15/12/2021
Osteoarthritis is a frequent cause of joint pain and disability. A new study compared two therapeutic strategies.
Osteoarthritis of the knee is an important cause of pain and disability. In most cases the joints of our body (like the knee) are composed of two bones that come into contact. In order to protect them from stress and wear caused by movements, the surface of the two affected bones is covered with a thin layer of cartilage. It acts a real “bearing” that, in case of osteoarthritis, can reduce in thickness causing symptoms such as pain, difficulty moving and stiffness.
Treatment of symptoms
Current guidelines require that the treatment of this condition be focused on pain relief until surgery to replace the damaged joint with a prosthesis becomes necessary. The first therapy that is most commonly used is the injection of corticosteroids directly into the joint but the data on the efficacy of this treatment in terms of duration of symptom relief are mixed. In addition, complications resulting from these injections, such as infection or increased degradation of joint cartilage, though not frequent, may occasionally occur. Besides the use of corticosteroids, clinical studies have shown that physical therapy (based on exercise and joint mobilisation) can relieve pain in the short and long term, improve joint function and reduce the need for pain medications. Despite this, however, this therapeutic strategy is not always considered.
23 April 2020Osteoarthritis is a frequent cause of joint pain and disability. A new study compared two therapeutic strategies.
Osteoarthritis of the knee is an important cause of pain and disability. In most cases the joints of our body (like the knee) are composed of two bones that come into contact. In order to protect them from stress and wear caused by movements, the surface of the two affected bones is covered with a thin layer of cartilage. It acts a real “bearing” that, in case of osteoarthritis, can reduce in thickness causing symptoms such as pain, difficulty moving and stiffness.
Treatment of symptoms
Current guidelines require that the treatment of this condition be focused on pain relief until surgery to replace the damaged joint with a prosthesis becomes necessary. The first therapy that is most commonly used is the injection of corticosteroids directly into the joint but the data on the efficacy of this treatment in terms of duration of symptom relief are mixed. In addition, complications resulting from these injections, such as infection or increased degradation of joint cartilage, though not frequent, may occasionally occur. Besides the use of corticosteroids, clinical studies have shown that physical therapy (based on exercise and joint mobilisation) can relieve pain in the short and long term, improve joint function and reduce the need for pain medications. Despite this, however, this therapeutic strategy is not always considered.
A comparison and contrast of two therapeutic strategies
The New England Journal of Medicine has published an article comparing these two therapeutic strategies. A randomised clinical trial was conducted to evaluate the effectiveness of physical therapy and intraarticular injection of corticosteroids. Of the 156 patients enrolled in the study, with an average age of 56 years, 78 were assigned to the intraarticular injection group and 78 to the physical therapy group. The initial characteristics of the symptoms, such as the severity of pain, were similar in both groups. After one year, the results of this study showed a superiority of physical therapy over cortisone injections, resulting in less severe pain, better joint function and reduced joint stiffness. It should also be borne in mind that some patients reported no improvement or even worsening (in particular, eighteen in the first group and seven in the second).
Therefore, this study demonstrates a superiority in the long
A comparison and contrast of two therapeutic strategies
The New England Journal of Medicine has published an article comparing these two therapeutic strategies. A randomised clinical trial was conducted to evaluate the effectiveness of physical therapy and intraarticular injection of corticosteroids. Of the 156 patients enrolled in the study, with an average age of 56 years, 78 were assigned to the intraarticular injection group and 78 to the physical therapy group. The initial characteristics of the symptoms, such as the severity of pain, were similar in both groups. After one year, the results of this study showed a superiority of physical therapy over cortisone injections, resulting in less severe pain, better joint function and reduced joint stiffness. It should also be borne in mind that some patients reported no improvement or even worsening (in particular, eighteen in the first group and seven in the second).
Therefore, this study demonstrates a superiority in the long
