Home-based exercises can effectively reduce knee pain stemming from cartilage tears and arthritis, and they appear to work well regardless of whether someone receives physical therapy alongside them, according to new research.
The stretching and strengthening routines delivered roughly equivalent pain relief whether participants received actual physical therapy, sham physical therapy, or no therapy at all, researchers reported on October 29 in The New England Journal of Medicine.
Lead researcher Dr. Jeffrey Katz, clinical director of the Orthopedic and Arthritis Center for Outcomes Research at Brigham and Women’s Hospital in Boston, explained in a news release: “On average, participants in all groups reported moderately severe pain at the start of the study and much milder pain three, six and 12 months later.”
Understanding the Prevalence
Tears in the knee cartilage—known as the meniscus—affect as many as 40% of middle-aged adults and 80% of individuals with knee arthritis, researchers noted in their background materials.
Study Design
The research enrolled nearly 900 people with an average age of 59. All participants experienced knee pain, had arthritis, and suffered from a meniscus tear. They were randomly divided into three groups.
The first group followed a 25-minute home exercise program four times weekly, using video and pamphlet guidance. The second and third groups combined the same home exercise routine with either genuine or placebo physical therapy sessions.
Key Findings
While participants who received either real or sham physical therapy showed slightly greater pain improvement at the six- and 12-month marks, researchers determined these additional benefits were likely not genuine.
Katz stated: “We observed similar improvement in the standard PT and sham PT groups, suggesting that personal interactions with a physical therapist may have been more influential than the physical therapy itself.”
Prior studies have indicated that 60% to 80% of physical therapy’s total benefit for knee arthritis comes from patient-therapist interactions rather than the therapeutic techniques themselves, researchers pointed out.
Text Messages Didn’t Help
Participants who received motivational text messages encouraging adherence to their home exercise programs showed no better pain outcomes than those who didn’t.
Researchers wrote: “The percentage of participants who adhered to home exercises during the first 3 months was virtually identical across all groups. Motivational text messages were not associated with differences in adherence to home exercises or in pain outcomes.”
The Bottom Line
These findings suggest that people dealing with knee arthritis and meniscus tears can achieve meaningful pain relief through consistent home exercise programs, potentially without the added time and expense of formal physical therapy sessions. The key appears to be following a structured exercise routine regularly rather than relying on any particular therapeutic intervention.