Knee Osteoarthritis: Physical Therapy vs Steroid Injection for Pain Relief

MedicalResearch.com Interview with:
Dr. Gail Deyle, PT, DSc, DPT, OCS, FAAOMPT
Professor with Baylor University Graduate School 

Dr. Gail Deyle, PT, DSc, DPT, OCS, FAAOMPT
Professor with Baylor University Graduate School

Study authors in addition to Gail Deyle are Chris Allen, Stephen Allison, Norman Gill, Benjamin
Hando, Evan Petersen, Douglas Dusenberry, and Daniel Rhon

Summary:

Physical therapy is superior to glucocorticoid (steroid) injections for stiff and aching knees says Dr Gail Deyle, a physical therapist specializing in orthopaedics and manual physical therapy. A study recently published in the New England Journal of Medicine directly compared physical therapy with glucocorticoid injections to determine which was better primarily at one year but also in the short term.

The research was a collaborative effort of providers from physical therapy, orthopaedics, and
rheumatology at two Army Medical Centers. Dr Deyle, who is a professor with Baylor University Graduate School, and the senior author of the study, states, our results leave no doubt that physical therapy should be strongly considered for patients with knee osteoarthritis. They will clearly benefit from a physical therapist’s hands-on treatment and decision making for exercise and activity selection.

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Knee Pain Relief by Emoblization of Joint Synovial Tissue

PainRelief.com Interview with:

Ari J. Isaacson MD
Director of Clinical Research
Clinical Associate Professor, Vascular Interventional Radiology
University of North Carolina

PainRelief.com:  What is the background for this study?

Response: The current treatments for pain due to osteoarthritis of the knee that does not respond to medication or physical therapy  include knee injections and knee replacement. However, some people are too young or unable to undergo knee replacement. Knee injections are often ineffective and need to repeated every few months. There is a need for a treatment option that can reliably relieve knee pain for a year or longer in patients who are not ready or able to undergo knee replacement.

Chronic Back and Knee Pain Relief: How Do Sham Procedures Compare to Surgery?

MedicalResearch.com Interview with:

Wayne B Jonas MD

Wayne B Jonas MD

H&S Ventures
Samueli Integrative Health Programs

MedicalResearch.com:  What is the background for this study?

Response: The findings of this study are based on a systematic review of 25 randomized clinical trials evaluating surgical type interventions (open surgeries, arthroscopic, endoscopic, laparoscopic, heart catheterization, radiofrequency, laser, and other interventions) for chronic back and knee pain. In each study, researchers had also performed sham procedures on a control group where they replicated the invasive procedure by omitting the step believed to be therapeutically necessary. The purpose of this it to determine how much of the effects are due to the placebo response.

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Low Carbohydrate Diet May Reduce Pain from Knee Osteoarthritis

PainRelief.com Interview with:
Robert E. Sorge, PhD | Associate Professor
College of Arts and Sciences
Department of Psychology
Director | PAIN Collective
UAB | The University of Alabama at Birmingham

PainRelief.com: What is the background for this study? What are the main findings?

Response: Our work in animals has shown that a poor-quality diet (high in refined carbohydrates) leads to widespread inflammation, activated immune cells and prolongs recovery from an injury. We have also shown that diet can reverse these effects. Therefore, we wanted to see whether we could reduce pain in people with knee osteroarthritis just by changing their diet.

We know that carbohydrates can lead to inflammation and oxidative stress, so we wanted to know whether reducing them would reduce pain or whether pain could be reduced by just losing weight – the knee is a weight-bearing joint, after all. We found that weight loss did not predict pain relief, but that the participants following a low-carb diet showed reduced daily pain, reported less pain interference in daily activities and had less pain when we evoked pain in their knees. The reduction in evoked pain was related to changes in oxidative stress.

Ours is a small study, but we believe that it is important to let people know that a change of diet can have a significant impact on their daily pain. Diets are modifiable and have no negative side effects – something not true of most pain-relieving medications.

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