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Physical Therapy No Better Than Sham Treatment for Hip Osteoarthritis — Physician’s First Watch

Medical News |
May 21, 2014

Physical Therapy No Better Than Sham Treatment for Hip Osteoarthritis

By Amy Orciari Herman

Physical therapy is no better than sham treatment for improving pain or function in patients with hip osteoarthritis, a JAMA study finds.

Some 100 adults with painful hip osteoarthritis were randomized to an active or sham treatment. Active treatment included 10 sessions of manual therapy, home exercises, and education over 12 weeks, followed by home exercises for 24 weeks. Sham treatment involved 10 sessions of inactive ultrasound and inert gel applied to the hip by a therapist over 12 weeks, followed by self-application of the gel for 24 weeks.

Pain and function, measured at weeks 13 and 36, improved in both groups but did not differ significantly between the groups. Significantly more active-treatment than sham-treatment patients reported mild adverse events (41% vs. 14%).

Dr. Thomas Schwenk, deputy editor of NEJM Journal Watch General Medicine, comments: "These results are disappointing to those of us who recommend nonpharmacologic and nonsurgical approaches to patients with hip osteoarthritis; however these results might simply reflect a program that was not sufficiently intense and came too late in the progression of disease."

Reader Comments (3)

tirupati reddy mbbs dch Physician, Pediatrics/Adolescent Medicine, anantapur ap india

In my experience based opinion, physiotherapy ,yoga pranayama have a certain role .Any studies to refute?Dont forget that the therapy need to be guided and supervised.

A. Lamb Sobh ABD Other, Other, UIUC

I find this typical of many articles; the wrong questions are being asked. For example, the modality of physical therapy in the US usually means a trip to the PT who gives them 'exercises' 'designed' to 'strengthen' muscles. What is missing from this conversation is why PTs in the US (unlike in Europe, Australia, etc. who are years ahead of us) do not do body work. Where is the pain coming from? Why? Why do they not include some kind of deep tissue work? Instead, we would rather go with hip replacements.

Morris L . Orocofsky M.D. Physician, Internal Medicine, Community Clinic

Reading the abstract, there was an improvement in the treated group in balance at thirteen weeks which would translate into help in not falling and fracturing your hip, and you have delayed surgery 9 mos. Perhaps the visual analog is not an effective objective measure of pain..

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