Nonpharmacologic management of osteoarthritis

Several nonpharmacologic interventions for osteoarthritis are in different stages of development, investigation, and application. Such interventions capitalize on current knowledge of the causes of symptoms, disease progression, and disability in patients with osteoarthritis. Many nonpharmacologic interventions are low in cost and incorporate self-management approaches or home-based activities and, as such, may ultimately have substantial public health impact. Recent studies and reviews of exercise, weight loss, education, inserts, footwear, bracing, therapeutic ultrasound, acupuncture, and pulsed electromagnetic field therapy will be highlighted in this review. For many of these interventions, further investigation will be necessary to define their place in the management of osteoarthritis. (C) 2002 Lippincott Williams Wilkins, Inc.