Study 1: What do patients with joint pain understand
by ‘Wear and tear’?
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Health care professionals have mixed views about the usefulness of the
concept of ‘wear and tear’ to explain OA to patients. Some see an advantage
of this explanation is to demedicalise mild cases of OA. Others claim it leads to
patients adopting an attitude that nothing can be done to improve joint pain
and stiffness.
27 people aged 56 to 87 with joint pain and stiffness, were interviewed at
baseline and followed up monthly for one year.
Findings
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Seeing their joint problem as a natural part of growing older helped
respondents to carry on life as normal.
Holding such a view did not cause respondents to avoid physical activity
in order to protect their joints from further wear and tear. Indeed some
increased activity to keep mobile.
Fulfilling everyday roles and tasks was important for staying well, and
respondents were prepared to cope with a degree of pain to achieve this.
The study found that perceiving joint pain and stiffness to be a
result of their bodies ageing helped respondents to feel well and
did not cause them to reduce physical activity. GPs should not be
concerned to make a positive diagnosis of OA.
Study 2: Self Care for Knee Pain
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Both NICE and the Musculoskeletal Services Framework promote supported
self-management as key to reducing pain and worsening symptoms as well as
reducing long-term secondary care utilisation.
Knee pain sufferers do not always engage with recommended self-
management strategies or consult with their GP.
22 adults who had not seen their GP about their knee problem in the last 12
months were interviewed and 10 also completed diaries.
Findings:
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People often adopt self-discovered self-management strategies for knee pain
(such as changing footwear or keeping mobile). Self-management was often
grounded in daily activities and maintaining a sense of routine and normality.
Some respondents exhibited uncertainty on knowing what to do beyond
current activities, what strategies are safe to try and whether to consult a GP.
Others positioned primary care as having a limited role in supporting self-
management.
Older adults with knee pain have mixed views on whether support
for self-management is required. The study indicates that there may
be missed opportunities for self-management advice.
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