FAQ: Managing Osteoarthritis During COVID-19 Outbreak

Dr. Sharon Kolansinki, OA expert and Professor of Clinical Medicine, Penn Musculoskeletal Center at the University of Pennsylvania answers some common questions and concerns about reducing infection risk and managing osteoarthritis (OA) symptoms during the novel coronavirus pandemic.

Question: Do my OA pain meds or other meds I take for another condition put me at greater risk of getting COVID-19?

When the pandemic began, there was concern that nonsteroidal anti-inflammatory drugs (NSAIDs) might increase the risk of infection with COVID-19 or cause severe illness.  However, the World Health Organization, the American College of Rheumatology and experts in epidemiology and NSAID pharmacology all report that there is no evidence that taking NSAIDs increases your risk.  Patients taking nonsteroidal anti-inflammatory drugs for osteoarthritis should continue to take them as prescribed by their care providers.

Question: I’m afraid to go to doctor’s appointment to manage my OA? What should I do?

Doctor’s offices and health care facilities are very familiar with infection control procedures to minimize the spread of viruses.  Many offices and medical centers have put even more procedures than usual in place to reduce the risk of spreading SARS-CO-v-2, the virus that causes COVID-19.  Some of these measures include mandatary masks for staff and patients, having hand sanitizer readily available, spacing out appointments to minimize the number of patients in the office at the same time, temperature checks and using social distancing guidelines in waiting areas.  You should call your doctor’s office to find out the measures they have put in place to protect patients and staff.

Question: Telemedicine is great for some things, but I need hands on for physical therapy (PT) and massage appointments.  Should I go?

During the stay-at-home orders, a lot of physical therapy was offered remotely.  However, this approach does have limitations for both the patient (in properly learning exercises) and in the ability of the therapist to assess how well the patient is doing.  Some PT locations are opening up to in person visits but there are limitations.  First, find out about your state’s guidance for health facilities as they reopen. Some restrictions include limiting the number of patients that can be seen at one time and other infections control procedures (extra cleaning and disinfecting of equipment) are likely to be in place, like your doctor’s office.  Call ahead and talk with the staff about precautions in place.  Being familiar with the procedures ahead of time can make you feel a lot more comfortable in the office.  You can also ask if you can alternate between telehealth and in person visits.

Services like massage therapy that may be given outside a medical center in a nonmedical setting may not have the same level of infection control procedures as doctor’s offices and medical centers.  Like with PT service providers, call ahead and discuss what is being done to protect clients beforehand.

Question: I’m at home more so I’m gaining weight because I don’t feel like exercising. How can I get motivated?

Exercise is a very important part of the treatment plan for most osteoarthritis patients, so it is important to keep regularly exercising.  It has become very challenging to get adequate exercise during the pandemic for a few reasons.  Gyms, YMCAs and pools may still be closed. The stress and worry so many of us have been experiencing have led to low spirits and less physical activity.  In addition, many of us have had more time for cooking and paying attention to food and so we may be gaining weight from diet changes as well as less exercise.

It is easier to get back on track with your exercise program if you set reasonable goals.  Consider devoting time each day to exercise.  Taking a short exercise break each day will make it less daunting than thinking about recreating your entire gym work out.  Can you take a 15-minute walk in your neighborhood?  Regular walking outdoors has become a great new habit many have adopted in the pandemic! Can you check out a YouTube video on chair yoga? Do you have some rubber bands from past physical therapy that would help you get back into stretching?  Can you call up a friend and exercise together on Skype?  As you work exercise back into your schedule you can expand and vary what you do. It does not have to be the same every day.

Question: I’m very stressed and worried about getting COVID-19. How can I deal with my anxiety?

It is important to acknowledge and deal with the anxiety that many of us are feeling.  Anxiety can interfere with your sleep and worsen your OA pain.  A first step may be to talk about your anxiety with your primary care doctor.  Friends and family can act as sounding boards.  Various mind body techniques can be helpful.  Mindfulness meditation, visualization and relaxation therapies can help.  Many apps are available that can take you through guided meditation.  Exercise is also a great option for stress and anxiety, especially exercises like yoga that are called mind-body exercises because they have benefits for both the body and mind.  However, if you’ve tried these options and anxiety is getting in the way of carrying out your usual daily activities, it is important to get professional help.  Your primary care provider can often refer you to a psychologist, psychiatrist or other therapist that be a valuable member of your health care team.  Many mental health providers offer telehealth sessions.

Question: Since I’m elderly, should I get a COVID-19 test even though I don’t have symptoms?

A test for the COVID-19 virus is valuable for diagnosing infection in people with symptoms.  Although we know that people can carry the virus and have no symptoms, there is no particular reason to get tested just on the basis of age.

Question: I don’t have access to a gym anymore. Which at home exercises are best for OA?

The best home exercises are the ones that appeal to you enough to do!  All exercise is valuable so, the good news is, you can choose from a menu of exercises rather than just being stuck doing the same ones over and over.  Walking is an excellent, flexible, no-equipment-needed place to start.  Depending on your limitations, you could start with 5 minutes, 10 minutes, 15 minutes and so on per day.  Stretching, strengthening and balance exercises are all important and each may have a place in your routine.  Do you have some routines from the last time you did physical therapy?  You might consider incorporating some of the exercises you have already been taught. Do you have a can of soup or a water bottle that use can use as a weight for arm exercises? Many gyms, YMCAs, yoga studios and other local enterprises offer free online classes.