Themed Review: Nonpharmacologic Approaches to Osteoarthritis

Osteoarthritis is the most common form of arthritis, occurring primarily in the older population. Pain, stiffness, and disability are the major complaints of the disease, which are best treated with pharmacologic and nonpharmacologic measures. The goals of therapy are pain relief, maintenance of function, and correction of deformities whenever possible to restore lost function. Nonpharmacologic treatments enhance the role of medicinal therapy in the management of chronic osteoarthritic pain. They help to improve overall lifestyle, build self-reliance, and instill a sense of control over the pain, which in turn may improve pharmacologic compliance. Nonpharmacologic therapy improves outcomes of total joint replacement and some other types of joint surgery. Options include patient as well as caregiver education, physical medical and rehabilitation, weight reduction, sleep hygiene, surgery, and psychosocial intervention. Alternative or complementary medicine, also referred to as integrative medicine, has become quite popular among many patients. Their effectiveness is not to be ignored, but for the most part, scientific evidence is sparse or missing. Clearly, in most patients, symptomatic osteoarthritis can be improved through a comprehensive, multidisciplinary approach.