3/17/22, 1:12 PM If you have knee pain, telehealth may help - Harvard Health

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If you have knee pain, telehealth

may help
January 11, 2022

By Robert H. Shmerling, MD, Senior Faculty Editor, Harvard Health Publishing

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3/17/22, 1:12 PM If you have knee pain, telehealth may help - Harvard Health

Just about everyone experiences knee pain at some point in their lives. Most of the time,
it follows an injury or strenuous exercise and resolves in a few days, but knee pain can
last months or even years, depending on the cause. A new study suggests telehealth
programs designed for people with knee osteoarthritis may help ease pain, improve
ability to function, and possibly even lead to weight loss.

What is osteoarthritis of the knee?

Osteoarthritis (OA) — the age-related, "wear-and-tear" degeneration of the knee joint — is
the number one cause of chronic knee pain, affecting nearly a quarter of people age 40
or older. It’s responsible for most of the 600,000 knee replacements in the US each year,
and more than $27 billion in annual healthcare spending.

How is it treated?
No treatment for knee OA is ideal or works in every case. Standard approaches to
treatment include pain management, exercise, and loss of excess weight.

Protect yourself from the damage of chronic

inflammation.
Science has proven that chronic, low-grade inflammation can turn into a silent killer that contributes
to cardiovas­cular disease, cancer, type 2 diabetes and other conditions. Get simple tips to fight
inflammation and stay healthy -- from Harvard Medical School experts.

LEARN MORE

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3/17/22, 1:12 PM If you have knee pain, telehealth may help - Harvard Health

For pain, people with knee OA may consider

anti-inflammatory drugs that are rubbed on the skin, such as diclofenac gel

anti-inflammatory medicines, such as ibuprofen

pain relievers, such as acetaminophen

injections of corticosteroids.

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3/17/22, 1:12 PM If you have knee pain, telehealth may help - Harvard Health

Opiates, arthroscopic surgery, and other injected treatments are not routinely
recommended due to risks, lack of proven benefit, or both. Knee replacement surgery has
a high success rate for knee OA, but is generally considered a last resort because it’s
major surgery that requires significant recovery time.

Virtual visits can help

Before the COVID-19 pandemic, many people with knee OA regularly saw their
healthcare providers to

monitor their pain and ability to function

consider changes in treatment

check for treatment side effects

determine if other problems are contributing to symptoms.

It turns out, much of this can be done virtually. The pandemic made it a necessity. And a
new study suggests it works.

What did the study on knee osteoarthritis find?

The study demonstrated that telehealth visits are a good way to provide care to people
with knee OA. The researchers enrolled nearly 400 participants who had knee OA and
were overweight or obese. They were divided into three groups:

Group 1 was given access to a website that provided information about OA, including
pain medications, exercise, weight loss, and pain management.

Group 2 received the same information as group 1, and also engaged in six exercise
sessions with a physical therapist by videoconference. These sessions lasted 20 to
45 minutes and included advice about self-management, behavioral counseling, and
education about choosing exercise equipment.

Group 3 followed the same format as group 2, and also had six consults by
videoconference with a dietitian about weight loss, nutrition, and behavioral
resources. These sessions also lasted 20 to 45 minutes.

After six months, participants in groups 2 and 3 reported pain relief compared to Group 1.
On a pain scale of 1 to 10:

3i d th 1b 15 i t
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3/17/22, 1:12 PM If you have knee pain, telehealth may help - Harvard Health
group 3 improved more than group 1 by 1.5 points

group 2 improved more than group 1 by about 1 point.

People in groups 2 and 3 also had better scores for function compared to group 1. All of
these improvements were considered meaningful and held up for at least 12 months.

In addition, those assigned to group 3 lost about 20 pounds over the course of the study,
while the other groups’ weights were nearly unchanged. That’s an important finding,
because excess weight can worsen osteoarthritis of the knee. Losing excess weight can
improve symptoms and help prevent the arthritis from getting worse.

Since there was no comparison with in-person care, it’s impossible to say whether these
virtual visits were better, worse, or similar to an office visit. In addition, this study did
not report the costs of these virtual sessions, the long-term impact of virtual visits, or
whether repeated virtual visits could maintain the improvements people reported.

The bottom line

The pandemic is giving researchers an opportunity to seriously study the potential value
and limitations of virtual care on a large scale. If these visits are as good as or better
than in-person visits for certain conditions and the costs are no greater, that’s a big deal.
A virtual visit can eliminate time spent in travel and the waiting room, and possible
parking fees that can make a brief doctor’s visit an expensive undertaking that takes
half the day. Virtual care also has the potential to reach patients who otherwise cannot
get to their doctor’s office.

Of course, telehealth isn’t equally available to everyone due to language barriers,

technical abilities, health insurance plans, or simply not having access to smartphones,
computers, or data plans. Some states are letting emergency measures supporting
telehealth services expire. And some insurers may resort to pre-pandemic rules about
coverage or physician licensing that create uncertainty about the future of telehealth.

This study and others suggest that it may be a mistake to curb telehealth just when it’s
catching on. More studies like the one described here may make the case to insurers,
regulatory agencies, healthcare providers, and patients that the future of medical care
should rely on more, not less, virtual healthcare, and encourage approaches that
overcome barriers to its use.
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ankles
Is joint pain holding you back? Perhaps an achy ankle or sore knee is making it difficult
to enjoy a run through your favorite park or even taking a short walk. Or maybe a
throbbing hip or shoulder prevents you from whacking a golf ball or performing simple
tasks like carrying a bag of groceries. The exercises in this report, The Joint Pain Relief
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help you stay independent long into your later years.

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