Non pharmacology methods for osteoarthritis of hip and knee
OA is common joint disease in middle age and old age population. People with hip and knee OA were experience with pain and functional disability.Treatment goals for these patients are to minimize pain,improve functional status and improve quality of life. Exercise is core in all treatment guidelines, also nonpharmacological treatment for those with hip or knee OA. Therapeutic ultrasound, neuromuscular as well as transcutaneous electrostimulation, pulsed magnetic field therapy, low-level laser therapy (LLLT), thermal therapy (hot or coldpack), acupuncture and assistive device (canes, insole and braces). These are regarded as multimodal therapeutic program as they helped to relief pain,improved functional status and also positive effect for quality of life.
Therapeutic exercise is recommended in all treatment guidelines of hip or knee OA patients. Exercise can be performed in supervised group classes or individual treatment program with physiotherapist or unsupervised at home.Aquatic exercise reduced jointloading in knee OA. Archimedes explained that “any object, wholly or partly immersed in a fluid, is buoyed up by a force equal to the weight of the fluid displaced by the object”. Strengthening exercise combined with general strength, flexibility, and functional exercises improve OA symptoms. Removing patient’s physical and mental barrier can help the patient to adhere long-term exercise program.
Walking aid (cane,crutch or walking frame) used in the contralateral hand of patient with hip and knee OA. Frame or wheeled walkers are suitable for patient with bilateral disease. Patient should ascend stair with good leg with cane intendem while descend with affected limb and cane together. Patients who need maximum assistance with balances houlduse walkers. Braces and orthoses may reduce bone on bone weight bearing distribution. Moreover, appropriate footwears are adviced to patients with hip or knee OA. Lateral wedged insoles can relief symptoms in patients with medialtibio-femoral compartment OA.
Some thermal modalities are accessible, affordable and patient’s first line choice for pain relief. During painful episode heat can be applied in the form of warm water, heatpacks, or wax therapy. Cryotherapy is using ice packs and commonly uses in acute attack of pain and inflammation. Transcutaneous electrical nerve stimulation(TENS) are provided by physiotherapist or patient can purchase their own. It blocks pain transmission in brain.Acupuncture also has effective in knee OA.
Reference (www.bcmj.org vol52,No8,October2010 BCMEDICAL JOURNAL)