Non pharmacological knee osteoarthritis treatment
Prof Deniz EVCIKa
a Department of Physical Therapy and Rehabilitation
Osteoarthritis (OA) is a chronic disorder which mostly results with functional impairment and disability. The goal of the treatment program is to decrease pain and disability and to increase functional capacity and quality of life. One of the main part of the treatment is nonpharmacological treatment modalities. These are such as weight loss, educational programs in modifying lifestyle and joint protective techniques, assistive devices, physical therapy (superficial and deep heat-cold applications, electrotherapeutic modalities, neuromuscular electrical stimulation), exercise and balneotherapy.
Exercise therapy includes both aerobic exercise and strengthening programs. Choosing an appropriate exercise program depends on the patient’s clinical evaluation and need. Although quadriceps muscle group is the primary stabilizer of knee joint, hamstring group exercises should also be recommended for a full performance. Progressive resistive exercise programs are found to have beneficial effects in pain and mobility. There are large evidence trials on the positive effects in the symptoms of OA of home-based exercise programs. Most of the studies reported the effectiveness of land-based exercises in knee OA patients. However aquatic exercises are another alternative for knee OA patients as it is safe,enjoyable and has no side effects.
One of the widely used treatment option is balneotherapy and spa therapy. It was found to be effective on pain relief, functional capacity and quality of life parameters. Thermal action and chemical minerals play a significant role in its beneficial effect, however there is not an accepted clear concept about its mechanism. There is growing level of evidence about balneotherapy and spa therapy in the management of knee OA and it seems to take part in some of the treatment recommendations.
1. Evcik D et al. Effectiveness of a home-based exercise therapy and walking program on osteoarthritis of the knee. Rheumatol Int. 2002 ;22:103-6.
4. Evcik D et al. The efficacy of balneotherapy and mud-pack therapy in patients with knee osteoarthritis. Joint Bone Spine. 2007 ;74:60-5.
Keywords : osteoarthritis, guidelines, non pharmacological treatment, exercise