Physical activity and chronic joint pain: the how and who
Chronic joint pain consistent with osteoarthritis one of the most debilitating conditions of our time. Chronic joint pain is expected to affect more and more people due to ageing populations and escalating obesity levels. Although osteoarthritis can affect any joint, the knee and hip joints are commonly affected. Exercise is a sub-category of physical activity, and all current clinical guidelines advocate regular ongoing exercise as cornerstone in the management of osteoarthritis. Alarmingly, almost 50% of people do not experience satisfactory pain relief with exercise programs. Dissatisfaction with treatment is frustrating for patients and potentially unnecessary if health professionals understood more about how physical activity modifies pain and could personalise physical activity management plans based on individual biomarkers and preferences.
Scientists have a very poor understanding how physical activity reliefs chronic joint pain. It is likely that exercise provides long term pain relief through various pathways, and that these pathways might differ between groups of patients. We proposed a series of complementary investigations to harness the potential benefits of physical activity to relief chronic hip/knee joint pain Specifically by: 1) developing a better understanding of what genetic factors (rare variants) are associated with chronic hip/knee pain; 2) exploring if genetic variants associated with response to exercise programs (physical fitness, body composition muscle strength) might help explain why people with 'good' levels of physical activity experience unacceptable levels of hip/knee pain; 3) understanding if 'good' physical activity levels can offset detrimental effects of lifestyle factors (e.g. sleep, sedentary behaviour) on hip/knee pain severity; and 4) comprehensively evaluating what factor mediates (relative variance) the beneficial effects of 'good' physical activity on hip and knee joint pain.