Physical therapy outperforms glucocorticoid Injection for Osteoarthritis of the knee

Anthony Crespo
Anthony Crespo Executive Assistant at AHS

Here at Allied Health Solutions we strive to offer the best service to our patients. Our hope is to find the best methods of recovery for you without the use of drugs or surgeries. Just recently we stumbled upon a study published in the New England Journal of Medicine. The study discussed the difference in effectiveness of both physical therapy and glucocorticoid injections on individuals who suffer from osteoarthritis of the knee joint.  

What is Osteoarthritis?

Osteoarthritis is the most common form of arthritis, affecting millions of people worldwide(2.). This form of arthritis is also referred to as a “wear and tear” disease which occurs when the protective cartilage that cushions the ends of your bones begin to wear down over time. The most commonly affected joints are the ones in the hands, knees, hips and spine. Symptoms that arise from osteoarthritis can usually be managed by staying active, maintaining a healthy weight and addressing nutritional deficiencies(2.) In some cases the disease may progress to a point where constant treatment protocols are necessary to maintain overall quality of life. 

The study

Both physical therapy and intra articular injections of glucocorticoids have been shown to produce clinical benefits with respect to osteoarthritis of the knee. The study conducted aimed to see which one was more beneficial. A randomized trial took place in the primary care setting within the U.S. Military health System. 156 patients with a mean age of 56 years were enrolled.  Patients presented osteoarthritis in one or both knees and were assigned in a 1:1 ratio to receive either glucocorticoid injections or to undergo physical therapy. The primary outcome measure was the total score on the Western Ontario and McMaster Universities Osteoarthritis index (WOMAC). Scores range from 0 – 240, with higher scores indicating greater sensations of pain and stiffness.  The secondary outcome measurements were the time needed to complete the alternate step test, the time needed to complete the timed up and go test, and the score on the global rating of change scale, all of which were assessed at 1 year.

The results 

The mean (±SD) baseline WOMAC scores were 108.8±47.1 in the glucocorticoid injection group and 107.1±42.4 in the physical therapy group. At 1 year, the mean scores were 55.8±53.8 and 37.0±30.7, respectively (mean between-group difference, 18.8 points; 95% confidence interval, 5.0 to 32.6), a finding favoring physical therapy. It was concluded that patients with osteoarthritis of the knee who underwent physical therapy had less pain and functional disability at 1 year than patients who were given intra articular glucocorticoid injections(1.) So before you consider the needle see if physical therapy is right for you

References

  1. Deyle GD;Allen CS;Allison SC;Gill NW;Hando BR;Petersen EJ;Dusenberry DI;Rhon DI;. (n.d.). Physical Therapy versus Glucocorticoid Injection for Osteoarthritis of the Knee. Retrieved September 28, 2020, from https://pubmed.ncbi.nlm.nih.gov/32268027/
  2. Osteoarthritis. (2020, February 22). Retrieved September 28, 2020, from https://www.mayoclinic.org/diseases-conditions/osteoarthritis/symptoms-causes/syc-20351925
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