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How much of a barrier is knee pain to physical activity with osteoarthritis?

Researchers recently investigated the link between knee pain and physical activity in individuals with osteoarthritis.

Many older individuals suffer from knee osteoarthritis (KOA). In this type of arthritis, the cartilage in the knee deteriorates, causing the bones to be in contact with each other. The resulting stiffness and knee pain can be alleviated with exercise, however, many individuals do not participate in physical activities partly due to the pain.

Conflicting evidence on pain and physical activity with knee osteoarthritis

There is conflicting evidence linking pain to physical activity among individuals with KOA, and a lack of research analyzing the link between daily walking and knee pain. As such, a recent study published in Arthritis Care & Research assessed activity and pain levels in older adults to determine the relationship, if any, between knee pain and daily walking.

Researchers recruited adults aged 40-70 with a knee osteoarthritis diagnosis, who had no other arthritis diagnoses, walking aids, or previous surgery or injury on their lower body. To measure steps taken, each participant was given an accelerometer to wear on their waist for a week, quarterly for three years. Participants also answered two questionnaires about the intensities and frequencies of their activities and pain experienced in order to assess their pain levels.

No link between the number of steps and knee pain

The final analysis included 59 participants, 11 of which were men and the remainder were women. Physical activity was higher in the summer compared to the other seasons, and old age and a high body mass index were associated with less physical activity. Based on the questionnaires and accelerometer data, knee pain was found to not be associated with the number of steps participants took.

Knee pain is not necessarily a barrier in physical activity

With the results of the study, it is now known that knee pain is not necessarily a barrier to participating in physical activities. Rather, other influences, which are still currently unclear, prevent individuals with KOA from getting adequate exercise. With this, future efforts should determine ways to increase physical activities in this population while managing knee pain.

Written by Monica Naatey-Ahumah, BSc


  1. Brisson, N.M., Gatti, A.A., & Maly, M.R. (2019). Pain Is Not Associated with Steps per Day in Persons with Mild‐to‐Moderate, Symptomatic Knee Osteoarthritis – A Mixed Models  Analysis of Multiple Measurements over 3 Years. Arthritis Care & Research.
  2. Hsu, H. & Siwiec R.M. (2019). Knee Osteoarthritis. Retrieved from


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