Bracing has been shown to be helpful in the treatment of knee arthritis. Often the obese and particularly the morbidly obese patients have a limb that is somewhat cone shaped and therefore ill-suited for brace fitting. A lateral or medial heel wedge can be of use in the varus or valgus knee, respectively.
Full Answer
What are the treatment options for morbid obesity?
In: Harrison's Principles of Internal Medicine. You'll need close medical treatment options for morbid obesity while taking a prescription weight-loss medication. Weight-loss surgery for obesity may be considered if you have tried other methods to lose weight that haven't worked and:.
Does obesity impact how well your arthritis Meds work?
Plus, obesity may impact how well some of your arthritis meds work, adds Caroline A. Andrew, MD, medical weight management specialist at the Hospital for Special Surgery in New York City.
Can obese obese people with osteoarthritis (OA) improve with weight loss?
Obese subjects with OA who lose weight may see improvement in their OA symptoms for several reasons.
How can I facilitate weight management practices with patients with arthritis?
There are many things you can do to facilitate safe and effective weight management practices with your patients with arthritis. First, address weight directly as an important component of arthritis management.
How is osteoarthritis treated in obese patients?
In such patients symptomatic slow acting drugs for OA (i.e. glucosamine, chondroitin) and some anti-oxidant drugs (i.e. curcumin, ginger extracts, copper) may be helpful thanks to their excellent benefit/risk ratio and their mode of action which may have a positive impact on both OA and obesity-related metabolic ...
What is the first treatment used if a person with osteoarthritis is overweight or obese?
Weight loss and exercise is the optimal approach to managing obese patients with osteoarthritis. Guidelines from the American College of Rheumatology 30 and European League Against Rheumatism 31 recommend the need for weight loss as well as exercise in the management of overweight or obese patients with OA.
Can morbid obesity cause arthritis?
Obesity can raise the risk of getting certain types of arthritis and it makes every type of arthritis harder to manage.
Can arthritis be reversed with weight loss?
If you have weight-induced joint pain, losing pounds and taking stress off your joints may ease your symptoms. While your body can't reverse arthritis or regrow cartilage, losing weight can help arthritic joints feel better and prevent further excess damage.
Does being overweight make arthritis worse?
Excess weight puts added stress on joints, particularly knees, causing pain and worsening arthritis damage. “Being just 10 pounds overweight increases the force on your knees by 30 to 40 pounds with every step you take,” says Kevin Fontaine, PhD, assistant professor of rheumatology at Johns Hopkins University.
What is the best exercise for arthritis?
Examples of low-impact aerobic exercises that are easier on your joints include walking, bicycling, swimming and using an elliptical machine. Try to work your way up to 150 minutes of moderately intense aerobic exercise per week. You can split that time into 10-minute blocks if that's easier on your joints.
What damage can be done to the joints of obese people?
Obesity frequently contributes to soft tissue damage and osteoarthritis—a progressive wear- and-tear disease of the joints. The impact of obesity is especially felt in osteoarthritis of the hip and knee joints. Every pound of body weight places four to six pounds of pressure on each knee joint.
What joint is most commonly affected in obese patients with osteoarthritis?
Hand OA is about twice as common among obese people as it is in leaner people. Being obese also increases the chances that once you have OA in one joint, you will develop it elsewhere. Obese people with OA in one knee, for example, are five times more likely than healthy-weight people to develop OA in the other knee.
Can you fix arthritis?
Although there's no cure for arthritis, treatments have improved greatly in recent years and, for many types of arthritis, particularly inflammatory arthritis, there's a clear benefit in starting treatment at an early stage. It may be difficult to say what has caused your arthritis.
How can I lose weight fast with arthritis?
Your best bet is a typical healthy diet with lots of vegetables, and some fruits and whole grains. You can also include healthy fats (like olive oil and nuts) and proteins (like fish). Aim to cut down on processed foods, too. Choose exercise that isn't hard on your joints.
What should you not do with osteoarthritis?
Osteoarthritis (OA) is the most common form of arthritis in the United States....5 Foods to AvoidRed meat and fried foods. Fried foods and red meat contain high levels of advanced glycation end products (AGEs), which are known for stimulating inflammation. ... Sugars. ... Dairy. ... Refined carbohydrates. ... Alcohol and tobacco.
