A New Study Points to a Surprisingly Simple Way to Ward Off Knee Pain

一项新的研究提议用一种非常简单的方法来避免膝盖疼痛

Encouraging new research suggests walking could help prevent new bouts of knee pain in people with osteoarthritis.

令人鼓舞的新研究表明，步行可以帮助预防骨关节炎患者（osteoarthritis）避免膝关节疼痛。

By Dani Blum

Published June 8, 2022Updated June 10, 2022

A promising new study suggests that walking could ward off knee pain for people with osteoarthritis.

一项有“应用前景”的新研究表明，步行可以让骨关节炎患者避免膝盖疼痛。

Researchers surveyed over 1,000 people ages 50 or older with knee osteoarthritis, the most common type of arthritis in the United States. Some had persistent pain at the outset, while others did not. After four years, those who started off without frequent knee pain and walked for exercise at least 10 times were less likely to experience new, regular bouts of stiffness or aches around their knees and had less structural damage in their knees. The study suggested that people with knee osteoarthritis who are bowlegged might particularly benefit from walking.

研究人员调查了 1000 多名 50 岁或50 岁以上患有膝骨关节炎（knee osteoarthritis）的人，这是美国最常见的一种关节炎。有些人一开始就有持续的疼痛，而另一些人则没有。四年后，那些刚开始时没有经常出现膝关节疼痛并步行至少 10 次【注：一天10次？还是一个星期10次？】的人不太可能出现新的、经常性的膝关节僵硬或疼痛，并且膝关节的结构损伤也较少。该研究表明，患有膝盖骨关节炎的人可能会特别受益于步行。

The research offers the potential of an easy — and free — way to combat one of the most common culprit of knee pain among older adults.

该研究提供了一种简单（且免费）的方法来对抗老年人膝痛最常见的致病原因。

The findings represent “a paradigm shift,” said Dr. Grace Hsiao-Wei Lo, an assistant professor at Baylor College of Medicine in Houston and the lead author on the study. “Everyone’s always looking for some kind of drug. This highlights the importance and likelihood that interventions for osteoarthritis might be something different, including good old exercise.” The research suggests that exercise could help manage osteoarthritis in other joints, she added, like those in the hips, hands and feet.

该研究的主要作者、休斯顿贝勒医学院助理教授 Grace Hsiao-Wei Lo 博士说，这些发现代表了“一种范式转变”。 “每个人都在寻找某种药物。这凸显了骨关节炎干预措施可能有所不同的重要性和可能性，包括好的日常运动。”研究表明，运动可以帮助控制其他关节的骨关节炎，她补充说，比如臀部、手和脚的关节。

Osteoarthritis, sometimes referred to as “wear and tear” arthritis, affects over 32.5 million adults in the U.S. and occurs when the joint cartilage breaks down and the underlying bone begins to change, according to the Centers for Disease Control and Prevention. The risk of developing the condition increases as you age, and around a third of people over 60 have knee osteoarthritis, Dr. Lo said. Many patients take medications like ibuprofen or naproxen to treat the pain, she added, which in large doses can lead to kidney issues and ulcers.

根据美国疾病控制和预防中心的数据，骨关节炎，有时也被称为“磨损性”关节炎，影响超过 3250 万美国成年人。骨关节炎发生在关节软骨分解并且下面的骨骼开始发生变化时。 Lo 博士说，随着年龄的增长，患这种疾病的风险会增加，大约 1/3 的 60 岁以上的人患有膝骨关节炎。她补充说，许多患者服用布洛芬或萘普生（ibuprofen or naproxen）等药物来治疗疼痛，大剂量服用会导致肾脏问题和溃疡。

Instead, they may be able to turn to exercise. For decades, health experts saw walking primarily as a way to boost cardiovascular health, said Dr. Elaine Husni, a rheumatologist at Cleveland Clinic who was not involved in the study. In recent years, though, doctors have looked to low-impact workouts to treat conditions like depression, cognitive impairment and mild osteoarthritis. But the new study shows that walking can also act as a preventive measure, Dr. Lo said, and suggests that people who are at higher risk of developing the condition may want to incorporate a regular walk into their routine. For instance, Dr. Lo herself said that, based on her findings, she should walk more, as her mother has osteoarthritis.

