Walk Away the Pain With a Cane

Knee osteoarthritis pain reduced through cane use

(RxWiki News) As new technologies become available everyday, we often forget about the old technologies that still work. The walking cane may seem like an outdated tool, but it turns out it may help some arthritis patients.

Using a cane everyday for two months helped reduce pain in patients with osteoarthritis of the knee. Cane use also improved function.

"Try walking with a cane to relieve your knee pain."

According to Jamil Natour, M.D., and colleagues at the Universidade Federal de Sao Paulo, people with knee osteoarthritis generally shift their weight almost completely to a part of the knee called the medial compartment.

"Therefore, decreasing the load on the medial compartment should be one of the treatment objectives for such patients," they suggest.

Even though most treatment guidelines for knee osteoarthritis recommend using a cane, there has been little research that tests whether canes actually help arthritis patients.

For this reason, Dr. Natour and colleagues set out to see if walking with a cane would lead to improvements in pain, function, general health, and energy used in patients with knee osteoarthritis.

Through a study of 64 patients with knee osteoarthritis, the researchers found that patients who used a cane showed significant improvements in pain at the end of two months, compared to those who did not use a cane.

Patients who used a cane also covered more distance in six minutes and used less energy, compared to those who did not use a cane.

Patients did not experience these improvements the moment they started using a cane. There is a sort of learning curve to using a cane, the study's findings show.

In the first month, patients had a harder time using the cane, as shown by shorter distances covered and a greater use of energy. By the end of the second month, however, they were able to walk with a cane about the same distance and using less energy than without the cane. They also had less pain at the end of two months.

The study's authors write that they "were surprised to discover that, despite the fact that cane use goes back as far as ancient Egypt, very few studies have been carried out on this topic."

Most of the previous studies on this topic have not compared cane use to other treatments. They have not even compared cane use to no cane use. "The present investigation is thus the first study to assess the effectiveness of this widely used gait-assistance device among patients with knee osteoarthritis," the authors explain.

For their study, the researchers assessed pain using a measurement system called a visual analogue scale (VAS). Function was measured using the Lequesne knee questionnaire and the Western Ontario and McMaster Universities (WOMAC) questionnaire.

General health was assessed using the short form 36 (SF-36) questionnaire. Energy expenditure was measured using the 6-minute walk test.

According to the authors, "An important finding in our study was pain following the walk test, a factor that could influence functionality." Patients who used a cane had a fair amount of pain after the walking test at the beginning of the study.

However, at 30 days and 60 days, these patients experienced less pain after the walking test. "This probably demonstrates adaptation to cane use, by reducing the weight load on the affected joint during gait, thereby reducing pain following the walk test," they write.

The authors conclude that a cane is a tool that can help reduce pain, improve function, and enhance aspects of quality of life in patients with knee osteoarthritis.

"The prescription of a cane should take into account the substantial increase in energy expenditure in the first month of use," they advise, "whereas energy expenditure is no longer a factor for concern by the end of the second month as a result of adaptation to cane use."

In other words, patients and doctors should realize that they may not see improved results in the first month of cane use. After the second month, however, patients will get used to how the cane works and experience positive results.

The full results of this randomized controlled trial are published in the Annals of Rheumatic Diseases

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Review Date: 
January 30, 2012