If your knee hurts, telehealth can help


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

What is osteoarthritis of the knee?

Osteoarthritis (OA) – the age-related degeneration and wear and tear of the knee joint – is the leading cause of chronic knee pain, affecting nearly a quarter of people 40 years of age or older. It is responsible for most of the 600,000 knee replacements in the United States each year and more than $ 27 billion in annual health care spending.

How is it treated?

No treatment for osteoarthritis of the knee is ideal or works in all cases. Standard approaches to treatment include pain management, exercise, and excess weight loss.

For pain, people with osteoarthritis of the knee may consider

  • anti-inflammatory drugs that are rubbed into the skin, such as diclofenac gel
  • anti-inflammatory drugs, such as ibuprofen
  • pain relievers, such as acetaminophen
  • corticosteroid injections.

Opioids, 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 osteoarthritis of the knee, but is generally considered a last resort because it is a major surgery that requires a significant recovery time.

Virtual tours can help

Before the COVID-19 pandemic, many people with osteoarthritis of the knee regularly saw their health care providers to

  • monitor their pain and ability to function
  • consider treatment changes
  • check for side effects of treatment
  • determine if other problems are contributing to the symptoms.

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

What did the knee osteoarthritis study find?

The study showed that telehealth visits are a good way to provide care for people with osteoarthritis of the knee. The researchers enrolled nearly 400 participants with osteoarthritis of the knee and overweight or obese. They were divided into three groups:

  • Group 1 was given access to a website providing information on osteoarthritis, including pain relievers, exercise, weight loss, and pain management.
  • Group 2 received the same information as Group 1, and also participated in six exercise sessions with a physiotherapist via video conference. These sessions lasted 20 to 45 minutes and included counseling on self-management, behavioral counseling, and education on choosing exercise equipment.
  • Group 3 followed the same format as Group 2 and also had six videoconference consultations with a dietitian on 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:

  • 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 functional scores compared to group 1. All of these improvements were considered significant and were maintained for at least 12 months.

Additionally, those affected in Group 3 lost around 20 pounds over the course of the study, while the weights of the other groups were almost unchanged. This is an important finding because being overweight can make osteoarthritis of the knee worse. Losing excess weight can improve symptoms and help prevent arthritis from getting worse.

Since there was no comparison to in-person care, it is impossible to say whether these virtual visits were better, worse, or similar to an office visit. Additionally, this study did not account for the costs of these virtual sessions, the long-term impact of virtual tours, or whether repeated virtual tours could sustain the improvements people reported.

The bottom line

The pandemic gives researchers the opportunity to seriously study the potential value and limitations of large-scale virtual care. If these tours are as good or better than in-person tours for certain conditions and the costs aren’t higher, that’s a big deal. A virtual visit can eliminate the time spent in travel and the waiting room, and the possible parking costs that can make a brief visit to the doctor an expensive undertaking that takes half a day. Virtual care also has the potential to reach patients who would otherwise not be able to make it to their doctor’s office.

Of course, telehealth is not accessible to all in the same way due to language barriers, technical capacities, health insurance schemes or simply not having access to smartphones, computers or plans. of data. Some states are allowing emergency measures supporting telehealth services to expire. And some insurers may resort to pre-pandemic rules regarding coverage or licensing of physicians, which creates uncertainty about the future of telehealth.

This study and others suggest that it may be a mistake to put the brakes on telehealth just as it is catching on. Further studies like the one described here could show insurers, regulators, healthcare providers and patients that the future of healthcare should rest on Following, not least, virtual health care, and encourage approaches that overcome barriers to its use.

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