No Benefit of Physical Therapy for Hip Osteoarthritis

Summary and Comment |
May 22, 2014

No Benefit of Physical Therapy for Hip Osteoarthritis

  1. Thomas L. Schwenk, MD

The intervention might have been “too little, too late.”

  1. Thomas L. Schwenk, MD

Some physical therapy (PT) components (i.e., exercise and manual therapy) benefit patients with hip or knee osteoarthritis. In this study, investigators examined the value of a more typical, multimodal PT program in 102 patients (mean age, 64; mean body-mass index, 29 kg/m2) with hip osteoarthritis diagnosed by standardized criteria of pain, radiographic changes, and functional difficulty. Participants were randomized to 10 PT sessions (session duration, 30–60 minutes) during 12 weeks or a sham intervention of inactive ultrasound with an inert gel. PT sessions involved strength, balance, and range-of-motion exercises, deep tissue massage, and home exercise recommendations.

At 36 weeks, changes in pain and function were not different between the PT and sham groups. On a 100-point visual analog scale, mean pain scores dropped from 59 mm to 44 mm in the PT group and from 58 mm to 39 mm in the sham group. Improvements in physical function were roughly the same in both groups.


These results are disappointing, but they might simply reflect a program that was not sufficiently intense and came too late in the progression of disease. Also, as prior studies have shown, many of the features of a multimodal physical therapy program add no incremental value to a structured exercise and weight-loss program. Although a recent meta-analysis of 60 studies showed that exercise benefited patients with lower-limb osteoarthritis (NEJM JW Gen Med Oct 24 2013), most of those studies focused on the knee, not the hip.

Editor Disclosures at Time of Publication

  • Disclosures for Thomas L. Schwenk, MD at time of publication Editorial boards UpToDate


Reader Comments (2)

Schainker, M.D. Physician, Rheumatology, Rockville Internal Medicine Group

disappointing result. Perhaps because sham group did so well. ? efficacy of placebo effect.

Benito Minzer Physician, Family Medicine/General Practice, Hospital

Why they Don't try with RPG (global postural repositioning)?

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