Alternative Medicine Review 2011 (Sep); 16 (3): 228Ė238 ~ FULL TEXT
Marcus Sanders, BS and Oliver Grundmann, PhD
College of Pharmacy, University of Florida, PO Box 100485, Gainesville, FL 32610
Osteoarthritis is one of the most common chronic in!ammatory conditions seen in the general population. Current pharmacological treatments focus on reduction of pain and increased mobility to improve overall quality of life. However, the relief afforded by current standard care is often insuficient and can be associated with significant side effects. Many patients, therefore, seek the option of non-standard therapies, such as nutritional and herbal supplements, acupuncture, and exercise regimens. Glucosamine, Harpagophytum procumbens, and acupuncture are among the most commonly used complementary and alternative medicine approaches utilized by patients suffering from osteoarthritis. Their clinical relevance, safety, and potential mechanisms of action are discussed in this review.
From the FULL TEXT Article
OARSI Non-pharmacological Treatment Recommendations
All patients with hip and knee OA should
be given information access and education
about treatment objectives and the
importance of changes in lifestyle, exercise,
pacing of activities, weight reduction, and
other measures to unload the damaged
joint(s). The initial focus should be on selfhelp
and patient-driven treatments rather
than on passive therapies delivered by health
professionals. Subsequently emphasis should
be placed on encouraging adherence to the
regimen of non-pharmacological therapy.
The clinical status of patients with hip or
knee OA can be improved if patients are
contacted regularly by phone.
Patients with symptomatic hip and knee
OA may bene"t from referral to a physical
therapist for evaluation and instruction in
appropriate exercises to reduce pain and
improve functional capacity. This evaluation
may result in provision of assistive devices
such as canes and walkers, as appropriate.
Patients with hip and knee OA should
be encouraged to undertake continuous
regular aerobic, muscle strengthening, and
range of motion exercises. For patients with
symptomatic hip OA, exercises in water can
Overweight patients with hip and knee OA
should be encouraged to lose weight and
maintain the weight loss.
Walking aids can reduce pain in patients with
hip and knee OA. Patients should be given
instruction in the optimal use of a cane or
crutch in the contralateral hand. Frames or
wheeled walkers are often preferable for
those with bilateral disease.
In patients with knee OA and mild/moderate
varus or valgus instability, a knee brace can
reduce pain, improve stability, and diminish
the risk of falling.
Every patient with hip or knee OA should
receive advice concerning appropriate
footwear. In patients with knee OA, insoles
can reduce pain and improve ambulation.
Lateral wedged insoles can be of
symptomatic bene"t for some patients with
medial tibio-femoral compartment OA.
Some thermal modalities may be effective
for relieving symptoms in hip and knee OA.
Transcutaneous electrical nerve stimulation
(TENS) can help with short-term pain control
in some patients with hip or knee OA.
Acupuncture may be of symptomatic benefit
in patients with knee OA.