How can I strengthen my obese knees?
Top 3 Low Impact Cardio Exercises for Bad KneesSwimming. Swimming is one of the best cardio exercises for your knees. ... Elliptical Trainer. If you're not a fan of swimming, you might want to consider trying an elliptical trainer. ... Walking.
How much does it hurt to be 10 pounds overweight?
If you’re 10 pounds overweight, it increases the force on your knees by 30 to 60 pounds with each step; being 100 pounds overweight means 300 to 600 pounds of extra pressure. All that extra weight on already damaged joints worsens the pain and stiffness and can accelerate disease progression.
Does losing weight help with knee pain?
According to a study published in the Journal of the American Medical Association, adults with osteoarthritis who lost weight through a combination of diet and exercise over a period of 18 months reported less knee pain.
Is it hard to lose weight with arthritis?
And maybe you feel just as frustrated about needing to lose weight to help manage your arthritis. Losing weight is hard — there’s no denying that. And when your joints are stiff and sore, when it hurts to exercise, when you’re exhausted from arthritis pain, the task can feel impossible.
Does obesity cause rheumatoid arthritis?
Exactly how obesity affects rheumatoid arthritis (RA) and other forms of inflammatory arthritis is unclear, but experts believe that inflammatory compounds from fat may play a role here too.
Does sugar cause arthritis?
And research shows regularly consuming sugar-sweetened drinks is linked to greater weight gain and obesity, which can make inflammatory arthritis symptoms even worse.
Is cardiovascular disease a complication of obesity?
Lower risk of comorbid conditions: Cardiovascular disease is a complication of both arthritis and obesity. The same is true for diabetes, as well as depression. Losing weight can help mitigate the risk, says Dr. Davis.
Is it worth fighting arthritis?
But it is a battle worth fighting. And it’s one you can win — if you take it one tiny step at a time. Obesity can raise the risk of getting certain types of arthritis and it makes every type of arthritis harder to manage. But losing even a little weight can have a huge impact on physical and mental health.
Does obesity cause knee osteoarthritis?
Obesity for example increases the risk of knee osteoarthritis but has a lesser effect on disease progression. In addition there is a weaker association with hip and hand osteoarthritis as well.
Is lack of exercise a cause of osteoarthritis?
Obesity as well as several other factors in the lifestyle is associated with osteoarthritis. Some of these include joint activity, lack of exercise, muscle weakness, and joint injury. Of these lack of exercise is also associated with obesity and muscle weakness is common in obesity as well.
What is the most significant impact of obesity on the musculoskeletal system?
The most significant impact of obesity on the musculoskeletal system is associated with osteoarthritis (OA), a disabling degenerative joint disorder characterized by pain, decreased mobility and negative impact on quality of life. OA pathogenesis relates to both excessive joint loading and altered biomechanical patterns together with hormonal ...
What is OA in health?
OA is a clinical syndrome of joint pain and dysfunction caused by joint degeneration, and affects more people than any other joint disease3. Currently, nearly 10 per cent of the population is affected and the prevalence increases with age. Obesity is the greatest modifiable risk factor for OA4,5,6.
Does weight loss help with OA?
Weight loss in OA can impart clinically significant improvements in pain and delay progression of joint structural damage. Further work is required to determine the relative contributions of mechanical and metabolic factors in the pathogenesis of OA. Keywords: Adipokine, body mass index, cartilage, obesity, osteoarthritis, weight loss.
Is obesity a chronic disease?
Obesity is associated with an elevated risk of an array of chronic diseases. The implications for the musculoskeletal system include both degenerative and inflammatory conditions2, with the greatest burden resulting from osteoarthritis (OA)2. OA is a clinical syndrome of joint pain and dysfunction caused by joint degeneration, ...
The problem
The number of patients requiring total knee arthroplasty (TKA) over the next 10 to 20 years is expected to exponentially increase. Many of these patients with degenerative arthritis of the knee suffer from obesity.
Evaluation
The evaluation of a patient who is morbidly obese with knee arthrosis begins with a thorough history and physical examination. Important comorbidities to define include coronary artery disease, diabetes mellitus, and obstructive sleep apnea syndrome (OSAS).
