Doctors are well-meaning and sincere in their care of patients with osteoarthritis.  But pressures and limitations in the daily practice of medicine sometimes make it difficult for doctors to implement programs with their patients that take extensive time and attention. 

Outside support is available, but many doctors are unaware of the benefits of self-care programs or even that self-care programs exist.  Moreover, some doctors are not aware of the influence of lifestyle factors on OA--things that might help an individual care for him or herseilf.  For example, in one study only 50 percent of general practice doctors told their osteoarthritis patients that excessive body weight may contribute to their conditions. In another study, a large percentage of doctors did suggest to their patients with OA that they lose weight and increase their daily amount of exercise.  However, according to the patients "concrete types of exercise were not mentioned and directions were mostly quite vague."  When asked about reasons for their failure to increase their physical activity, the patients reported "pain, lack of knowledge regarding respective offers, lack of mobility, and lack of motivation."

Most general practice doctors said they did not inform patients about self-help groups or arthritis self-care programs.  Many doctors stated that a lot of patients complained about reasons that they would not participate in such programs anyway.  However, in these studies, the patients "always welcomed basic information on self-help groups."  The patients were often unsure of the potential benefits of such programs, because the doctor did not convey these benefits with confidence.  According to the patients, "receiving just a short, vague hint without a clear advice or motivation was regarded as insufficient."

[Rosemann, T, Wensing, M, Joest, K, et al. Problems and needs for improving primary care of osteoarthritis patients: the views of patients, general practitioners and practice nurses. BMC Musculoskeletal Disorders 2006, 7:48.]

While doctors are often unaware of the benefits of self-care programs it is important that you understand the potential of taking charge of your own joint health through a self-care program.  This is made abundantly clear in three studies, that we’ll summarize briefly.

The first is a study of 544 people at Coventry University.  One group was active in an arthritis self-management program, while the other group was not.  They were tested at the beginning of the study, at 4 months, and at 12 months.

At 12 months, those in the self-management group had significantly:

• Improved exercise habits
• Better symptom management
• Better diet 
• More relaxation
• Improved pain
• Less fatigue
• Less anxiety
• Less depression 
• Better mood

A randomized controlled study of the Arthritis Self-Management Programme in the UK

In another study, 79 people were enrolled to see whether a self-management program improved their osteoarthritis of the knee.  They were tested at 8 weeks, 6 months, and 12 months.  Those on the self-management program experienced significant improvement in their pain, physical function, social function, vitality, and mental health status over the 12 month study period. 

[Coleman, S, Briffa, K, Conroy, H, et al. Short and medium-term effects of an education self-management program for individuals with osteoarthritis of the knee, designed and delivered by health professionals: a quality assurance study. BMC Musculoskeletal Disord 2008;9:117.]

In the third study, over 140 people with osteoarthritis were enrolled in a self-management program that included exercise.  The authors found that "the intervention had a highly and significant positive effect in pain reduction, fatigue, knee range of motion, the practice of exercise routines and the number of medical consultations."  The doctors went on to say that there was also "an improvement in functional status over a 16-week period." 

[Yip, YB, Sit, JW, Fung, KK, et al. Impact of an arthritis self-management programme with an added exercise component for osteoarthritis knee sufferers on improving pain, functional outcomes, and use of health care services: An experimental study. Patient Educ Couns 2007;65(1):113-21.]

Even though your doctor might not be fully aware of the benefits of a smart self-management program, the growing number of studies in this area show that true gains in joint comfort, mobility, and quality of life are possible.

Volunteers' experiences of becoming arthritis self-management lay leaders: "It's almost as if I've stopped aging and started to get younger!".

A randomized controlled study of the Arthritis Self-Management Programme in the UK.