Osteoarthritis is a common chronic joint condition that affects roughly 10% of adults in the United States. Because it’s associated with obesity and advancing age, the condition is becoming more and more common. Two of the most common parts of the body affected by osteoarthritis include the hips and knees, which can cause considerable disability and dramatically affect one’s quality of life. Doctors of chiropractic use a variety of treatment approaches to manage musculoskeletal disorders, which includes supervised exercises and manual therapies. Is there a way to know which approach might be most beneficial for the hip or knee osteoarthritis patient?
In a study published in 2013, researchers sought to answer this question by recruiting 206 older adults who were under physician care and on a waitlist for surgery to address hip or knee osteoarthritis. The participants were separated into four groups: 1) manual therapy plus usual care; 2) supervised exercise plus usual care; 3) manual therapy plus supervised exercise and usual care; 4) usual care only. To track results, the researchers used the evidenced-based Western Ontario and McMaster Osteoarthritis Index (WOMAC) questionnaire, administering it at the start of the study, during the 16-week treatment phase (which included nine treatment sessions), at the conclusion of care, and one year later. Participants also underwent physical performance tests to track functional improvement.
The WOMAC uses a 0 (no disability) to 241 point (full disability) scale, of which all participants averaged a 100.8 score, indicating 42% disability. While WOMAC scores crept slightly upward in the usual care only group, the participants in the three treatment groups experienced improvement with disability falling to an average of 12%, 7%, and 6% disability in groups 1, 2, and 3, respectively.
The authors conclude that supervised exercises and manual therapies are superior to no treatment for patients with knee or hip osteoarthritis. Doctors of chiropractic often use a multimodal approach that includes both exercises and manual therapies for the management of musculoskeletal conditions, including osteoarthritis. Because each patient’s case is unique and they may respond differently to care, a chiropractor will monitor the patient’s progress and if necessary, modify their treatment approach for the purpose of reducing pain and disability to the greatest extent possible.