Study reveals two new approaches (with the aid of your spouse) can help improve the self-management of osteoarthritis pain.
According to research funded in part by NIAMS, by using spouse-assisted coping skills training and exercise training, patients with osteoarthritis of the knees can improve:
- physical fitness (including leg flexion and muscle strength)
- coping with pain
- self-efficacy (a sense of feeling more in control of ones health)
What Is Osteoarthritis?
Osteoarthritis is the most common type of arthritis, especially among older people.
Osteoarthritis is a joint disease that mostly affects the cartilage. Cartilage is the slippery tissue that covers the ends of bones in a joint. Healthy cartilage allows bones to glide over one another. In osteoarthritis, the surface layer of cartilage breaks down and wears away. This allows bones under the cartilage to rub together, causing pain, swelling, and loss of motion of the joint.
People with osteoarthritis usually have joint pain and limited movement. Unlike some other types of arthritis, osteoarthritis predominantly affects the joints and not internal organs.
Rheumatoid arthritis (the second most common type of arthritis) does affect other parts of the body besides the joints.
According to NIAMS:
- Osteoarthritis is one of the most frequent causes of physical disability among adults.
- More than 20 million people in the U.S. now have osteoarthritis.
- By 2030, over 20% of Americans (about 70 million people) will have passed age 65 and will be at risk for osteoarthritis.
- More than half of the population age 65 or older would show x-ray evidence of osteoarthritis in at least one joint.
- Before age 45, more men than women have osteoarthritis, whereas after age 45, osteoarthritis is more common in women.
About the Study
The study tested seventy-two married osteoarthritis patients with persistent knee pain.
Study participants and their spouses were randomly assigned to one of four groups:
- those receiving spouse-assisted coping skills training alone
- those receiving exercise training alone
- those receiving both spouse-assisted coping skills training and exercise training
- those only receiving standard osteoarthritis care
Patients assigned to the spouse-assisted coping skills training alone group, together with their spouses, attended twelve two-hour sessions for training in both pain coping and couples skills. Patients that were assigned to spouse-assisted coping skills training plus exercise training, received the spouse-assisted coping skills training and also attended twelve-weeks supervised exercise training. Patients who were assigned to the exercise training alone group received just an exercise program.The study was undertaken by Francis Keefe, Ph.D at Duke University Medical Center, and his colleagues at several other institutions including the University of North Carolina, the University of Connecticut, and Wofford College.
Data from the study suggests that a combination of both spouse-assisted pain coping skills training and exercise training leads to more improvements than could be achieved with either approach alone.
- spouse-assisted training (either alone or in combination with exercise training) was found to produce improvements with self-esteem and better coping strategies.
- exercise training (either alone or in combination with spouse-assisted coping skills training) caused improvements in physical fitness, leg flexion, and muscle strength.
The study findings also show the importance of self-efficacy in adjusting to living with arthritis.
Over the past 15 years, spouse-assisted coping skills training and exercise training were developed as two approaches toward the self-management of osteoarthritis pain. This resulted from recognizing that medical treatments have limitations.
Should People With Arthritis Exercise?
Studies have shown that exercise helps people with arthritis. Arthritis-friendly exercise reduces joint pain and stiffness and increases flexibility, muscle strength, cardiac fitness, and endurance. It also helps with weight reduction and contributes to an improved sense of well-being.
People with arthritis should always discuss their exercise plans with a doctor. The amount and form of exercise recommended for each person will vary depending on:
- type of arthritis
- joints involved
- inflammation level
- joint stability
- joint replacements
- other limitations
Sources: A Spouse Can Help Ease the Pain of Osteoarthritis, NIAMS, 7/05; NIAMS, Handout on Health: Osteoarthritis, 7/02; NIH Publication No. 01-4855; PMID: 15288394, Effects of spouse-assisted coping skills training and exercise training in patients with osteoarthritic knee pain, Pain 2004;110: 539-549