery for those who have failed dieting attempts prior to discussing knee surgical options.

Tips for Losing Weight to Treat Knee Pain

Weight loss is a proven treatment for arthritic knee pain, but few people use it. Losing excess pounds can seem like a big challenge. Below are a few ideas for successfully achieving and maintaining weight loss. Incorporating just one or two of these ideas into a daily routine may produce notable weight loss.

1. Eliminate One Bad Habit

Removing one fattening or sugary item from a daily diet can make a big difference over time. For example, a person can trade in a morning muffin for a piece of fruit or swap out sweetened beverages for water.

See Foods for a Healthier Gut and Less Arthritis Pain

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2. Make Meals from Scratch

By making meals from scratch, people can avoid most trans fats as well as unnecessary sugar, additives, and preservatives, which many processed foods contain. Research suggests that additives and preservatives are associated with inflammation1 and obesity.2

See An Anti-Inflammatory Diet for Arthritis

3. Eat More Fiber Every Day

Increasing fiber intake is often recommended for losing weight. Eating high-fiber foods can make a person feel full, thereby decreasing the cravings for high-caloric foods. Why?

  • Fibrous foods take up more space with fewer calories. A candy bar or sugary granola bar can be 180 to 300 calories. A cup of uncooked leafy greens has less than 10 calories. A large vegetable salad can be filling and less than 100 calories. (Keep in mind that adding bacon bits, croutons, candied nuts, and heavy dressings can add several hundred calories.)
  • Fibrous foods take longer to digest. Digestion times vary from person to person, but in general, fibrous foods such as fruits and vegetables take longer to break down in the stomach and large intestine, leaving people feeling full long after they have eaten. Candy and baked goods, such as crackers and cookies, are digested quickly, so people feel hungry again sooner.

Leafy greens are not the only high-fiber foods. Other vegetables, fruits, beans, rolled oats and many other foods are high in fiber.

See The Ins and Outs of an Anti-Inflammatory Diet

In This Article:

  • How Effective is Weight Loss for Treating Knee Arthritis Pain?
  • Tips for Losing Weight to Treat Knee Pain

4. Burn a Few More Calories Each Day

While reducing calorie intake is the most reliable way to lose weight, burning calories can also help shed pounds. Hitting the gym, swimming, and doing water aerobics are tried-and-true ways to burn calories, but there are other ways to expend energy. Going for a walk each day, gardening, or doing gentle yoga and stretching on the living room floor will burn more calories than sitting still.

See Aerobic Exercise for Knee Arthritis

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5. Do Not Eat Before Bed

Putting an end to after-dinner snacks and late-night eating habits is an easy way to drop pounds. Not only does this approach cut out unnecessary calories, it helps the body digest and metabolize food; the body’s digestive and metabolic systems work most efficiently during the day.3 -5

A physician or registered dietician can work with patients to discuss the above ideas for weight loss as well as other ideas.

How Being Overweight can cause Knee Pain

/ News / How Being Overweight Can Cause Knee Pain

November 20, 2018

Are you or someone you know suffering from chronic knee pain due to being overweight? Knee pain the most common complications of being overweight or obese, therefore losing even the smallest amount of weight can help ease your suffering and significantly lower your risk of osteoarthritis (OA).

Maintaining a healthy weight has numerous health benefits. Researchers suggest that losing just 10% of your total body weight can reduce overall inflammation in the body. By decreasing the amount of weight-bearing pressure on the knees not only lowers the amount of wear-and-tear, but it also extends your range of motion making every day activity much more enjoyable.

Weight loss is the best natural way to ease knee pain and lower the risk of developing OA and the first place to start is nutrition and eating habits. See below for a few meal-time tips and tricks to get you on track to your healthy weight!

-Plan every meal. Research shows that our most unhealthy meal of the day is one we don’t plan ahead for.

– Pack your lunch instead of grabbing something at the food court. You only ever know ALL of the ingredients when you make it yourself.

– Reduce portion sizes. Pack a lite snack to hold you over.

