Tai Chi for the arthritic knee

Nov 9, 2009 1:45 PM

I have many wonderful memories of my grandmother, but one of the most vivid, strangely enough, is of her attempting to get out of her chair. She'd shift to the front of the cushion, brace herself against the armrests, and slowly rise to almost standing—only to plop back down into the cushion, usually with an exasperated chuckle. She had a good sense of humor about her knee problems, but they did cause her frequent pain and were more than just a nuisance as she tried to get on with her day.

Like millions of older Americans, my grandmother had osteoarthritis in her knee. This joint disease can cause pain, stiffness, and limited movement, making even simple tasks (such as getting up from a chair) difficult. Many people rely on painkillers to cope with their symptoms. Exercise and physical therapy can also help, although the improvements are often modest. However, a new study suggests that Tai Chi is one type of exercise that can be particularly beneficial for people with this chronic condition.

The study compared two groups of people age 55 or older who had osteoarthritis of the knee. One group met twice weekly for Tai Chi classes. The other met twice weekly for general wellness instruction and stretching exercises. Both groups were asked to practice their exercises at home for at least 20 minutes a day.

At the end of their 12-week course, people in the Tai Chi group had a 75 percent drop in their pain, on average, and a 72 percent improvement in their ability to do everyday tasks. People in the wellness and stretching group also reported some improvements, but these were much smaller than in the Tai Chi group.The researchers used questionnaires to score people's symptoms, as well as their mental state, their quality of life, and other indicators of wellbeing. Besides doing better on pain and physical function, the Tai Chi group also had greater improvements in depression and health-related quality of life.

So, what's at work here? Researchers think the physical and mental aspects of Tai Chi may make it particularly helpful for people with osteoarthritis. This traditional Chinese exercise features slow, rhythmic movements designed to bring about mental relaxation and enhance balance, strength, and flexibility. For those with long-term joint problems, this mind-body focus might improve their physical symptoms as well as help them cope better mentally.

What you need to know. These findings are quite promising. However, the study was very small, with only 40 participants. So although it suggests that Tai Chi can help people with knee osteoarthritis, we need larger studies to know for certain.

If you have osteoarthritis of the knee and would like to try Tai Chi, be sure to tell your instructor about your joint issues. An experienced instructor can help you avoid any positions that might put your knee under too much stress. In the study, for example, none of the Tai Chi positions required bending the knee more than 90 degrees.

—Sophie Ramsey, patient editor, BMJ Group

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Osteoarthritis is common in adults over 65. Find out if you're at risk, read about how osteoarthritis is diagnosed, and take a look at our comparison of 16 drug and non-drug treatments (subscribers only).

Photo courtesy of Diana bella