Review article

https://doi.org/10.33004/reumatizam-67-2-9

Evidence-based non-pharmacological treatment of osteoarthritis

Ivan Vlak ; Institute of Physical Medicine, Rehabilitation and Rheumatology, Clinical Hospital Center Split, Split, Croatia
Tonko Valak ; Department of Rehabilitation and Physical Medicine, School of Medicine, University of Split, Split, Croatia

Abstract

Osteoarthritis (OA ) is the most common rheumatic joint disease, but also a disease that affects the entire joint and all structures surrounding the joint (periarticular structures). Literature dealing with this topic most commonly includes results related to the treatment of knee osteoarthritis (OA ), while other localisations of degenerative changes of the joints are not researched in such a detailed way. In addition to that, these degenerative changes exhibit less evidence strength, so the same will be used in this review. According to the latest 2019 ESCEO guidelines for the treatment of OA , non-pharmacological treatment (NPT) has an important role in OA treatment and it is a part of all OA treatment algorithms, and it has to be a part of evidence-based medicine (EBM). With technological progress in rehabilitation medicine, new solutions have appeared, as well as new forms of NPT aimed at helping patients, relieving pain, increasing the patients’ functional ability and improving their quality of life. Due to this, in this literature review, which was accessed through the Cochrane library, PEDro database and PubMed search, we mostly found discussions about new technologies in OA treatment. During that search, we can easily conclude that results of many systematic reviews and meta-analyses about the use of conventional methods of physical therapy did not change much compared to the methods used 10 years ago. When it comes to all of these methods, medical exercise is considered to be the most effective one, with the highest evidence strength. Nowadays, as opposed to literature sources in the past, in most literature we are able to find a significantly more accurate and precise definition of the term “physical activity”. It is defined as an activity performed
during an individual’s stay at their workplace, during transport, while doing one’s chores or housework, and during leisure time. We believe that the newest, modern technologies in rehabilitation medicine, such as the following ones: high-intensity laser therapy (HILT ), extracorporeal shock wave therapy (ESWT), radio frequency (RF) and electromagnetic therapy super inductive system (SIS ), present the biggest challenge in the NPT of OA today. These treatment methods, according to the available EBM data, have shown outstanding efficiency in the treatment of OA by reducing the patients’ pain, improving patients’ functional ability as well as their quality of life, with minimal adverse effects. Today, the general opinion is that we should give advantage to modern technologies in combination with already well- known and defined medical exercises with implementing preventive activitie

Keywords

Osteoarthritis, knee – rehabilitation, therapy; Exercise therapy; Physical therapy modalities; Laser therapy; Extracorporeal shockwave therapy; Radiofrequency therapy; Pulsed electromagnetic field therapy; Pain; Treatment outcome; Evidence-based medicine

Hrčak ID:

262174

URI

https://hrcak.srce.hr/262174

Publication date:

14.9.2021.

Article data in other languages: croatian

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