这些病人也许可以通过锻炼减轻病痛。没有参与这项研究的克利夫兰诊所的风湿病学家伊莱恩胡斯尼博士说，几十年来，健康专家主要将步行视为促进心血管健康的一种方式。然而，近年来，医生们一直在寻求低影响的锻炼来治疗抑郁症、认知障碍和轻度骨关节炎等疾病。Lo 博士说这项新的研究表明，步行也可以作为一种预防措施，并建议那些有较高患病风险的人将定期步行纳入他们的日常生活中。Lo 博士说，例如，根据她的发现，她应该多走路，因为她的母亲患有骨关节炎。

The study began in 2004 and documented participants’ baseline knee pain, using radiographs to assess their osteoarthritis. Researchers then asked participants to document their exercise habits and reviewed their symptoms at regular follow-up visits, asking how frequently their knees hurt.

该研究始于 2004 年，记录了参与者的基线（当时的）膝关节疼痛，使用 X 光片评估他们的骨关节炎。然后，研究人员要求参与者记录他们的运动习惯，并在定期随访时回顾他们的症状，询问他们膝盖受伤的频率。

After four years, 37 percent of the study participants who did not walk for exercise (not including the occasional trip to the train or grocery store) developed new, frequent knee pain, compared with 26 percent who did walk.

四年后，37% 的不步行锻炼（不包括偶尔走去地铁站或杂货店）的研究参与者出现了新的、频繁的膝关节疼痛。而步行的研究参与者这一比例为 26%。

Of course, researchers cannot definitively say that walking staved off knee pain, and it did not appear to lessen existing pain. Self assessments can be less accurate than fitness trackers or step counters. And the researchers did not track the distance or frequency that people walked, nor did they recommend strategies for how and when people with osteoarthritis should incorporate walking into their exercise routines.

当然，研究人员不能肯定地说步行可以避免膝盖疼痛，而且它似乎并没有减轻现有的疼痛。自我评估可能不如健身追踪器或计步器准确。研究人员没有追踪人们步行的距离或频率，也没有推荐骨关节炎患者如何以及何时将步行纳入日常锻炼的策略。

Still, the results bolster what clinicians already understand about how to manage osteoarthritis. Consistent movement can help create muscle mass, strengthening ligaments around the joints that have osteoarthritis, Dr. Husni said. Walking is a low-intensity, low-impact workout, allowing people to maintain the strength and flexibility that are critical for healthy joints, she added.

尽管如此，这些结果还是支持了临床医生已经了解如何管理骨关节炎的知识。 Husni 博士说，持续的运动可以帮助产生肌肉，加强患有骨关节炎的关节周围的韧带。她补充说，步行是一种低强度、低冲击的锻炼方式，可以让人们保持对健康关节至关重要的力量和柔韧性。

“It’s an intervention that anyone can do,” she said. “You have no excuse. You can do it anywhere you are.”

“这是任何人都可以做到的，”她说。 “你没有借口。你可以在任何地方走路。”

Those who are already in pain should be careful to not overdo exercise, though, said Dr. Justen Elbayar, a sports medicine specialist in the orthopedic surgery department at NYU Langone Health who was also not involved in the study. Walking long distances might exacerbate aches in some patients with severe arthritis, he said — but for those with smaller amounts of arthritis, “it’s one of the best exercises you can do.”

不过，纽约大学朗格尼健康中心骨科运动医学专家贾斯滕·埃尔巴亚尔博士（他没有参与这项研究）说，那些已经处于疼痛状态的人应该注意不要过度运动。他说，长距离步行可能会加剧一些患有严重关节炎的患者的疼痛——但对于那些患有较轻关节炎的人来说，“这是你能做的最好的运动之一。”

He recommends that people start with a small, short walk, gradually building up distance over time. The goal of the exercise is to provide muscular support to an arthritic knee, he said, and to let the joints, tendons and tissues become acclimated to the walking.

他建议人们从短步行开始，随着时间的推移逐渐增加距离。他说，这项运动的目的是为患有关节炎的膝盖提供肌肉支撑，并让关节、肌腱和组织适应步行。

He also suggested using supportive shoes, drinking plenty of water during a walk and taking frequent rests if tired or new to it. After a long walk, icing the knee may also help relieve discomfort, he added.

他还建议穿合适的鞋，散步时多喝水，如果累了或刚开始走路（锻炼身体），要经常休息。他补充说，在长途步行后，用冰袋敷膝盖也可能有助于缓解不适。

While a stroll down the street can’t repair cartilage or remedy existing pain, the exercise offers a compelling and accessible option for staving off the more intrusive aspects of osteoarthritis, Dr. Lo said. After all, she added, “walking doesn’t cost a cent.”

Lo 博士说，虽然在街上漫步不能修复软骨或缓解现有的疼痛，但这项运动提供了一种引人注目且易于使用的选择，可以避免骨关节炎更具侵入性的方面。她补充说，毕竟“走路不花一分钱。”【注：好像不对。一寸光阴一寸金。呵呵。】