Short-Term Pain Can Mean Long-Term Gain For Osteoarthritis Patients

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Source:   Center For The Advancement Of Health (http://www.cfah.org/)

Date:   Posted 8/26/2002

Short-Term Pain Can Mean Long-Term Gain For Osteoarthritis Patients

Research has repeatedly shown that regular exercise can provide long-term

pain relief for those who suffer from knee osteoarthritis. Unfortunately,

getting these patients to start an exercise program can be difficult,

because isolated periods of physical activity may increase pain and

discourage further exercise.

New research, however, provides insight that may help patients with knee

osteoarthritis get over the " pain hump " when they begin a program of

physical activity: evidence that the increased pain immediately following

exercise is short-lived.

" Explaining to patients that the increased pain they feel right after

exercising isn't long-lasting -- and helping them cope with that temporary

increase -- may help them stick with an exercise program long enough to

obtain [a] long-term reduction in pain, " says lead author C. Focht,

Ph.D., of East Carolina University.

Prior research, he notes, indicates that this reduction in pain can result

not only in greater comfort, but also in a greater sense of psychological

well being and more participation in physical activity.

To better understand the extent and duration of the pain caused by

individual workouts or other types of activity, Focht and his colleagues

recruited 32 adults with osteoarthritis in one or both knees who were

involved in a larger study of arthritis, diet and activity called ADAPT. All

were overweight or obese -- a factor known to exacerbate knee the negative

impact osteoarthritis has on quality of life -- as well as older than 60 and

reporting that their knee pain caused physical limitations and difficulty

with daily activities.

Prior to their enrollment in ADAPT, all subjects had been sedentary.

Each participant carried a pager and a notebook for six consecutive days.

Pager tones throughout each day signaled participants to record how much

knee pain they felt, as well as factors that might influence that level,

such as mood and any medications taken.

Every other day, participants engaged in a one-hour period of programmed

exercise. On the other days, they refrained from this activity.

In general, the researchers report in the August issue of the ls of

Behavioral Medicine, participants rated their daily pain as weak to

moderate. Pain on non-exercise days tended to follow a pattern: lowest when

recording began at 7 a.m., rising gradually to its highest level at around 3

p.m., then falling gradually until recording stopped at 9:30 p.m.

On exercise days, the pain curve was similar but showed a significant spike

immediately after exercise. This increase, Focht observes, was higher than

expected based on the time of day, reported stress levels or use of

medications, confirming that it was likely exercise-induced.

Of particular interest, Focht reports, is the researchers' observation that

pain the participants reported immediately after exercising tended to abate

in the evening, indicating that the exercise-induced pain increase typically

did not linger.

" Given that exercise training has been found to be beneficial for the

reduction of pain, our findings have significant implications for the role

of exercise therapy in patients with knee osteoarthritis, " Focht and his

colleagues conclude.

Focht cautions that these findings may not apply to apply " to osteoarthritis

patients experiencing distressing or excruciating pain, " or to those who are

" novice exercisers. " Additional research, he notes, is needed to

characterize the post-exercise pain response of such individuals.

The study was conducted at Wake Forest University, where funding came from

the Claude D. Pepper Older Americans Independence Center and the General

Clinical Research Center of Wake Forest University.