Wear and repair in osteoarthritis: exercise, not surgery, is key

Ask the 2.2 million Australians who live with osteoarthritis to describe their condition and, invariably, ‘pain’ will be a recurring theme and ‘surgery’ often the solution.

A new partnership between the University of South Australia and Arthritis SA is set to challenge those beliefs and other myths surrounding the debilitating condition.

UniSA postdoctoral researcher Dr Felicity Braithwaite has today (World Arthritis Day) been named the inaugural John Stuart Colville Fellow, a three-year $150,000 research post focused on musculoskeletal pain.

Made possible by a bequest to Arthritis SA, the fellowship will adopt a 2020 approach, using virtual reality (VR) to educate people about osteoarthritis (OA), a condition that goes back millions of years – with evidence of arthritis found in dinosaur fossils.

Dr Braithwaite (pictured right) will use VR to educate people living with osteoarthritis about the pain system in an interactive, immersive way, challenging common misconceptions about the condition.

“People with osteoarthritis often have strong beliefs about what is going on in their body and it can be challenging for them to embrace a new concept of pain,” she says.

“By engaging their senses through light and sound, we hope to illustrate how pain works and how it can be successfully managed through exercise as a viable option to surgery.”

In Australia, 62 per cent of initial GP referrals for painful lower limb osteoarthritis are directly to orthopaedic surgeons. Despite sound evidence to show that diet and exercise help relieve OA, health professionals often overlook non-invasive interventions such as exercise and weight management ahead of surgery,” Dr Braithwaite says.

“Relying solely on health professionals to ‘do the right thing’ has been – and is likely to continue to be – largely ineffective at achieving changed outcomes.

“Therefore, we need to empower those living with osteoarthritis to be the experts of their own condition; to self-manage it instead of looking for the quick fix via surgery.”

Education has been identified as the top priority for improving OA care, not only among those impacted directly by osteoarthritis, but in the community as well.

For example, people with OA often believe – incorrectly – that exercise will only exacerbate the ‘wear and tear’ on their vulnerable joints instead of relieving their pain, Dr Braithwaite says.

“The best evidence shows that exercise is highly effective at reducing OA pain, regardless of the severity of joint damage.”

Research shows that only 10 per cent of people with painful osteoarthritis know enough about the condition to understand how pain works and the best way to manage their condition.

Dr Braithwaite says “passive mindsets” are common in chronic conditions such as OA, where people often have co-morbidities and rely on diagnostic tests or surgery instead of starting an exercise program.

“Active coping strategies include seeking out help and not waiting for ‘the cure’. That’s what we intend to focus on in educating people with OA, alongside health professionals and the community.”

CEO of Arthritis SA, Denise McMillan-Hall, said her organisation was “extremely grateful” to the Colville family.

“This bequest has enabled us to collaborate with the University of South Australia to manage one of the most debilitating impacts of living with arthritis. Arthritis SA is committed to improving the quality of life of all of those impacted by arthritis, and translation of research into active pain management in daily life will be an enormous step forward.”

Dr Braithwaite will be officially congratulated tomorrow night at a public lecture delivered by UniSA clinical scientist Professor Lorimer Moseley, one of the world’s leading experts in pain management.

Hosted by Arthritis SA, the lecture falls a day after World Arthritis Day and the subject will be “The might and wonder of your amazing pain system.” For more details, visit their website.

/UniSA Release. View in full here.