General advice about knee osteoarthritis

Your patient needs to understand the nature of knee OA, what happens biologically in her knees, because this is a wear and tear disease. She will have to learn how to manage her pain and disease from now on. So, you need to share basic information with her. Even though she does not have an academic background she seems to have a good grasp of the basic concepts you have been discussing in your visits. So, you begin by explaining the basics: (you can even give her the following in print)

There’s no cure for osteoarthritis, but there are things you can do for yourself that can make a difference to how the condition affects you. There are also some treatments available that could significantly reduce your pain.

Exercise: You’ll need to find the right balance between rest and exercise. It’s important to carry on with your exercises even if you start to feel better, as stopping or reducing the amount of exercise you do could cause your symptoms to come back again. A physiotherapist can advise you on the best exercises to do, but you’ll need to adjust your daily routine including them to get the most benefit from them.Your physiotherapist may recommend hydrotherapy (aquatic therapy) which can help get muscles and joints working better and, because the water is warmer than in a normal swimming pool, it can be very soothing and relaxing. 

Maintaining a healthy weight: Being overweight increases the strain on your joints, especially your knees. It makes it more likely that you’ll develop osteoarthritis and that your arthritis will get worse over time. This means that you may adjust your dietary habits if you are overweight to be able to lose some weight. 

Pacing daily activities – don’t tackle all your physical jobs at once. Break the harder jobs up into chunks and do something gentler in between. Keep using your knee even if it’s slightly uncomfortable, but rest it before it becomes too painful.

Addressing feelings of depression or anxiety: a recommendation of  psychological therapies might help you, such as cognitive behavioural therapy (CBT) and stress-relieving techniques.

Using mHealth applications for managing chronic pain of OA (See supporting info for more advice)

One important issue that comes up, is sleep. Patient mentions that she is really worried about her sleep quality. During the day she has trouble concentrating and she experiences fatigue.