The researchers compared 12 non -drug approaches, from the knee to hydrotherapy, including the supervised exercise. Result: the most effective care is not necessarily those that we imagine.
When knee osteoarthritis steals mobility
Gonarthrosis is one of the most widespread and invalidant chronic diseases. It causes pain, stiffness and loss of mobility, to the point of transforming each daily movement into an ordeal. Anti-inflammatory drugs and infiltration are often used, but their side effects are pushing researchers and clinicians to explore safer alternatives.
A team brought together 139 clinical trials, involving nearly 10,000 patients, to compare 12 non -drug therapies: low intensity laser, high intensity laser – Hilt, tens electrostimulation, interferential current, short wave diathermia, ultrasound, soles, knee, exercise, hydrotherapy, kinesio -taping and shock waves.
Simple care more effective than use of high-technology
The results published in Plos One Are striking: the knees, hydrotherapy and supervised exercise largely lead the ranking. The use of ultrasound or certain high-tech therapies is much less convincing.
- Using the WOMAC score, the symptomatic severity index of the lower limb osteoarthritis, the kneee obtains the best probability according to the success (18.7 %), the exercise follows (22.8 %) and the Hilt (25.3 %), while the ultrasound is at the end of the ranking (82.6 %).
- For the function score, the kneee comes first (0.1 %) then hydrotherapy (12 %) and exercise (32.6 %). Hydrotherapy has the highest probability (4.1 %) followed by the exercise (25.1 %).
- For going into operation, the kneery is still classified first (9.4 %). These percentages and rankings come from the detailed success table of the study.
One of the authors explains without detour: “Knee orthotics, hydrotherapy and exercise are the most effective non -drug therapies for knee osteoarthritis. They reduce pain and improve mobility without gastrointestinal or cardiovascular risks linked to current painkillers. Patients and clinicians should favor these options based on evidence“.
Another researcher adds: “Our analysis of nearly 10,000 patients reveals that simple and accessible therapies such as knee orthosis and exercises in aquatic environment surpass technological options such as ultrasonotherapy. This could reshape clinical directives in order to favor safer and less expensive interventions “.
The future of care: favor the useful to the invasive
The authors insist on the variability of study designs, the often modest size of tests and the diversity of treatment durations, which can limit the accuracy of rankings and calls for additional research, in particular on the effectiveness of techniques associations and their cost-effectiveness nevertheless, they call for a pragmatic reorientation: give priority to what works today, hydrotherapy and supervised exercise paths – these solutions being both accessible and at a lower risk compared to systematic drugs. These conclusions are against the subject of a tendency to bet on expensive technological solutions. For researchers, the emergency is clear: orient medical recommendations to accessible, safe and already proven care.
Concretely, this means strengthening access to supervised exercise programs, offering more hydrotherapy sessions and providing suitable kneepers. In patients’ lives, these choices can alleviate pain and restore autonomy without drug risk.
Research also underlines the importance of acting on other levers, such as weight loss, which can reduce the load on joints and permanently improve everyday life: a loss of 5 to 10 % of body weight has a moderate effect on pain and is among the recommended measures in parallel with physical therapies. For the record, the prolonged use of anti-inflammatory drugs must be discussed on a case-by-case basis due to the documented gastrointestinal and cardiovascular risks.
Experts recall that these approaches are not spectacular, but they really change the lives of the people concerned.