Reduce the Pain of Knee Osteoarthritis with Tai Chi

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By John M. de Castro, Ph.D.


“tai chi provides benefit by improving muscle strength and coordination, which leads to better joint stability. In addition, the mind-body aspects and breath control promote mental calmness, which may help to break the cycle of arthritis pain.” – Harvard Health


Osteoarthritis is a chronic degenerative joint disease that is the most common form of arthritis. It produces pain, swelling, and stiffness of the joints. It is the leading cause of disability in the U.S., with about 43% of arthritis sufferers limited in mobility and about a third having limitations that affect their ability to perform their work. In the U.S., osteoarthritis affects 14% of adults over 25 years of age and 34% of those over 65.


Knee osteoarthritis effects 5% of adults over 25 years of age and 12% of those over 65. It involves the whole joint, including articular cartilage, meniscus, ligament, and peri-articular muscle. It is painful and disabling. Its causes are varied including, hereditary, injury including sports injuries, repetitive stress injuries, infection, or from being overweight.  There are no cures for knee osteoarthritis. Treatments are primarily symptomatic, including weight loss, exercise, braces, pain relievers and anti-inflammatory drugs, corticosteroids, arthroscopic knee surgery, or even knee replacement.


Gentle movements of the joints with exercise appears to be helpful in the treatment of knee osteoarthritis. This suggests that alternative and complementary practices that involve gentle knee movements may be useful in for treatment. Indeed, yoga practice has been shown to be effective in treating arthritis and mind-body practices in general have been shown to reduce the gene expressions that underlie the inflammatory response which contribute to arthritis. Tai Chi would seem on the surface to be perfect treatment as it involves slow gentle movement of the limbs and mindfulness and has been shown to be beneficial for a wide range of conditions. Indeed, it has been shown to reduce the physical symptoms of knee osteoarthritis. So, it would seem reasonable to look further into the effectiveness of Tai Chi, in treating knee osteoarthritis.


In today’s Research News article “A Supplemental Report to a Randomized Cluster Trial of a 20-Week Sun-Style Tai Chi for Osteoarthritic Knee Pain in Elders with Cognitive Impairment.” See:

or see summary below or view the full text of the study at:

Tsai and colleagues performed a multicenter randomized controlled trial of the effectiveness of Tai Chi for the treatment of the pain from knee osteoarthritis. They recruited elderly (aged 60 and over) patients with knee osteoarthritis who also had cognitive impairment and randomly assigned them to either practice Tai Chi for 3 40-minute sessions per week for 20 weeks or a control condition that received attention control education on an identical schedule. Before and after training and four times during training the patients were measured for pain, pain behaviors, and analgesic intake.


They found over training Tai Chi practice produced a significant reduction in pain and analgesic intake that increased in magnitude over time. There was also a significant reduction in pain behaviors. The effects were not affected by the degree of cognitive impairment. Unfortunately, there was no follow-up evaluation to determine if the effects last beyond the times of active practice. They also did not have another exercise for comparison. So, it can’t be determined if the gentle exercise or the mindfulness properties of Tai Chi were effective.


These are interesting results that extend the findings that Tai Chi is an effective treatment for the pain of knee osteoarthritis. They also demonstrated that Tai Chi was effective regardless of cognitive impairment. Since, the ancient gentle practice of Tai Chi is completely safe, can be used with the elderly and sickly, and is inexpensive to administer, it would appear to be an excellent treatment for knee osteoarthritis sufferers.


So, reduce the pain of knee osteoarthritis with tai chi.


“Tai chi helps patients preserve and improve function by increasing strength, flexibility and coordination while avoiding aggravation of arthritic pain and inflammation. Tai chi is a particularly appealing form of exercise, as it is very low impact and emphasizes balance, coordination and strength. Tai chi is safe and has been shown to reduce falls in the elderly.” – Matthew Hepinstall



CMCS – Center for Mindfulness and Contemplative Studies


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Study Summary

Tsai, P.-F., Chang, J. Y., Beck, C., Kuo, Y.-F., Keefe, F. J., & Rosengren, K. (2015). A Supplemental Report to a Randomized Cluster Trial of a 20-Week Sun-Style Tai Chi for Osteoarthritic Knee Pain in Elders with Cognitive Impairment. Complementary Therapies in Medicine, 23(4), 570–576.



Objective: This was a secondary data analysis of a cluster-randomized clinical trial that tested the efficacy of a 20-week Sun-style Tai Chi (TC) program in reducing pain in community-dwelling elders with cognitive impairment and knee osteoarthritis (OA). The study also examined whether elders’ level of cognitive function was related to the outcomes of the TC program.

Method: Elders (N=55) were recruited from 8 study sites. Each site was randomly assigned to participate in either a 20-week TC or an education program. Verbal report of pain was measured by a Verbal Descriptor Scale (VDS) at Weeks 1, 5, 9, 13, 17 and 21 (designated as Times 1-6). Pain behaviors and analgesic intake were also recorded at Times 1-6.

Results: At post-test, scores on the VDS and observed pain behaviors were significantly better in the TC group than in the control group (p=.008-.048). The beneficial effects of TC were not associated with cognitive ability.

Conclusion: These results suggest that TC can be used as an adjunct to pharmacological intervention to relieve OA pain in elders with cognitive impairment.


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