Walking towards healthier knees

"Until this finding, there has been a lack of credible treatments that provide benefit for both limiting damage and pain in osteoarthritis," said Dr. Grace Hsiao-Wei Lo, assistant professor of immunology, allergy and rheumatology at Baylor, chief of rheumatology at the Michael E. DeBakey VA Medical Center and first author of the paper.

The researchers examined the results of the Osteoarthritis Initiative, a multiyear observational study where participants self-reported the amount of time and frequency they walked for exercise. Participants who reported 10 or more instances of exercise from the age of 50 years or later were classified as "walkers" and those who reported less were classified as "non-walkers."

Those who reported walking for exercise had 40% decreased odds of new frequent knee pain compared to non-walkers.

"These findings are particularly useful for people who have radiographic evidence of osteoarthritis but don't have pain every day in their knees," said Lo, who also is an investigator at the Center for Innovations in Quality, Effectiveness, and Safety at Baylor and the VA. "This study supports the possibility that walking for exercise can help to prevent the onset of daily knee pain. It might also slow down the worsening of damage inside the joint from osteoarthritis."

Lo said that walking for exercise has added health benefits such as improved cardiovascular health and decreased risk of obesity, diabetes and some cancers, the driving reasons for the Center for Disease Control recommendations on physical activity, first published in 2008 and updated in 2018. Walking for exercise is a free activity with minimal side effects, unlike medications, which often come with a substantial price tag and possibility of side effects.

"People diagnosed with knee osteoarthritis should walk for exercise, particularly if they do not have daily knee pain," advises Lo. "If you already have daily knee pain, there still might be a benefit, especially if you have the kind of arthritis where your knees are bow-legged."

Others who participated in the research include Dr. Surabhi Vinod with Baylor; Dr. Timothy E. McAlindon, Dr. Jeffrey B. Driban and Michael J. Richard with Tufts Medical Center; Dr. Matthew S. Harkey with the Michigan State University; Dr. Andrea M. Kriska and Dr. Bonny Rockette-Wagner with University of Pittsburgh; Dr. Charles B. Eaton with Brown University Warren Alpert Medical School of Brown University and School of Public Health of Brown University; Dr. Marc C. Hochberg with University of Maryland School of Medicine; Dr. Rebecca Jackson with Ohio State University; Dr. C. Kent Kwoh with the University of Arizona in Tucson, School of Medicine; and Dr. Michael C. Nevitt with the University of California, San Francisco.

Lo was supported by K23 AR062127, an NIH/NIAMS funded mentored award; this work was supported in part with resources at the VA HSR&D Center for Innovations in Quality, Effectiveness, and Safety (#CIN 13-413), at the Michael E. DeBakey VA Medical Center.