Conservative treatment
As in all patients with degenerative joint disease conservative treatment should be optimized before considering surgical options. The patient’s obesity should be frankly discussed outlining its effect on their arthrosis and mobility and the challenges they face if and when surgical intervention is entertained.
Preoperative optimization
While managing the patient’s disease process conservatively, comorbidities should be optimized before surgical intervention (regardless of the type of surgery planned). Patients with coronary artery disease will require evaluation and clearance by their primary care physician or cardiologist.
Surgical options
Surgical options for knee arthrosis include arthroscopy, osteotomy, and arthroplasty. Knee arthroscopy with debridement and lavage of the joint is not advocated in this patient population and should be avoided.
Surgical equipment
Before proceeding to surgery it is important to have proper surgical equipment and implants available. A leg holder that attaches to the operating table is very helpful ( Fig. 1 ). Owing to the severe deformity of some of these knees, collateral ligament insufficiency is common as well as major bone loss or voids.
Surgical process (total knee arthroplasty)
Two surgical assistants can be helpful for limb positioning and retraction. There is no place for minimally invasive knee surgery in this patient population. An attempt is made to exsanguinate the limb and use a standard tourniquet.
How to manage weight with arthritis?
First, address weight directly as an important component of arthritis management. Clearly advise all overweight and obese patients to lose weight.
How much weight can you lose with pharmacotherapy?
In general, if a patient does not lose 4.4 lbs (2 kg) in the first four weeks of treatment, the patient can be considered a non-responder to pharmacotherapy. Drug therapy may also be used during the weight maintenance phase of treatment. Safety and effectiveness beyond one year of total treatment have not been established.
How to calculate BMI?
BMI is calculated by dividing the patient’s weight in kilograms is divided by height in meters, squared. Tocalculate your patient’s body mass index, insert your patient’s weight in pounds and height in feet and inches. According to the new guidelines, overweight is a BMI of 25-29.9 while obesity is a BMI of 30 or greater.
What is the most common joint disorder with symptoms in the hands, knees, hips, back, and neck?
Osteoarthritis is the most common joint disorder with symptoms in the hands, knees, hips, back, and neck. It is unclear exactly how excess weight influences OA.
Is weight loss a risk factor?
At a given level of overweight or obesity, patients with additional risk factors are considered to be at higher risk for health problems, and would benefit from weight loss as well as modification of risk factors.
Does weight loss help knee OA?
The Benefits of Weight Loss. Even small amounts of weight loss reduce the risk of developing knee OA. Preliminary studies suggest weight loss decreases pain substantially in those with knee OA. If obesity increases the development and progression of knee OA, can weight loss reverse these effects?
Is Johns Hopkins Arthritis Center educational?
All information contained within the Johns Hopkins Arthritis Center website is intended for educational purposes only. Physicians and other health care professionals are encouraged to consult other sources and confirm the information contained within this site. Consumers should never disregard medical advice or delay in seeking it because of something they may have read on this website.
What is class 3 obesity?
Obesity class 3: BMI of 40 or higher. . This class of obesity is also categorized as “severe” obesity. Generally speaking, you are morbidly obese if you are 100 pounds heavier than your recommended weight.
What is the BMI of a person who is overweight?
If you have a BMI of 25.0 to less than 30, you are in the overweight range.. If you have a BMI of 30.0 or higher, you are in the obesity range. Additionally, you can divide obesity into three separate categories of severity: Obesity class 1: BMI between 30 and less than 35. Obesity class 2: BMI between 35 and less than 40.
How is obesity determined?
Obesity is determined by your body mass index (BMI). This score is calculated by finding your height and weight on the BMI chart. Morbid obesity is defined by a BMI of 40 or greater.
Why is obesity bad for your life?
Type 2 diabetes – Obesity may lead to insulin resistance, creating inconsistent blood sugar levels that your body cannot maintain without the help of medication and diet changes.
What is the BMI of a healthy weight?
If you have a BMI of 18.5 to less than 25 , you are in the healthy weight range.
How to calculate BMI?
Measures your weight and height to calculate BMI. Checks your vital signs, including blood pressure, heart rate, and breathing. Measures your waist circumference. Completes blood tests to check for the signs of health conditions like diabetes . Keep in mind that your waist size is also tied to increased health risks.