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Exercise and Manual Therapy May Lower Pain in People with Osteoarthritis

Exercise and Manual TherapyAccording to a new study, regular physical exercise, manual therapy or both can help people with hip or knee osteoarthritis (OA) to improve pain, stiffness and physical function. The research findings were presented at the Annual Meeting of the American College of Rheumatology in Boston.

Osteoarthritis is a chronic joint disease that generally affects middle-age and older adults. The condition causes progressive damage to the joint cartilage, bringing about changes in the joint structure such as fluid accumulation, bone overgrowth and loosening and weakness of muscles and tendons. These conditions may impair movement and result in chronic joint pain and swelling.

The primary aim of the study was to determine whether a comprehensive program involving both exercise and manual therapy would provide additional benefits over and above conventional medical treatment. The researchers analyzed more than 206 osteoarthritis patients over a period of two years in order to measure the effect adding physical therapy exercise and manual therapy or a combination of both treatment modalities to standard care as compared to continuing the usual medical care for OA alone.

The participants were put through a series of physical performance tests such as 40-meter fast-paced walk, timed up-and-go and a 30-second sit-to-stand. Their progress was measured using the Western Ontario and McMaster (WOMAC) OA index. Lower WOMAC scores show improvement in pain, stiffness and physical function. The mean age of the OA patients in the study was 66 years with a mean WOMAC score of 100.8 at baseline. The findings of the research can be summarized as follows:

  • After 2 years, it was found that the participants who underwent physical exercise and manual therapy or a combination of both reported better WOMAC scores than those who had only the usual medical care for OA.
  • Participants who received exercise in addition to their usual care showed improvements of 31.7 WOMAC points when compared to usual care alone. On the other hand, participants who underwent manual therapy along with medical care displayed a relative improvement of 30.1 WOMAC points.
  • The difference in WOMAC improvement for participants who received exercise and manual therapy (along with usual medical care) did not meet the 28 point a priori threshold for clinical significance, but this group showed 26.2 WOMAC point improvement more than the group that got only usual care.
  • It was found that patients in the exercise group showed higher mean changes on most of the physical performance tests than those in the other groups.

This study reveals the important role that exercise and manual therapy play in managing hip and knee pain.

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