Researchers recognize the “catch-22 effect” in knee osteoarthritis patients who battle obesity. The knee pain makes them inactive which leads to weight gain and the weight gain leads to greater pain in the knee. The greater pain in the knee is caused by heightening of chronic inflammation. Chronic inflammation in the knee leads to bone and soft tissue destruction. Here is the research:
- From Brigham and Women’s Hospital, Boston University School of Public Health: “Being obese or overweight, the quality of the diet, severe pain, and severe dysfunction are significantly associated with physical inactivity in adults with knee osteoarthritis.” 1
- Doctors at Stanford University say that being obese causes accelerated breakdown of cartilage tissue. 2
- Doctors at Duke University School of Medicine say that treatment plans that reduce pain, manage pain with appropriate coping skills and lifestyle behavioral weight management can modify the inflammatory state (reduce inflammation) and lead to more successful treatment and weight reduction.3
- Doctors at Monash University in Australia examined whether concentrations of circulating sex steroid hormones in overweight and obese men were associated with higher risk of primary knee and hip arthroplasty (replacement). The answer: Yes, low plasma androstenedione (testosterone) concentration is associated with an increased risk of both knee and hip arthroplasty for osteoarthritis in overweight and obese men. 4
How much of quality life is lost to patients with knee pain? To obesity? To a combination of knee pain and obesity?
Researchers writing in the Annals of Internal Medicine sought to answer these questions. They looked at subjects between the ages of 50 and 84 and sought to estimate quality-adjusted life-years lost due to obesity and knee osteoarthritis and health benefits of reducing obesity prevalence to levels observed in the 1990’s when obesity was much less prevalent.
Here is what they found: Non-obese patients with knee pain from osteoarthritis – almost 1.9 years quality life-years lost. For patients with both osteoarthritis knee pain and obesity 3.5 years of quality life lost.
Amazingly the researchers found that if physicians tackled the problems of obesity in osteoarthritis knee pain “findings suggested that reversing obesity prevalence to levels seen 10 years ago would avert 178,071 cases of coronary heart disease, 889,872 cases of diabetes, and 111,206 total knee replacements.”5
Weight loss is knee pain management
Recent research from American and Australian doctors is significant. The researchers examined more than 1300 patients over the age of 64 who were suffering from knee pain and obesity. What the doctors were looking for was for the effects of weight loss on the joint pain of the study subjects. The effects were significant.
Even a weight loss of 2.5% meaning 5 pounds on a 200 pound frame showed significant improvement in pain.6
Despite the benefits, weight loss is difficult to achieve
Despite these findings, the researchers had to also conclude that even desiring and attempting to lose weight, obese people with symptomatic knee osteoarthritis more commonly reported weight gain.
At the Magaziner Center for Wellness we take a holistic view of the body, even from an orthopaedic standpoint. We believe it is crucial to obtain recovery from an injury or to cure chronic pain; Stem Cell Injections, PRP and Prolotherapy cannot be given just into that injured joint. We need to look at joints above and below the injury, and make sure they are stable. If these areas are left unstable, and not treated, then the original injury has a greater chance to recur.
We bring a comprehensive understanding of thyroid, hormonal, metabolic and nutritional medicine to our treatment of our patients. Since regular exercise and a healthy diet are crucial when it comes to controlling weight, we speak to each patient about his or her lifestyle habits, as well as his or her biochemistry, in order to create a customized treatment plan.
For the long run, we help our patients understand food choices and their impact on the body. Our goal is to help our patients maintain their weight loss for a lifetime, by educating them on proper nutrition and changing body chemistry to reduce cravings.
Do you have questions about knee pain, testosterone and weight management? Contact us!
1. Losina E, Walensky RP, Reichmann WM. Impact of obesity and knee osteoarthritis on morbidity and mortality in older Americans. Ann Intern Med. 2011 Feb 15;154(4):217-26.
2. Nishimuta JF, Levenston ME. Meniscus is more susceptible than cartilage to catabolic and anti-anabolic effects of adipokines. Osteoarthritis Cartilage. 2015 Apr 23. pii: S1063-4584(15)01134-6. doi: 10.1016/j.joca.2015.04.014. [Epub ahead of print]
3. Huebner JL, Landerman LR, Somers TJ, Keefe FJ, Guilak F, Blumenthal JA, Caldwell DS, Kraus VB.
Exploratory Secondary Analyses of a Cognitive-Behavioral Intervention for Knee Osteoarthritis Demonstrate Reduction in Biomarkers of Adipocyte Inflammation. Osteoarthritis Cartilage. 2016 Apr 15. pii: S1063-4584(16)30015-2. doi: 10.1016/j.joca.2016.04.002. [Epub ahead of print]
4. Hussain SM, Cicuttini FM, Giles GG, Graves SE, Wang Y. Relationship between circulating sex steroid hormone concentrations and incidence of total knee and hip arthroplasty due to osteoarthritis in men. Osteoarthritis Cartilage. 2016 Apr 12. pii: S1063-4584(16)30024-3. doi: 10.1016/j.joca.2016.04.008. [Epub ahead of print]
5. Lee J, Song J, Hootman JM, et al.Obesity and other modifiable factors for physical inactivity measured by accelerometer in adults with knee osteoarthritis: Data from the osteoarthritis initiative (OAI). Arthritis Care Res (Hoboken). 2012 Jun 5. doi: 10.1002/acr.21754. [Epub ahead of print]
6. Atukorala I, Makovey J, Lawler L, Messier SP, Bennell K, Hunter DJ. Is there a dose response relationship between weight loss and symptom improvement in persons with knee osteoarthritis? Arthritis Care Res (Hoboken). 2016 Jan 19. doi: 10.1002/acr.22805. [Epub ahead of print]