How to Fix Chronic Knee and Hip Pain

Many people suffer from chronic knee and hip pain, and often have trouble finding a way to permanently heal the condition.

Fortunately, researchers have been exploring different exercise approaches to help alleviate this problem. In a recent study published in the Journal of Novel Physiotherapies, a team of scientists compared the effectiveness of a program focused on improving whole-body postural alignment to reduce chronic knee and hip pain.

Chronic Knee Pain

Many people suffer from chronic musculoskeletal pain, especially in the knees and hips as they get older. This can significantly reduce quality of life. Chronic knee pain affects an estimated 25% of people over age 55, while around 10% have symptomatic hip osteoarthritis by age 60.

Poor posture and misalignment of the body is thought to be a major contributing factor to developing chronic musculoskeletal pain. When body segments are misaligned, it puts excess strain on muscles and wear on the joints. Research has linked poorer posture to increased incidence of pain in areas like the neck, shoulders and back.

This study looked at whether a corrective exercise program focused on improving whole-body postural alignment could reduce chronic knee and hip pain. The program used was the Egoscue Method (EM), which prescribes personalized menus of corrective exercises aimed at bringing the body into better alignment based on an individual’s specific postural faults.

Forty participants with chronic knee and/or hip pain were recruited and randomly assigned to either an exercise treatment group that did EM exercises for 2 weeks or a control group that maintained their usual routine. Participants kept daily logs rating their levels of pain at rest and during movement. They also completed a standardized arthritis questionnaire (WOMAC) at baseline, 1 week and 2 weeks to assess pain, stiffness and physical function.

Therapeutic Regime

The results showed that the EM corrective exercises significantly reduced knee and hip pain over the 2-week period in the exercise group compared to the control group. According to the participants’ daily logs, pain levels during movement decreased by an average of 0.11 cm per day on a 0-10 scale in the exercise group, while the control group did not improve.

The WOMAC scores, which evaluate arthritis symptoms and function, also improved significantly in the exercise group after 2 weeks but not in the control group. The exercise group had a 60% reduction in their overall WOMAC score, a 67% improvement in the function subscore, and a 51% decrease in the pain subscore from their baseline levels.
Interestingly, pain levels did not decrease significantly right after the first session of corrective exercises. The benefits seemed to accrue over the 2 weeks as the participants continued doing the exercises at home most days.

This aligns with research showing therapeutic exercise can improve chronic joint pain and function, although most previous studies looked at more general strengthening and aerobic exercises rather than posture-specific corrective exercises.

A key premise of the Egoscue Method is that misaligned posture, through compensations by other body areas, can create imbalances and excess strain that leads to musculoskeletal pain – even in areas quite distant from the postural fault. So addressing whole-body alignment is thought to be important.

The corrective exercises prescribed by the EM aim to bring the body closer to an ideal posture and reduce muscular imbalances. Exercises common in the program include stretches, controlled motions and isometric contractions targeting muscles around misaligned joints.

A strength of this study was its randomized controlled design, which allows for causal inferences. Potential confounding factors like age, BMI, arthritis status and past injuries were also controlled for statistically.

Significant Results

However, some limitations are that the 2-week duration may have been too short to detect postural changes, participants self-reported their exercise compliance unsupervised, and lifestyle factors outside the study could have impacted pain levels. Overall, this initial study suggests the Egoscue Method of posture-focused corrective exercises could be an effective way to significantly reduce chronic knee and hip pain and improve physical function in just 2 weeks of performing the exercises regularly. This posture-based approach shows promise as a safe, cost-effective treatment option.

More research over longer periods is still needed, including directly measuring postural changes and other outcomes like quality of life. But for those suffering from persistent joint pain, a program emphasizing correction of postural alignment could provide significant relief.

Vehrs, Z., Hager, R. L., George, J. D., Myrer, J. W., Vehrs, P. R., & Eggett, D. L. (2019). Effect of a Short-term Corrective Exercise Program on Chronic Knee and Hip Pain. Journal of Novel Physiotherapies, 9(1), 404. https://doi.org/10.4172/2165-7025.1000404