Nonsurgical management of osteoarthritis, with an emphasis on nonpharmacologic measures
K. D. Brandt
Department of Medicine, Indiana University School of Medicine, Indianapolis, USA.
Osteoarthritis is treated primarily with nonsteroidal anti-inflammatory
drugs. Concern is growing, however, among physicians and patients about the
gastrointestinal side effects of these agents. Nonpharmacologic measures
are underused in the treatment of osteoarthritis; isometric exercise and
provision of social support may be as effective as nonsteroidal
anti-inflammatory drugs in reducing pain and improving mobility in patients
with knee osteoarthritis. Recent data argue persuasively for a change in
our strategy for treatment of patients with osteoarthritis: the treatment
program should emphasize nonpharmacologic measures, with drugs used in an
adjunctive role. Only when this approach is not effective should
nonsteroidal anti-inflammatory drugs be prescribed, and then, in the lowest
dose needed for symptomatic relief.