– Make sure to have at least one vegetable, every meal.

– Eat s l o w l y… let your mind catch up with your stomach!

– Go for a walk immediately after a meal. Even if only for 5-10 minutes!

– Take the stairs.

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Weighing the Benefits of Dropping a Few Pounds

Weighing the Benefits of Dropping a Few Pounds

Gaining weight puts a lot of extra stress and strain on your knees, which must bear the brunt of those excess pounds. The added pressure increases wear and tear, contributing to osteoarthritis. On the flip side, losing weight can help you take a load off, literally. One study (Arthritis and Rheumatism, July 2005) found that every lost pound subtracts four pounds of pressure from the knees for each step taken. In practical terms, losing just 10 pounds means that each knee is subjected to 48,000 fewer pounds of pressure for every mile walked.

Small losses, big gains

The implication: Even a fairly small weight loss can make a big difference for overweight people with knee osteoarthritis. Two other studies bear out this assumption.

Study 1. The larger of the studies was the Arthritis, Diet, and Activity Promotion Trial (ADAPT; Arthritis and Rheumatism, May 2004), conducted by researchers at Wake Forest University. It included 316 adults ages 60 and older who were overweight and had knee osteoarthritis. These individuals were randomly assigned to either a treatment group (diet, exercise or diet-plus-exercise) or a control group that simply got general information about a healthy lifestyle.

The best results were achieved by those in the diet-plus-exercise group, who lost about 6 percent of their body weight over an 18-month period. For someone starting out at 200 pounds, that would mean losing just 12 pounds over the course of a year and a half. This modest weight loss combined with moderate exercise led to the greatest overall improvements in pain, physical function and the ability to get around.

Study 2. Results from a second study, conducted by researchers at Johns Hopkins University, were reported at the 2006 annual meeting of the American College of Rheumatology. This study included 30 overweight adults with knee osteoarthritis who took part in a weight loss program. The program consisted of 16 weekly classes on diet, exercise and lifestyle change. After the classes ended, the group got back together every three months for a year to talk about keeping the weight off.

At the end of the 16-week class period, participants had lost an average of 15 pounds. They regained some of that weight over the next year, but they kept off more than half of it, on average. Weight loss was associated with lasting reductions in pain. And a positive cycle seemed to ensue. Decreased pain, in turn, was associated with better weight maintenance, probably because being in less pain made it easier to stay motivated and active.

Lose to win

To lose weight, you need to take in fewer calories through food than you burn off by exercise. You can do that by eating less or exercising more — but the best results are often achieved with a combination of both. Since a pound of fat is about 3,500 calories, you can lose that amount in a week by aiming for a deficit of 500 calories a day. For instance, you might aim to burn an extra 200 calories through exercise and cut another 300 calories from your diet.

The bottom line

If you’re overweight, dropping a few excess pounds can reduce the wear and tear on your knees. Beyond that, losing just 5 percent to 10 percent of your body weight can lower your odds of developing heart disease or having a stroke. And when combined with exercising at a moderate level of effort for 30 minutes a day, 5 days a week, it can help prevent or delay the onset of type 2 diabetes. So lose a few pounds, and you may gain better health.

PLEASE NOTE: The studies and their findings that are presented in this article are for informational purposes only and are not meant to take the place of the advice of your doctor. By providing you with this information, Sanofi is not endorsing its content nor does it represent that the information is necessarily appropriate for you. You should consult with your doctor before starting any new health or exercise regimen.

“Weight Loss Reduces Knee-Joint Loads in Overweight and Obese Older Adults with Knee Osteoarthritis.” S.P. Messier et al. Arthritis and Rheumatism. July 2005, vol. 52, no. 7, pp. 2026-2032.

“Exercise and Dietary Weight Loss in Overweight and Obese Older Adults with Knee Osteoarthritis: The Arthritis, Diet, and Activity Promotion Trial.” S.P. Messier et al. Arthritis and Rheumatism. May 2004, vol. 50, no. 5, pp. 1501-1510.

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