Physical Therapy Underused in the Management of Knee Osteoarthritis 

It has been recently reported that physical therapy is underused in the treatment of knee osteoarthritis (OA) in the military. This report was based upon military data on 130,000 men and women. Instead, people in the military who were diagnosed with knee OA were much more likely to receive an injection rather than being referred to a physical therapist.

This is just one of many examples of health care that is out of step with clinical guidelines, and therefore out of step with best practice. Research evidence supports conservative (physical therapy) treatment as a first step in the management of knee OA.

Of all problems of the musculoskeletal system, OA is the most common, and the knee is the joint most susceptible to OA. Traditional medical approaches to treating knee OA include medication (Non-steroidal Anti-inflammatory Drugs), injections, and surgery. The focus on early treatment is pain control. Yet, OA is a condition that represents mechanical breakdown of joints. This in turn is usually due to the inability of joint structures to offset loading forces on the joint over time. Common loading forces include walking, climbing, carrying, and running.

This is where the physical therapist comes in. Physical therapy intervention for knee OA is designed to protect the joint while also improving the integrity of joint structures. Physical therapists are experts at assessing pain and have many tools to help control pain. Medications will also help to control pain, and can be used in conjunction with physical therapy. However, no pill will strengthen the muscles and other tissues that protect the knee joint. This is why it is so important for people with knee OA to see the physical therapist first.

If you have symptoms of knee OA, consider seeing your physical therapist. Physical therapy moves beyond pain control, and will help to address the underlying problems that cause OA in the first place. 

Marcia Spoto PT, DC, OCS