Medical therapy for OA should begin with full-strength acetaminophen and topical therapy, then proceed to nonsteroidal anti-inflammatory drugs and selectively to tramadol and other opioids. Ineffective treatments for OA include vitamin D and antioxidant supplements, shoes specifically designed for persons with OA, lateral wedge insoles for medial knee OA, physical therapy for hip OA, ionized wrist bracelets, and hyaluronic acid injections. Radiography can confirm the diagnosis of OA and may be helpful before surgical referral, but findings tend not to correlate well with symptoms.Įxercise, physical therapy, knee taping, and tai chi are beneficial for knee OA. SORT: KEY RECOMMENDATIONS FOR PRACTICE Clinical recommendation This article provides a brief summary and review of the best available patient-oriented evidence for OA. Osteoarthritis (OA) is a condition commonly encountered in primary care. Vitamin D supplements, shoes specifically designed for persons with OA, antioxidant supplements, physical therapy for hip OA, ionized wrist bracelets, lateral wedge insoles for medial knee OA, and hyaluronic acid injections are not effective. Corticosteroid injections may be helpful in the short term. Joint replacement may be considered for patients with moderate to severe pain and radiographically confirmed OA. Medical therapy provides modest benefits in pain reduction and functional improvement however, nonsteroidal anti-inflammatory drugs, tramadol, and other opioids have significant potential harms. Exercise, physical therapy, knee taping, and tai chi are beneficial for knee OA. Radiography can confirm the diagnosis and may be helpful before surgical referral, but findings generally do not correlate well with symptoms. Patients older than 50 years who have joint pain, minimal morning stiffness, and functional impairment likely have OA. Osteoarthritis (OA) should be suspected in patients with pain in the fingers, shoulders, hips, knees, or ankles, especially if they are older than 40 years.
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