My name is Julia Shannon, and I recently completed my Bachelor of Science in Human Kinetics at the University of Guelph. This past winter semester, I had the privilege of completing an internship at Motion Plus Physiotherapy. As part of my intern role, I performed an in-depth review of the scientific literature studying how exercise impacts strength and cognition. Below is a brief summary of my findings from this research process.
Have you ever woken up with a “twinge” in your back? Ever moved the wrong way and felt your back tighten up? Well, you are not alone. Low back pain is a common experience that occurs at least once in 70% of the population’s lifetime (McIntosh and Hall, 2009). Episodes of low back pain can be described as intense pain, muscle tension and stiffness around the area. In certain cases, symptoms can include pain down one leg.
Bed rest may appear to be the best solution with acute low back pain, but according to research staying active can be more beneficial. A systematic review by McIntosh and Hall (2009) found that compared to bed rest, staying active was more effective in reducing pain and improving function in 3-12 weeks. The authors also noted that increased bed rest can result in increased negative effects such as joint stiffness and loss of muscle strength. The use of anti-inflammatories (NSAIDs), muscle relaxants, advice to stay active and exercise all resulted in better outcomes than rest alone. It is important to note, however, the potential adverse effects which can occur, such as gastro-intestinal problems from NSAIDs and drowsiness, dizziness and nausea from muscle relaxants (McIntosh and Hall, 2009).
So, what kind of activity should you do if you wake up with low back pain or move the wrong way? It depends on the person as everyone will present in various ways and have different limitations. Your Physiotherapist can assess your situation, educate you on how to best stay active and prescribe specific low back exercises that can allow you to reach your goals.
Have you ever experienced knee joint noises that make you wonder if your tissues are rubbing or grinding against each other while going up or down the stairs, squatting or kneeling? Have you wondered what that means or if it is damaging? This noise or feeling is called crepitus which can be caused by nitrogen gas bubbles popping, tendons sliding over bony structures or one bone rubbing on another. Generally, crepitus is not painful and does not necessarily mean that you have arthritis.
A paper by de Oliveira Silva et al., (2018) studied 126 women aged 18-35 years. Some had patellar (kneecap) pain (n=65) and some had no pain (n=51). The study found that 50% of those with patellar pain had crepitus while 33% with no knee pain also had crepitus. Pazzinatto et al., (2019) looked at 584 men and women aged 45-78 years with knee arthritis and crepitus (n=361) and with knee arthritis without crepitus (n=233). Their aim was to assess if crepitus negatively affected people’s perception of their knee health and overall function. They concluded people with both knee pain and crepitus reported higher levels of pain and lower quality of life but functionally performed equally to those with no crepitus. In a separate study, Pazzinatto et al., (2019) studied 4566 participants aged 45-79 years who presented with arthritis with and without crepitus. At the 3 year follow up, the authors found those with arthritis and crepitus were at no greater risk for a total knee replacement than those with arthritis alone.
What does all this mean?
We can conclude that the crepitus in your knee can be a normal phenomenon regardless of age, does not indicate the severity of knee arthritis and may be present without pain. If you have crepitus in your knee with no pain, you can continue to be active regardless of the presence of arthritis. We know keeping active is one of the best ways to maintain a healthy knee. If you have pain in your knee(s) with or without crepitus, it would be a good idea to seek out a Physiotherapist to help reduce your pain and maximize your function.
The articles mentioned above can be found using the following links: