A pain in the knee

by | Exercise and Fitness, Pain

Persistent knee pain, often experienced by people with knee osteoarthritis, is a major contributor to disability and can cause loss of function and impaired quality of life.

Exercise and physical therapy are known to improve pain symptoms in people with knee osteoarthritis (see this month’s Tai Chi story).

Pain-Coping Skills Training (PCST) is another intervention recommended to treat pain from knee osteoarthritis and involves cognitive behavioural principles targeting low self-efficacy, poor pain coping and pain catastrophising.

For many, particularly people living in rural and remote areas, accessing specialists to prescribe and supervise these treatments can be difficult. The internet could play a role in removing this barrier, facilitating wider spread access to these services.

Researchers evaluated the effectiveness of an internet-delivered intervention combining physiotherapy home exercises with automated PCST on pain and physical function in people with chronic knee pain.

Participants were aged 50 years and over, experienced consistent knee pain and had mild to moderate physical dysfunction. They were allocated to either the intervention or control group. People in the intervention groups received three internet-delivered treatments.

The first was educational content with exercise and pain management strategies. The second was an interactive PCST program with learning modules and tasks to practice pain-coping skills.

Finally, participants were provided with seven Skype sessions with a physiotherapist over a 12 week period and given a home-exercise program to be performed three times per week. The control group received access to educational material only.

The intervention group reported greater improvements in both pain and physical function at three and nine months’ time.


Internet delivered interventions could provide substantial benefit to people with chronic knee pain, particularly those with barriers to access including financial hardship or geographic remoteness.

Pain and limited physical function can impede on a person’s quality of life and ability to live independently. It’s important to consider ways to facilitate easy and effective access to good quality solutions.

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