Nonmedicinal therapies for osteoarthritis.

Given the modest efficacy of medicinal therapy for OA, nonpharmacologic therapy is popular. Convincing evidence exists to support the efficacy of exercise and muscle strengthening for patients with knee OA. Weight loss is likely to be effective, as are some types of biomechanical alterations, possibly including elastic knee supports and the use of canes and crutches. The clinical management of patients with OA should sample broadly from these treatments, especially because they may offer other health benefits as well (i.e., aerobic exercise and weight loss). The optimal use of these modalities requires a team approach to patient care, in which the physician works closely with a physical therapist and nutritionist. This integrated approach may lead to decreases in pain and disability for the patient with OA.