Revolutionary Trial Favors Exercise Over NSAIDs For Knee Arthritis

Could properly performed squats, lunges and leg lifts relieve knee osteoarthritis symptoms better than Celebrex or Advil?

This groundbreaking study found a tailored 12-week exercise program yielded superior improvement in pain, function and quality of life compared to NSAID treatment in knee osteoarthritis patients. The findings support conservative exercise therapy over risky anti-inflammatories.

Could simply exercising properly relieve knee arthritis symptoms better than pills? For osteoarthritis sufferers worldwide, movement may soon trump medication as first-line treatment.’

A landmark randomized controlled trial published in Cartilage reveals 12 weeks of customized strengthening, flexibility and stabilization exercise training leads to significantly greater relief from knee osteoarthritis symptoms and functional limitations than standard NSAID treatments (celecoxib [aka Celebrix]), diclofenac (aka Voltaren) and naproxen [aka Advil]).¹

Study lead author Dr. Jing Chao of Hebei Medical University explains,

“This study shows that exercise rehabilitation provides significant improvements in pain, other symptoms, and quality of life compared to that achieved by conventional treatments.”

The study divided 166 knee osteoarthritis patients randomly into a structured, progressive lower limb exercise program performed under physiotherapist guidance for 20 minutes daily or control groups receiving standard care with NSAIDs over 12 weeks.²

Per Dr. Chao,”the average Western Ontario and McMaster Universities (WOMAC) scores after treatment were 84.4 ± 15.2, 108.3 ± 3.9, 107.4 ± 5.4, and 107 ± 6.0 in the exercise rehabilitation, diclofenac, naproxen, and celecoxib groups, respectively.”

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This demonstrates profoundly increased symptomatic relief from customized training versus all drugs tested.

The tailored physical therapy yielded statistically significant superior improvements in joint pain, stiffness and physical function compared to all medication groups as measured by standard Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and Lysholm knee surveys.³ The exercise group also experienced greater gains in overall wellbeing, quality of life and knee range of motion.

This pioneering study supports a pivot in knee osteoarthritis care away from risky anti-inflammatories towards exercise and active self-management as first line treatment. The trial cements exercise therapy’s prime role for durably improving function and quality of life in knee arthritis sufferers without drugs.

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For more information on the profound, evidence-based health benefits of exercise, visit our database on the subject here.

For natural approaches to osteoarthritis, visit our database on the subject here.

On the dangers of NSAIDs, visit our database on the subject here.

References

1. Chao J, Zhang J, Bai X, Yang P, Gong Q. Effect of Systematic Exercise Rehabilitation on Patients With Knee Osteoarthritis: A Randomized Controlled Trial. Cartilage. 2021 Dec;13(1 Suppl):1734S-1740S. doi: 10.1177/1947603520903443.
2. The 12-week tailored exercise program combined lower limb strengthening (quadriceps activations, straight leg raises), flexibility (ankle pumps, prone hip extensions), and core stabilization exercises (side leg lifts, stability ball knee extensions and hip abductions) under guidance of a physiotherapist.
3. As measured by the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and Lysholm knee survey scales, assessing knee pain, stiffness, and functional limitation.
4. Bhala N, Emberson J, Merhi A, Abramson S, Arber N, Baron JA, Bombardier C, Cannon C, Farkouh ME, FitzGerald GA, Goss P, Halls H, Hawk E, Hawkey C, Hennekens C, Hochberg M, Holland LE, Kearney PM, Laine L, Lanas A, Lance P, Laupacis A, Oates J, Patrono C, Schnitzer TJ, Solomon S, Tugwell P, Wilson K, Wittes J, Baigent C. Vascular and upper gastrointestinal effects of non-steroidal anti-inflammatory drugs: meta-analyses of individual participant data from randomised trials. Lancet. 2013 Aug 31;382(9894):769-79. doi: 10.1016/S0140-6736(13)60900-9. Epub 2013 May 30. Erratum in: Lancet. 2013 Aug 31;382(9894):770. Baigent, Colin [added]. PMID: 23726390; PMCID: PMC3778977.
5. Bhala N, Emberson J, Merhi A, Abramson S, Arber N, Baron JA, Bombardier C, Cannon C, Farkouh ME, FitzGerald GA, Goss P, Halls H, Hawk E, Hawkey C, Hennekens C, Hochberg M, Holland LE, Kearney PM, Laine L, Lanas A, Lance P, Laupacis A, Oates J, Patrono C, Schnitzer TJ, Solomon S, Tugwell P, Wilson K, Wittes J, Baigent C. Vascular and upper gastrointestinal effects of non-steroidal anti-inflammatory drugs: meta-analyses of individual participant data from randomised trials. Lancet. 2013 Aug 31;382(9894):769-79. doi: 10.1016/S0140-6736(13)60900-9. Epub 2013 May 30. Erratum in: Lancet. 2013 Aug 31;382(9894):770. Baigent, Colin [added]. PMID: 23726390; PMCID: PMC3778977.
6. Zhang X, Donnan PT, Bell S, Guthrie B. Non-steroidal anti-inflammatory drug induced acute kidney injury in the community dwelling general population and people with chronic kidney disease: systematic review and meta-analysis. BMC Nephrol. 2017 May 2;18(1):156. doi: 10.1186/s12882-017-0538-9. PMID: 28464900; PMCID: PMC5413246.