T’ai Chi for Osteoarathritis: An Introduction for Primary Care Physicians

Osteoarthritis represents a major cause of disability in the older population because of its predilection for the large, weight-bearing joints, such as the hip and knee. It is a chronic, potentially progressive disorder that significantly limits mobility and activities of daily living. Multiple treatment options are avialable, ranging from conservative to operative and from economical to expensive.

One conservative, economical intervention that has proven popular with older patients is the Chinese art of tai chi ch’uan. For the aged population, t’ai chi can serve as a low-impact form of exercise for the entire body. It can improve range of motion, flexibility, strength, and balance.

Because most Western physicians lack training in traditional Chinese medicine, the purpose of this article is to provide a basic introduction to t’ai chi ch’uan. We explain its potential benefits as a therapeutic modality and its use as one element in the overall treatment of the patient with osteoarthritis.

Goals of therapy For the patient with osteoarthritis, the goals of rehabilitation and activity modification are to prevent further disability and dysfunction and to lessen the severity of pain and degree of limitation. . . .

What is t’ai Chi? . . . T’ai chi resembles a slow-moving dance routine. The continuous, softly-flowing movements . . . are done in a relaxed state, and deep [diaphragmatic] breathing is continued throughout the routine. . . . t’ai chi movements do satisfy the basic rules of rehabilitation for the patient with osteoarthritis. They are easy to learn, require the use of the major joints of the body, and serve as a low-impact, low-risk activity that increases range of motion, strength, coordination, and balance. . . .

Conclusion Practicing t’ai chi may help those suffering with osteoarthritis by strengthening the joint musculature and increasing range of motion and flexibility. Preliminary studies have demonstrated the effectiveness of t’ai chi in increasing balance and reducing the risk of falls in the older population. Practiced along or with a partner, t’ai chi may also reduce stress and promote physical and mental wellness.

The authors do not suggest that t’ai chi can cure cartilage and bone deterioration, but as a physical therapy it may serve as an adjunct to standard medical treatment. Beginning low-impact, weight-bearing exercises early in the course of osteoarthritis can lessen the severity of joint pain and dysfunction and the secondary deleterious effects on strength and balance.

About the Authors: Dr. Lumsden is a fourth-year resident, department of orthopedic surgery, and Dr. Matire is an attending physician, department of diagnostic imaging and nuclear medicine at the Union Memorial Hospital, Baltimore. Mr. Baccala is research assistant, department of biology, Loyala College, Baltimore.