Knee and Hip Osteoarthritis Management: A Review of Current and Emerging Non-Pharmacological Approaches

Abstract

Osteoarthritis (OA) is a leading cause of disability in the USA. Numerous clinical practice guidelines specify non-pharmacological strategies as the core management approach for OA. Although several of these strategies are efficacious, clinical practice remains primarily focused on analgesic use and invasive treatments such as joint replacements. This practice gap may be due to several factors such as a lack of accessibility or awareness of non-pharmacological interventions in clinical care, concentration on pain alone—which neglects other disability-related symptoms such as fatigue, and sleep difficulty, and placement of prevention and wellness with this lifelong disease as lower priority on the part of providers and payers. As referral patterns to rehabilitation for OA are scant, future research should focus on how to package established non-pharmacological interventions and increase accessibility at the point of care when patients are seeking services. Providers then would have the means to link patients to the plethora of community resources for OA management. Furthermore, a more holistic approach to symptom management that targets physical activity, diet, education, and behavior change is needed, with interdisciplinary healthcare professionals playing a larger role in tailoring non-pharmacologic interventions to individuals.