Must know osteoarthritis research for your knee and hip

For those of you who have been following us for a while, you know that we are big on research. Just January alone, 23 research papers in our Facebook group. These papers are also freshly published (i.e., published within the same month) so you know we are 100% up to date with the latest research. Today, we will share our top five favourite papers with you.

UK updated their osteoarthritis clinical guidelines (2023)

knee osteoarthritis, knee pain singapore
This continues to shock a lot of people but osteoarthritis or “degeneration” of the knee is NOT a wear and tear condition. Contrary to popular belief, exercise does not make your joint pain worse. In fact, it is widely reported to improve both pain and function.

Clinical guidelines are evidence-based recommendations that are published either by countries or medical associations to guide clinical decision-making for clinicians. In other words, they tell chiropractors and physiotherapists what are the best things they should be doing for their clients.

Because we get thousands and thousands of research studies published every year, it’s impossible for clinicians to keep up to date with every single one of them. Clinical guidelines condense the latest research into actionable recommends to … somewhat make things easier for chiropractors.

Here are the three recommendations they have for osteoarthritis:

• Do not need imaging if you’re above 45 years old, have activity related joint pain, and have either no morning joint related stiffness or morning stiffness that lasts no longer than 30 minutes

• Therapeutic exercise is important for people with osteoarthritis to reduce pain and improve physical function and quality of life

• Analgesia should only be used for the shortest possible time, primarily to support therapeutic exercise

For almost a decade now, exercise is the top recommendation for osteoarthritis. This is the narrative that evidence-based chiropractors and researchers have been pushing for but resistance to exercise for chronic pain is still strong particularly in asian countries such as Singapore.

In one of the workshops we did earlier at Yu Neng Primary School, one of the earliest questions we got was if people with spinal osteoarthritis or spondylosis can exercise. Specifically, can these patients lift weights?

The answer is yes (we will share more later).

The resistance to exercise probably stems from the misinformation that osteoarthritis is considered by many to be the result of wear and tear of the joints. Because that is the typical understanding, the expectation is that regular exercise will “wear” out the joints even more. This lead to many patients avoiding exercise. Because they wrongly believe because to be bad for their condition.

The end result? It is a missed opportunity for patients with osteoarthritis to recover from their condition!

There is ample and robust evidence to strongly demonstrate that exercise is good for your joints. Even for people with osteoarthritic pain.

Exercise is better than medication for hip and knee osteoarthritis

strength training for seniors
Just because you are older doesn’t mean you cannot squat or lift weights! Do you know seniors above 65 years old are recommended to do strength training at least THRICE per week? The older you are, the more you should be lifting!

An entirely different paper found exercise to be better than anti-inflammatories and paracetamol! Shocking right?

The status quo when it comes to prescription for knee pain or hip pain from most doctors will be paracetamol, NSAIDs, and/or muscle relaxants. To date, I have not heard of any doctors prescribing exercises for their patients.

Yes, I have heard of many doctors recommending exercise but these recommendations are largely broad strokes advice and non-meaningful in treating their patients’ pain.

If exercise is as good as medication when it comes to hip pain and knee pain, why are doctors not prescribing it more? Especially since exercise has a lot less side effects than oral medications.

To  be absolutely clear, previous studies have shown paracetamol to be ineffective against joint pain and that NSAIDs should be avoided if possible!

Knowing what to do is simply not good enough

life coaching, ICF singapore
Coaching is more than just telling people what to do. It’s about drawing into our clients strength to help them achieve their own personal goals. Did you know our chiropractor Jesse Cai is a certified solution-focused coach?

By the time you are done reading our blog, you should be extremely convinced that exercise is your long-term pain solution. This is very well studied and there is almost no contention to why exercise is superior.

However, knowing that exercise is good for you is simply not enough. Even knowing what exercises you should be doing is not good enough.

A study, also published this month, investigated why some patients respond to exercise while others don’t. It comes down to being empowered. According to the researchers, patients who respond better to exercise felt empowered to change. This is important because it highlights that head knowledge alone is not good enough.

You still have to take action.

In fact, the authors found that amongst those who didn’t respond, the participants were able to identify as poor adherence to exercise as one of the reasons.

This is why we frequently utilise coaching principles in our work. Both Jesse and Justin are certified coaches. The reason we emphasise this is because just telling pain patients what to do is not enough to drive meaningful recovery outcomes. Reminding patients that they are not going to get better is also not going to help them either.

How to find freedom from chronic pain?

As a chiropractor in Singapore, I work with professionals to help them help themselves find a long-term pain solution. We partner our clients and use a combination of both exercise and lifestyle change to deliver successful recovery results for them.

To find out more about how our unique, empowerment-based approach can help you, drop us a message via the form below.



Frustrated by the lack of results-driven and ethical chiropractic clinics in Singapore, Chiropractor Jesse Cai found Square One Active Recovery to deliver meaningful and sustainable pain solutions.

Our goal? To make our own services redundant to you.

*We do not offer temporary pain relief such as chiropractic adjustments, dry needling, or any form of soft tissue therapy.