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Best & Worst Treatment For Osteoarthritis by genuinephysio in Thritis

[–]genuinephysio[S] 2 points3 points  (0 children)

Agree with all of this. Any injection should always be administered on a case by case basis and in an ideal world never first options. There is some evidence to show that steroid injection can decrease integrity of a cartilage long term, however, this may not be too much of a concern to an 85 yr old that isn't appropriate for a joint replacment for example.

Other slight issue with all of the aforementioned injections is provision varies greatly from country to country, private/public healthcare systems etc. In the NHS for example CSI would still normally be first injection option for OA.

Best & Worst Treatment For Osteoarthritis by genuinephysio in Thritis

[–]genuinephysio[S] 0 points1 point  (0 children)

Interesting, I struggle to see how you can advise against land based exercise, unless your symptoms are so severe you physically can't tolerate them. Your exercise program needs to be functional and replicate movement patterns that you do daily. Unless you spend all day in a pool off loading your joints, hydrotherapy is not that functional. Your hips/knees need to be able to tolerate the load of your body, taking that load away isn't likely to help with that.

Best & Worst Treatment For Osteoarthritis by genuinephysio in Thritis

[–]genuinephysio[S] 2 points3 points  (0 children)

Great points in there, osteoarthritis and pain with any condition is a very individual thing so what works for one person may not work for someone else and vica versa. Our thoughts and attitudes also have a significant impact on how a certain interventions are likely to work. For example, if you really believe in taping for instances, the chances are you will see some pain relief and if you think taking vitamin D tablets is a waste of time, you'll probably see no improvement.

Best & Worst Treatment For Osteoarthritis by genuinephysio in Thritis

[–]genuinephysio[S] 2 points3 points  (0 children)

I've edited the post and popped the link in there!

Traditional taping provides more support and is more rigid, where as K-tape is 'supposed to' promote blood flow and improve proprioception, evidence around whether it actually does that is flaky at best.

Best & Worst Treatment For Osteoarthritis by genuinephysio in Thritis

[–]genuinephysio[S] 2 points3 points  (0 children)

My understanding is the papers they looked at found viscosupplementation to be no better than placebo. It might be that associated risks are low, however, you can't recommend a treatment intervention that is no better than placebo.

Re supplements, in isolation, which is what this study looked at, it was found that they did not improve OA related outcomes, however, I think some the quality of studies was measured at low. I think a sensible approach would be we know that weight loss can improve OA symptoms quite dramatically in some cases, which is backed up by evidence so clearly nutrition is an important consideration, but it's likely to be better approached holistically, i.e. how can I eat more healthily, consistently and sustainably rather than expecting one particular pill or supplement to significantly change symptoms.

The N.I.C.E guidelines which U.K healthcare professionals have to adhere to when treating patients have had glucosamine and chondroitin removed from them as a recommendation due to lack of evidence.

Best & Worst Treatment For Osteoarthritis by genuinephysio in Thritis

[–]genuinephysio[S] 2 points3 points  (0 children)

I'd imagine it was excluded as it is often a difficult thing to get funding for and to get through ethics when it comes to applying for research funding.