Beating osteoarthritis knee pain: Beyond special shoes

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We have plenty of fairy tales about shoes that work magic in people’s lives: glass slippers that brought love to Cinderella, and sparkly red heels that gave Dorothy powers in MGM’s version of The Wizard of Oz.

In real life, footwear magic is limited to “unloading” shoes that may help relieve knee pain from osteoarthritis. These unloading shoes have stiffer soles, and slightly tilted insoles that reposition the foot, intended to reduce (or unload) strain on the knee. But a studypublished online July 12, 2016, in Annals of Internal Medicine suggests that unloading shoes are no better than a good pair of walking shoes at making pain disappear.

About the study

Researchers randomly assigned 164 people with knee arthritis (age 50 or older) to wear either new unloading shoes or new conventional walking shoes every day for six months. By the end of the study, it appeared that both types of shoes were equally effective at reducing pain and improving physical function, with pain reduced an average of about 25%, and function improved by about 22%. It didn’t prove that both shoes are equally effective, but an editorial accompanying the study says the findings highlight “the promise of simple biomechanical interventions” to address knee pain.

Both shoes used in the study cost $180. But custom-made unloading shoes, and even custom-made insoles that can be inserted into a shoe, can cost many hundreds of dollars.

What to look for in a walking shoe

If you’re going to try a walking shoe to reduce your knee pain, look for certain features, such as:

  • a “stability-type” sneaker with a rigid sole and supportive insole
  • a slightly curved “rocker” sole that helps distribute the body more weight evenly as you walk. This sole may not be right for you if you have balance problems.

And remember that fit is important, too. Seek out:

  • a wide, roomy toe area (what shoe salespeople call the toe box)
  • length at least half an inch beyond your longest toe
  • a sturdy area around your heel (called a heel counter), so your foot stays in place and doesn’t slip around, which can cause friction and pain.

“Most of the sneaker brands make this shoe (New balance, Brooks, Saucony, Asics), so they are widely available. The take home here is that any supportive, rocker-bottom type shoe makes walking with knee osteoarthritis easier,” says Dr. Holly Johnson, an orthopaedic surgeon and instructor at Harvard Medical School. “The other important thing is that keeping physically active is so crucial to bone and joint health. If the shoes make people feel better when they walk, and therefore they walk more, this leads to so many health benefits. Find something comfortable and go with it.”

Other options

Walking shoes aren’t the only way to relieve knee pain without surgery. “I see success stories without surgery every day,” says Dr. Clare Safran-Norton, Clinical Supervisor of Rehabilitation Services at Harvard-affiliated Brigham and Women’s Hospital.

Her top recommendations include:

  • Physical therapy: Dr. Safron-Norton suggests that a person with knee arthritis undergo at least three months of physical therapy as a first line of treatment. The program should include a series of exercises to strengthen and stretch the muscles that support the knee.
  • Weight loss: Shedding pounds reduces the pressure you place on your knee. That’s significant, since the force you place on your joints can be up to six times your body weight.
  • Injections: Corticosteroid injections can temporarily reduce pain and swelling, which can make it less painful to take part in physical therapy.
  • Acupuncture: The studies about whether acupuncture relieves knee pain are mixed, but Safran-Norton says the treatment is helpful to some people. “If the problem is pain, it may work. If the problem is biomechanical or weak muscles, it probably won’t.”
  • Supplements: Research has provided mixed results on chondroitin and glucosamine supplements to relieve pain, but Safran-Norton says some of her patients feel the pills make a difference. Chondroitin sulfate helps to keep cartilage from deteriorating. Glucosamine stimulates cartilage formation and repair.

Don’t expect these things to work magic overnight. “You’ll feel a difference after going to physical therapy once or twice a week for two-to-four weeks,” says Safran-Norton. The rest of the methods are used best in conjunction with physical therapy, not in place of it, she advises.

With a little trial and error, you have a good chance of finding knee pain relief without surgery — and you may get a fairy tale ending. If knee pain persists, you may need to speak with an orthopaedic expert about surgery. But save that for a last resort.

Bible verses for today’s meditation and inspiration: Matthew E. McLaren

Genesis 39:23 The chief jailer did not supervise anything under Joseph’s charge  because the LORD was with him; and whatever he did, the LORD made to prosper.

Joshua 1:7 “Only be strong and very courageous; be careful to do according to all the law which Moses My servant commanded you; do not turn from it to the right or to the left, so that you may have success wherever you go.

2 Chronicles 20:20 They rose early in the morning and went out to the wilderness of Tekoa; and when they went out, Jehoshaphat stood and said, “Listen to me, O Judah and inhabitants of Jerusalem, put your trust in the LORD your God and you will be established. Put your trust in His prophets and succeed.”

2 Chronicles 26:5 He continued to seek God in the days of Zechariah, who had understanding through the vision of God; and as long as he sought the LORD, God prospered him.

Ecclesiastes 11:6 Sow your seed in the morning and do not be idle in the evening, for you do not know whether morning or evening sowing will succeed, or whether both of them alike will be good.

Proverbs 16:3 Commit your works to the LORD And your plans will be established.

Esther 8:15 Then Mordecai went out from the presence of the king in royal robes of blue and white, with a large crown of gold and a garment of fine linen and purple; and the city of Susa shouted and rejoiced.

Deuteronomy 29:9 “So keep the words of this covenant to do them, that you may prosper in all that you do.

Psalm 118:25 O LORD, do save, we beseech You; O LORD, we beseech You, do send prosperity!

Proverbs 15:22 Without consultation, plans are frustrated, But with many counselors they succeed.

Proverbs 21:30 There is no wisdom and no understanding And no counsel against the LORD.

Acts 5:34-39 But a Pharisee named Gamaliel, a teacher of the Law, respected by all the people, stood up in the Council and gave orders to put the men outside for a short time. And he said to them, “Men of Israel, take care what you propose to do with these men. “For some time ago Theudas rose up, claiming to be somebody, and a group of about four hundred men joined up with him. But he was killed, and all who followed him were dispersed and came to nothing.     

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