In adults with osteoarthritis of the knee, is conservative management more effective than intra-articular corticosteroid injections in relieving pain?

CLINICAL QUESTION: In adults with osteoarthritis of the knee, do conservative management methods such as weight reduction, physical therapy, Tai Chi, non-steroidal anti-inflammatory drugs (NSAIDs), and others provide more and longer pain relief and functionality of the knee, as well as overall well-being, when compared to corticosteroid knee injections? ANSWER: Yes. Although there are limited head-to-head trials directly comparing each alternative method to corticosteroid injections, overall evidence appears to indicate conservative methods as being more effective than injections, especially when considering long-term pain relief and functionality.