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