title: Nonsurgical management of osteoarthritis, with an emphasis on nonpharmacologic measures.
abstract: Osteoarthritis is treated primarily with nonsteroidal anti-inflammatory drugs. Concern is growing, however, among physicians and patients about the gastrointestinal side effects of these agents. Nonpharmacologic measures are underused in the treatment of osteoarthritis; isometric exercise and provision of social support may be as effective as nonsteroidal anti-inflammatory drugs in reducing pain and improving mobility in patients with knee osteoarthritis. Recent data argue persuasively for a change in our strategy for treatment of patients with osteoarthritis: the treatment program should emphasize nonpharmacologic measures, with drugs used in an adjunctive role. Only when this approach is not effective should nonsteroidal anti-inflammatory drugs be prescribed, and then, in the lowest dose needed for symptomatic relief.
mesh_terms: D005081:Exercise Therapy; D006358:Hot Temperature; D006801:Humans; D007719:Knee Joint; D010003:Osteoarthritis / Q000453:epidemiology / Q000473:pathology / Q000523:psychology / Q000628:therapy*; D015995:Prevalence; D012307:Risk Factors; D012944:Social Support; D014481:United States / Q000453:epidemiology