| Osteoarthritis (OA) of the knee is one of the most | | | | manual acupuncture, static magnets, and ultrasound |
| common maladies seen in a rheumatology office. | | | | therapies, and minimal improvement with pulsed |
| The standard forms of treatment include | | | | electromagnetic fields. |
| non-steroidal anti-inflammatory drugs (NSAIDS), | | | | In contrast, there was significant clinical improvement |
| topical analgesics (eg., "rubs"), injections of | | | | following treatment with TENS, EA, and LLLT. The |
| glucocorticoids ("cortisone"), injections of | | | | improvements were about the same for all three |
| viscosupplements (lubricants), and bracing. | | | | treatments. |
| Arthroscopic treatment - going into the joint with a | | | | From the data, the pain relieving effects of TENS |
| small telescope and cleaning out the knee- is | | | | was still present at 2-4 weeks following treatment |
| occasionally helpful. For advanced cases, surgery with | | | | and that of EA was retained for 8 weeks after the |
| joint replacement is needed. | | | | end of treatment. LLLT also appeared to give slight |
| However, there are other approaches that have | | | | pain relief up to 8 weeks after treatment was |
| been used that are non-invasive and can provide | | | | discontinued. |
| short term relief. These are termed "physical | | | | The authors noted that while the sample sizes were |
| modalities". These physical measures such as electrical | | | | small, the results seen with these physical modalities |
| stimulation, electroacupuncture, and low level laser | | | | compared favorably with results seen with drug |
| ("cold laser") therapies have been reported to be | | | | treatment for knee osteoarthritis. |
| helpful as an adjunctive approach to pain relief for | | | | Also, electrical stimulation and low-level laser therapy |
| patients with OA of the knee. | | | | had potentially fewer and less severe side-effects |
| Recent evidence has surfaced supporting the role of | | | | than that associated with NSAID therapy. |
| physical modalities. A recent study (Bjordal M, et al | | | | In addition, the beneficial effects of the physical |
| BMC Musculoskeletal Disorders 2007; 8) reviewed a | | | | modalities seemed to last longer after discontinuation |
| total of 33 randomized, placebo-controlled studies | | | | which is also different than that occurring with |
| where OA of the knee was treated using different | | | | NSAID, where the beneficial effects wear off once |
| modalities. | | | | the drug is discontinued. |
| Treatments used in these studies included | | | | The bottom line is that physical modalities offer |
| transcutaneous electrical nerve stimulation (TENS), a | | | | another potential option for patients suffering from |
| low level type of electrical stimulation, | | | | the pain of OA of the knees. It is important to |
| electroacupuncture (EA), where electrical impulses are | | | | remember that many patients with OA of the knees |
| delivered at specific points near and around the joint, | | | | may have co-morbid conditions- other medical |
| low level laser therapy (LLLT) - also know as "cold | | | | problems- that may prohibit them from receiving oral |
| laser", pulsed electromagnetic fields, manual | | | | medicines for their osteoarthritis. Physical modalities |
| acupuncture, static magnets, and ultrasound. | | | | may provide a solution to pain relief. |
| There was no clinically significant improvement after | | | | |