The importance of nonpharmacologic approaches in management of osteoarthritis1

  • Kenneth D. Brandt
    Requests for reprints should be addressed to Kenneth D. Brandt, MD, Rheumatology Division, Indiana University School of Medicine, 541 Clinical Drive, Room 492, Indianapolis, Indiana 46223
    Indiana University Multipurpose Arthritis and Musculoskeletal Diseases Center, Rheumatology Division, Indiana University School of Medicine, Indianapolis, Indiana, USA
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      Treatment of the patient with osteoarthritis should be comprehensive, with nonpharmacologic approaches considered as primary therapy, and analgesics and nonsteroidal anti-inflammatory drugs (NSAIDs) assigned to an adjunctive role. These nonmedicinal approaches can include joint protection strategies; the use of thermal modalities (heat and cold) and transcutaneous electrical nerve stimulation (TENS); the development of exercise programs (that focus not only on the localized impairment, but on the functional limitations and disability secondary to inactivity); weight loss programs; the use of patellar tapping, wedged insoles, tidal irrigation (of the knee); and the introduction of coping skills and social support.
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