“We’re All looking for solutions”: A qualitative study of the management of knee symptoms.

While the frequency of osteoarthritis (OA) increases with age, the first signs begin in the fourth or fifth decade. Not much is known about how younger adults respond to OA. This paper explores how people age 35-65 years manage knee symptoms. Six focus groups were conducted with 41 participants (mean age 50.9 years; 63% female) who self-reported a diagnosis of OA or reported knee symptoms (i.e. pain, aching or stiffness) on most days of the previous month. Purposive sampling was used, seeking variation in age and sex. The principles of constructivist grounded theory guided data collection and analysis. Data were analyzed using a constant comparative method. Participants participated in a process of proactively trying to find ways to control knee symptoms and disease progression. Their approach to management was not linear, but rather, a process that moved back and forth between searching for “solutions” and active management (ongoing use of strategies). During the process, participants consulted health care providers but frequently perceived that medical care offered limited options and guidance. Management was constructed as a “never-ending” process that required effort and personal resources.

The study found that participants were proactive in looking for ways to manage knee OA symptoms. There is a mismatch between participants’ proactive approach and the reactive approach of the health care system that has focused on late stage disease. Programs and supports within the formal and informal health care system are needed to make it possible for people to successfully manage knee symptoms across the lifespan.