Physical treatments for osteoarthritis
Physical treatments are often used as adjunctive therapy in the management of osteoarthritis; however, apart from exercise, physical treatments have a limited role in management because of a lack of evidence, low-certainty evidence of benefit, or evidence suggesting they are not effective. However, because some patients report a benefit and these interventions are unlikely to be harmful, a trial may be reasonable based on patient preference.
In patients with knee or hip osteoarthritis, thermotherapy (application of heat or cold), or the use of a walking stick, may reduce pain and enable physical activity. In patients with patellofemoral osteoarthritis, there is limited evidence that medially directed taping of the patella may provide short-term pain relief. Taping should not be used in isolation and is most useful as an adjunct to encourage patients to start their exercise program. Long-term use of taping may be limited by local skin reactions. There is also some evidence to support the use of a patellofemoral brace for pain relief in patients with patellofemoral osteoarthritis and this may be considered as an alternative to taping.
Evidence suggests that acupuncture, transcutaneous electrical nerve stimulation (TENS), lateral heel wedge insoles, manual therapy, magnets and valgus braces are not effective in the management of osteoarthritis.
For discussion of physical treatments for hand osteoarthritis, see Osteoarthritis of the hand.