KNEE braces, water therapy and exercise are the most beneficial non-drug therapies for knee osteoarthritis (KOA), according to a new meta-analysis of more than 100 clinical trials.
Researchers examined the current evidence on non-drug therapies for treating KOA.
They looked at data from 139 clinical trials involving nearly 10,000 people to compare 12 different non-drug treatments.
These included laser therapy, electrical stimulation, braces, insoles, kinesiology tape, water-based therapy, exercise and ultrasound.
Knee braces came out on top across most categories, including reducing pain, improving function and relieving stiffness.
Hydrotherapy - exercises or treatments performed in warm water - was found to be effective at easing pain, while general exercise was also consistently effective, improving both pain and physical function.
High-intensity laser therapy and shock wave therapy showed some benefits, while ultrasound consistently scored the lowest in effectiveness.
They concluded that physical therapy has promising effects on KOA, offering potential treatments that reduce pain and improve mobility without the gastrointestinal or cardiovascular risks linked to common pain medications.
"Our analysis of nearly 10,000 patients reveals that simple, accessible therapies like knee bracing and water-based exercise outperform high-tech options like ultrasound," wrote the authors.
"Patients and clinicians should prioritise these evidence-based options," they added.
The authors noted that due to methodological differences, small sample sizes, and variability in treatment duration among the 139 included studies, the precision of the rankings may be reduced.
Future studies should examine the clinical efficacy of combined therapies, as well as their cost-effectiveness, they said.
"This could reshape clinical guidelines to focus on safer, lower-cost interventions."
Read the paper HERE.
MEANWHILE, a study from Monash University has found that diabetes drug metformin can reduce the pain of people with KOA and overweight or obesity, possibly delaying the need for knee replacements.
The study included 107 participants with pain from KOA, but without diabetes, who took up to 2,000mg of metformin or a placebo for six months.
Knee pain was measured on a 0-100 scale, with 100 being the worst pain.
The metformin group reported a 31.3 point reduction in pain after six months, compared to 18.9 for the placebo group, which was considered a "moderate" effect.
"These results support use of metformin for treatment of symptomatic knee osteoarthritis in people with overweight or obesity," the researchers concluded.
Study lead Professor Flavia Cicuttini said metformin now provided GPs with a safe and low-cost alternative they could offer patients, in addition to managing weight and increasing activity.
The full paper is HERE. KB
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