Guideline for the management of knee and hip osteoarthritis

Recommendations

Manual therapy, weight management and heat/cold therapy

Non-pharmacological interventions

Manual therapy, weight management and heat/cold therapy


 

Intervention: Massage therapy – Knee and/or hip

Recommendation

It may be appropriate to offer a short course of massage therapy for some people with knee and/or hip osteoarthritis (OA). This should be considered only as an adjunctive treatment to enable engagement with active management strategies, and only for  short term, cognisant of issues related to cost and access.

Strength of recommendation

Conditional for recommendation

Quality of evidence

Low

Intervention: Manual therapy (stretching, soft tissue and/or joint mobilisation and/ or manipulation) – Knee and/or hip

Recommendation

It may be appropriate to offer a short course of manual therapy (stretching, soft tissue and/or joint mobilisation and/ or manipulation) for some people with knee and/or hip OA. This should be considered only as an adjunctive treatment to enable engagement with active management strategies and only for short term, cognisant of issues related to cost and access.

Strength of recommendation

Conditional for recommendation

Quality of evidence

Very low

Intervention: Weight management – Knee and/or hip

Recommendation

We strongly recommend weight management for people with knee and/or hip OA. For those who are overweight (body mass index [BMI] ≥25 kg/m2) or obese (BMI ≥30 kg/m2), a minimum weight loss target of 5–7.5% of body weight is recommended. It is beneficial to achieve a greater amount of weight loss given that a relationship exists between the amount of weight loss and symptomatic benefits. Weight loss should be combined with exercise for greater benefits. For people of healthy body weight, education about the importance of maintaining healthy body weight is essential.

Strength of recommendation

Strong for recommendation
(weight management)

Conditional for recommendation
(combination weight management plus exercise)

Quality of evidence

Very low

Intervention: Heat therapy – Knee and/ or hip

Recommendation

It may be appropriate to offer local heat therapy (eg hot packs) as a self-management home strategy for some people with knee and/or hip OA. This should be considered only as an adjunctive treatment.

Strength of recommendation

Conditional for recommendation

Quality of evidence

Very low

Intervention: Cold therapy – Knee and/or hip

Recommendation

We suggest not offering local cold application  (eg ice packs) for people with knee and/or hip OA.

Strength of recommendation

Conditional against recommendation

Quality of evidence

Very low

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